[Senate Hearing 119-32]
[From the U.S. Government Publishing Office]
S. Hrg. 119-32
EXAMINING NATIVE COMMUNITIES' PRIORITIES
FOR THE 119th CONGRESS
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HEARING
BEFORE THE
COMMITTEE ON INDIAN AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINETEENTH CONGRESS
FIRST SESSION
__________
FEBRUARY 12, 2025
__________
Printed for the use of the Committee on Indian Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
U.S. GOVERNMENT PUBLISHING OFFICE
59-783 PDF WASHINGTON : 2025
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COMMITTEE ON INDIAN AFFAIRS
LISA MURKOWSKI, Alaska, Chairman
BRIAN SCHATZ, Hawaii, Vice Chairman
JOHN HOEVEN, North Dakota MARIA CANTWELL, Washington
STEVE DAINES, Montana CATHERINE CORTEZ MASTO, Nevada
MARKWAYNE MULLIN, Oklahoma TINA SMITH, Minnesota
MIKE ROUNDS, South Dakota BEN RAY LUJAN, New Mexico
JERRY MORAN, Kansas
Amber Ebarb, Majority Staff Director
Jennifer Romero, Minority Staff Director and Chief Counsel
C O N T E N T S
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Page
Hearing held on February 12, 2025................................ 1
Statement of Senator Cortez Masto................................ 45
Statement of Senator Murkowski................................... 1
Statement of Senator Schatz...................................... 2
Statement of Senator Smith....................................... 3
Witnesses
Bird, Kerry D., President, National Indian Education Association. 26
Prepared statement........................................... 28
Butler, Hon. Rodney, Chairman, Mashantucket Pequot Tribal Nation;
President, Native American Finance Officers Association (NAFOA) 20
Prepared statement........................................... 23
Lewis, Kuhio, CEO, Council for Native Hawaiian Advancement....... 32
Prepared statement........................................... 33
Macarro, Hon. Mark, President, National Congress of American
Indians........................................................ 4
Prepared statement........................................... 6
Smith, Hon. William, Alaska Area Representative; Chairman,
National Indian Health Board................................... 12
Prepared statement........................................... 14
Appendix
Crevier, Francys, CEO, National Council of Urban Indian Health
(NCUIH), prepared statement.................................... 51
Hines, Aaron, Chair, Northwest Portland Area Indian Health Board,
prepared statement............................................. 55
Malone, Julie A., Osage Nation Member and Shareholder in the
Osage Mineral Estate, letter submitted for the record.......... 57
Stverak, Jason, Chief Advocacy Officer, Defense Credit Union
Council (DCUC), letter submitted for the record................ 58
EXAMINING NATIVE COMMUNITIES' PRIORITIES FOR THE 119th CONGRESS
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WEDNESDAY, FEBRUARY 12, 2025
U.S. Senate,
Committee on Indian Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 2:30 p.m. in room
628, Dirksen Senate Office Building, Hon. Lisa Murkowski,
Chairman of the Committee, presiding.
OPENING STATEMENT OF HON. LISA MURKOWSKI,
U.S. SENATOR FROM ALASKA
The Chairman. Good afternoon. I call this oversight hearing
to order.
Today we are following a long tradition in this Committee,
and that is kicking off the new Congress with a hearing that is
focused on Native communities' priorities. This Committee is
the only committee in Congress that has the charge to serve the
interests of Native people across our Federal Government, and
we take it seriously.
The way that we live up to that charge is we listen. We
listen first. And by listening to you as Native leaders
highlight what is important to your communities and the work
that you are doing, the Committee can ensure that our work
aligns. That way, we can make progress together on the most
pressing issues.
I think this approach works. Over the last few years,
working together, we have made historic bipartisan progress on
important issues like public safety and justice, with the
passage of the Tribal Title in the VAWA 2022, as well as
numerous MMIW initiatives. We are seeing huge investments in
critical infrastructure such as sanitation and broadband
through our work on the Bipartisan Infrastructure Law.
But there is always, always more to do. The issues and the
needs are wide-ranging, which is why today we have
representatives from many different sectors, including
education, health, finance, and economic development.
So how we approach these issues may not be the same for
every Native community. We recognize that. We respect that
there are different service delivery and self-determination
models across the Country, whether you are in Alaska or whether
you are in Hawaii, New Mexico, Minnesota. We recognize that.
I want to take just a few words here this afternoon about
the new administration, because as we are making our new start
in the Congress, the administration is as well. There has been
a flurry of activity already with new OMB directives. Some of
these I know have caused concerns as tribes and Native
communities rely on Federal funding and on tribal programs that
flow from the Federal Government's trust, treaty and statutory
obligations to Native peoples. So know that we are listening.
I immediately raised your concerns to the new
administration every chance I got, including in my meetings
with the President's nominees. We sent a letter to OMB urging
them to acknowledge that tribes have a unique political status
and to clarify across the Federal Government that as the
administration carries out its initiatives, it does so in a way
that respects this unique political status and the Federal
Government's responsibility to Native people.
I think they are starting to get it, but we have to be
diligent here. There are many good Federal partners at the
agencies that understand these issues, at the Department of
Interior, with Secretary Burgum. They were the first to issue
that secretarial order. There have been others that have now
followed, so we are going to get there.
Today's hearing again will help us chart our path forward
together in this Congress. I want to thank those of you that
will be providing your comments to the Committee today. I look
forward to hearing from you, and I welcome those that have
gathered here in our Committee room.
It is not very often that I walk in and I see a line to
come into the Senate Indian Affairs hearing. So recognizing
that we are talking about priorities and seeing a full house is
just yet one more indicator of the importance of the good work
of this Committee.
I now turn to my friend and colleague, the Vice Chair, for
his opening statement.
STATEMENT OF HON. BRIAN SCHATZ,
U.S. SENATOR FROM HAWAII
Senator Schatz. Thank you, Chair Murkowski. Leaders from
across Indian Country, Hawaii, Alaska, welcome, and thank you
for joining us today.
I would also like to extend a warm aloha to Kuhio Lewis,
the CEO of the Council for Native Hawaiian Advancement, CNHA,
which is the leading voice on enhancing Native Hawaiian
cultural, economic, political, and community development
opportunities. Thank you for your leadership for Native
Hawaiians.
As the strongest voice for Native priorities in the
Congress, this Committee has a responsibility to engage with
and represent all of your interests, not just in Congress, but
across the Federal Government. We made historic bipartisan
gains over the last four years to advance Federal support for
Native communities. That work literally would not have happened
without our partnership.
That is why it is so important to continue this tradition,
making our first order of business in the 119th Congress to put
Native communities' priorities directly in the spotlight. As in
prior Congresses, today's priorities hearing is a real
opportunity to align what we do with the hard work that you are
doing on the ground, to listen and learn what is working, what
is not, and to begin to build on our bipartisan achievements,
strengthen tribal sovereignty, continue to uphold the Federal
trust and treaty responsibilities to Native communities.
So I look forward to this conversation. Thank you.
The Chairman. Thank you, Vice Chair.
I understand that Senator Smith, you would like to make an
opening statement as well.
STATEMENT OF HON. TINA SMITH,
U.S. SENATOR FROM MINNESOTA
Senator Smith. Thank you so much, Chair Murkowski and Vice
Chair Schatz.
I am going to be very brief because I am super interested
in the panel and all of your perspectives. Buzhu, aaniin to the
representatives from Minnesota's 11 sovereign tribal nations. I
am so glad to see you here.
I want to maybe just put a point on what you said, Chair
Murkowski, about helping the new administration, two things,
one that the strong tradition of bipartisanship on this
Committee I think serves us quite well. I know that everybody
who is here believes in that and understands that these issues
are not partisan issues.
Second, I want to just say I appreciated very much the work
that I know you are already doing, that we all are doing, to
make sure that this new administration does not catch up in its
funding freezes or stops initiatives that are specific to
Indian Country. Because those initiatives are about the trust
and treaty responsibilities that the Federal Government has to
Native people. It is not about any particular policy or
initiative that might be out there, particularly related to
diversity, equity and inclusion.
So I am just grateful for your perspective on that, and I
look forward to the panel.
The Chairman. Thank you, Senator Smith.
Any other opening statements?
With that, we will turn to our witnesses. Again, we have a
very esteemed panel, thank you. We will first hear from the
Honorable Mark Macarro, who is the President of the National
Congress of American Indians. NCAI has been meeting in
Wahington, D.C. this week, and I know that many of us had an
opportunity to be in front of your membership.
He will be followed by the Honorable William Smith, who is
the Chairperson and Alaska Area Representative for the National
Indian Health Board. Chief Bill, it is good to have you back
before the Committee.
Next, we have the Honorable Rodney Butler. He is the Board
President for the Native American Financial Officers
Association. Welcome, good to see you.
On the education front, we have Mr. Kerry Bird, who is the
Board President of the National Indian Education Association,
also meeting here in Washington, D.C. this week.
Then virtually, as Vice Chair Schatz has mentioned, we have
Mr. Kuhio Lewis, who is the Chief Executive Officer of the
Council for Native Hawaiian Advancement.
So you know, gentlemen, we have your full testimony as part
of our Committee record already. It will be included as part of
that. So we would encourage you to try to keep your comments to
about five minutes, so that we have more opportunities for
questions after you have given us your statements.
So we will go in the order of introduction, beginning with
President Macarro.
STATEMENT OF HON. MARK MACARRO, PRESIDENT, NATIONAL CONGRESS OF
AMERICAN INDIANS
Mr. Macarro. [Greeting in Native tongue.] Thank you, Chair
Murkowski and Vice Chair Schatz, for allowing me to testify to
this Committee on Indian Country's priorities for the 119th
Congress.
My name is Mark Macarro. I am the Tribal Chairman for the
Pechanga Band of Indians in California. But today I come before
you as the current President of the National Congress of
American Indians, founded in 1944. NCAI is the oldest, largest,
and most representative Indian and Alaska Native organization
serving the broad interests of Indian Country, Indian tribal
governments, and their communities.
Tribal nations are inherently sovereign governments with
unique legal and political status. This has been long
recognized by Congress and reaffirmed by the United States
Supreme Court. Congress and the administration must continue to
recognize tribal nations as sovereign governments and support
clear directives that reinforce the legal and political status
of tribal nations.
Federal funding programs that deliver services and
facilitate the sovereignty and self-determination of tribal
nations are created by Federal laws and policies that reinforce
the obligation of the Federal Government to fulfill its trust
and treaty obligations to support tribal nations and their
citizens and their institutions.
When Congress is acting under its unique obligation toward
tribal nations and their citizens, they have the legal status
as a political class rather than as a suspect racial class
under the principles of constitutional legal analysis. The U.S.
Supreme Court has consistently recognized and upheld the
distinct legal and political status of tribal nations and their
citizens.
The Department of Interior and Secretary Order 3416
directing its agency on implementation of administration
priorities recognized that the statutory authorities and treaty
and trust obligations of the Department, that is Interior, to
tribal nations, are legal requirements that must not be
impaired. So we ask that Congress and the administration ensure
Federal funding for tribal programs is not paused, reallocated,
reclassified, or de-prioritized when implementing any executive
order or other administration priority.
Ensure that in limiting the Federal workforce, sufficient
Federal employees are available to deliver on all the trust and
treaty obligations. Tribal nations support this
administration's efforts to alleviate burdensome regulations
and other barriers that hinder tribal self-governance and
economic development, but these efforts must be developed in
close consultation at all levels of government with tribal
nations to ensure there are no unintended consequences.
Now, to staffing levels and vacancies at IHS. Chronic
Indian health care workforce shortages have continued to plague
tribal citizens and tribal communities. Finding and keeping
qualified health care professionals in tribal hospitals,
clinics, and facilities has been challenging due to current
funding levels and location, primarily rural areas. The recent
U.S. Office, well, I will just say OPM, the recent email from
OPM to approximately 2 million Federal employees has caused
confusion and concern among many, including those who
tirelessly serve in Indian Country.
Among those Federal employees are health care professionals
within the Indian Health Service. This action has immediate
consequences for tribal citizens and tribal communities that
receive life-saving services through the IHS.
Reduction to an already short-staffed health care provider
does not honor the legal and political obligations made to
tribal nations and puts lives at risk. We thank Congress for
its recent steps to strengthen its treaty and trust obligations
through its continued support of IHS advance appropriations.
However, reducing health care professionals that serve our
citizens and communities is a step in the wrong direction.
H.R. 741, the Stronger Engagement for Indian Health Needs
Act of 2025, is a step in the right direction. We urge your
support for this legislation.
The Federal Government has a fundamental duty to ensure
public safety on tribal lands, rooted in treaty and trust
obligations to tribal nations. This obligation has been
recognized by Congress, notably in the Tribal Law and Order
Act, which underscores the Federal responsibility to prevent
crime in Indian Country. The BIA Office of Justice Services'
2021 report to Congress highlights a critical funding crisis,
revealing that public safety and justice in Indian Country is
currently funded at only 12 percent of actual need.
The funding shortfall is $3 billion. It indicates a need
for approximately 25,000 additional personnel to ensure
adequate safety and justice services in tribal communities.
The Federal standard for officers is 2.4 per 1,000 people.
Using the Oglala Sioux Tribe as an example, at .6 officers per
1,000 people and 53,000 tribal members, there is a huge
disparity. These disparities are common amongst all our
especially land-based tribes, and it cannot continue.
To address these alarming unmet needs, Congress must commit
to providing sufficient funding for public safety and justice
programs in Indian Country, ensuring safe and secure
communities for tribal citizens.
In closing, I will close with jurisdiction. The public
safety crisis in Indian Country is deeply rooted in historical
jurisdictional challenges, stemming from regulations, statutes
and Supreme Court decisions over the past 150 years. This legal
framework endangers lives by limiting the ability of tribal
nations to effectively police and prosecute criminal
activities, allowing dangerous individuals to evade justice.
Congress must address and eliminate these barriers faced by
tribal nation law enforcement and justice systems to empower
them in safeguarding their communities.
I am over time. I appreciate the consideration. My last
sentence is, we really need NAHASDA, to put the shorthand on
housing. Thank you.
[Laughter.]
[The prepared statement of Mr. Macarro follows:]
Prepared Statement of Hon. Mark Macarro, President, National Congress
of American Indians
On behalf of the National Congress of American Indians (NCAI),
thank you for holding this hearing to address tribal priorities for the
119th Congress. I am Mark Macarro, Chairman of the Pechanga Band of
Indians and President of the National Congress of American Indians
(NCAI).
In 1944, tribal leaders gathered in response to federal policies
that sought to terminate the legal trust relationship once and for all.
Our forbears organized on the principles of dialogue and consensus, and
we continue those practices today as the oldest and largest
representative organization serving the broad interests of Tribal
Nations and communities. We continue their work to preserve the treaty
and sovereign rights of Tribal Nations, advance the government-to-
government relationship, and remove structural impediments to tribal
self-determination.
NCAI is honored and grateful to testify in front of the 119th
Congress, and wishes to highlight the following policy priorities:
I. Appropriations
The promises made by the U.S. Government in treaties and agreements
with Tribal Nations are today known as part of a trust responsibility
that your forbears assumed. It is a sacred responsibility to ensure
that these promises are kept. Last month, the U.S. Government
threatened to stop payment on its promises, forgetting this
responsibility and forgetting that millions of dollars are administered
in Indian Country by Indian Country, because Tribal Nations are parties
to self-governance compacts and contracts. We ask you not to take
lightly actions that break your sacred trust, and to deliver on the
promises of protections that have been guaranteed to us in these very
halls.
We see the proposed Budget of the U.S. Government for FY 2025, and
note with appreciation that it includes requests for mandatory funding
of Indian Health Services (IHS) and Department of Interior (DOI) to
promote permanency and stability in self-governance. We likewise see
and appreciate the investments under the Bipartisan Law and the
Inflation Reduction Act, and ask that you keep in mind the benefits of
these and similar programs as we proceed with our testimony.
A. Indian Health Service-Expand and Sustain IHS Advance Appropriations
In a historic first, the FY 2023 Omnibus provided an advance
appropriation for the Indian Health Service. Enactment of Advance
Appropriations for the IHS marked a paradigm shift in the nation-to-
nation relationship between Tribal Nations and the United States. Prior
to that enactment, IHS was the only federal provider of health care
that was on the regular, annual discretionary appropriations process.
Until the entirety of the IHS budget is provided mandatory direct
appropriations, it is critical that Congress continue advance
appropriations. Advance appropriations for the IHS are consistent with
the trust and treaty obligations reaffirmed by the United States in the
Indian Health Care Improvement Act. Until all IHS spending is
mandatory, including funding for full and adequate staffing, NCAI is
supportive of the Workgroup in its request for expanding IHS advance
appropriations to every account in the IHS discretionary budget. This
includes items such as increases from year-to-year that adjust for
inflation, population growth, and the Indian Health Care Improvement
Fund. The IHS need-based funding cost estimate for FY 2026 is
approximately $60.04 billion. \1\
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\1\ Workgroup publications available at: https://www.nihb.org/
category/government-affairs/indian-health-service-ihs-budget/, accessed
on: February 10, 2025.
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Both IHS and Tribal Nations have the collaborative tools to produce
reliable advance appropriation requests and implement full year advance
appropriations. For this appropriations cycle, Tribal Nations will have
already provided official input on the FY 2027 budget to IHS. This
budget will be presented to the Department of Health and Human Services
this year.
B. Department of the Interior-Bureau of Indian Affairs (BIA)
The BIA is the primary agency responsible for providing services
throughout Indian Country, either directly or through compacts or
contracts with Tribal Nations. The robust operation of these programs
and services remain essential for the health, safety, and social and
economic well-being of Tribal Nations and surrounding communities.
Unfortunately, chronic underfunding and understaffing of tribal
programs perpetuates systemic issues such as generational poverty in
Indian Country that could be reduced or eliminated by funding tribal
programs in amounts that sincerely meet the federal government's treaty
and trust obligations to Tribal Nations.
As with IHS, spending for Indian Affairs programs should be
mandatory spending with a form of automatic annual adjustment to
account for inflation and changes in jurisdiction or eligibility as
identified by datasets mutually agreed upon by Tribal Nations and the
federal government. Additionally, inclusion of certain mandatory
account payments under discretionary spending caps, such as Contract
Support Costs and Payments for Tribal Leases, has resulted in a net
drag on the amount of funding provided for tribal programs. This fails
to fulfill treaty and trust obligations to Tribal Nations. Moving
federal spending for these obligations to mandatory spending will
better match the legal obligations of providing such funds and fix the
unintended effects that mandatory obligations through discretionary
spending can have on other discretionary spending (such as lapses in
funding via continuing resolutions). In recent years the growth of
Contract Support Costs and Payments for Tribal Leases is evidence of
how successful these programs are for Tribal Nations, but under the
current discretionary spending they must compete with the other
discretionary spending accounts within Indian Affairs.
NCAI recommends $27.1 billion for Indian Affairs programs in FY
2026, consistent with the official FY 2026 recommendation of the
Tribal/Interior Budget Council (TIBC). \2\ Within TIBC's FY 2026
recommendations are robust increases for all base-funded programs, and
additional funding to address public safety and justice in tribal
communities. Please keep in mind that such increases have a ripple
effect that also benefit the economic and social wellbeing of our
citizens and all those who visit or do business in our communities.
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\2\ TIBC Tribal Representatives' FY 2026 Budget Submission to the
Department of the Interior, April 9, 2024, accessed at: https://
cdn.sanity.io/files/raa5sn1v/production/
9c4e1e12d80bfbcd11d349b24dd86ecf1a89ee23.pdf
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C. Environmental Protection Agency (EPA)
As place-based Peoples, Tribal Nations have sacred histories and
maintain cultural practices that tie them to their current land bases
and ancestral territories. As a result, tribal Peoples directly, and
often disproportionately, suffer from the impacts of environmental
degradation.
50 years after the passage of the Clean Water Act, 52 of 84
eligible Tribal Nations have EPA-approved water quality standards, \3\
which are a cornerstone of the Clean Water Act. Given the disparate
access of tribal communities to safe, clean water, NCAI recommends a
five percent tribal set-aside for each of the National Safe Drinking
Water State Revolving Fund (DWSRF) and the National Clean Water Act
State Revolving Fund (SRF).
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\3\ Environmental Protection Agency, EPA Actions on Tribal Water
Quality Standards and Contacts, https://www.epa.gov/wqs-tech/epa-
actions-tribal-water-quality-standards-and-contacts, accessed February
10, 2025.
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Additionally, NCAI recommends $145 million be appropriated for the
EPA Tribal General Assistance Program and $30 million for the Tribal
Air Quality Management Program.
D. Reclassify Contract Support Costs and 105 (l) Tribal Leases as
Mandatory
Spending
NCAI, the National Tribal Budget Formulation Workgroup (Workgroup),
and the Tribal Interior Budget Council (TIBC) request such sums as may
be necessary to fully fund statutory and legally obligated Contract
Support Costs (CSC). We hold the position that contract support costs
should be provided through mandatory spending. This must be done as an
interim step until the full IHS and Bureau of Indian Affairs (BIA)
budgets are moved to mandatory funding. IHS and the BIA provided
estimated contract support costs for FY 2026 to the Workgroup and TIBC
at $1.07 billion for IHS and over $421 million for the BIA. Within the
IHS, approximately 60 percent of the budget is operated by Tribal
Nations under the authority of the Indian Self-Determination and
Education Assistance Act (ISDEAA).
The Act allows Tribal Nations to assume the administration of
programs, services, functions, and activities previously carried out by
the federal government. The IHS and BIA transfer operational costs for
administering programs to Tribal Nations through the ``Secretarial
amount,'' which is the amount IHS and BIA would otherwise have spent to
administer the programs. In other words, the U.S. Government has
contracted with Tribal Nations to fulfill the duties of its trust
obligation to those Nations; this is a workable system that delivers
superior services and it must be defended against cuts and funding
freezes. In addition, Tribal Nations are authorized to receive an
amount for contract support costs that meets the statutory definition
and criteria. If IHS and BIA's budgets continue to be funded through
annual discretionary appropriations, NCAI, the Workgroup, and TIBC
support that the appropriation continue in such sums as may be
necessary, due to the mandatory nature of these contract support costs
obligations.
The ISDEAA also authorizes IHS and BIA to enter a lease for a
facility upon the request of a Tribal Nation or tribal organization for
the administration or delivery of programs, services, and other
activities under the Act. Lease requests have increased rapidly as the
usage of the program authority has expanded; many of the Tribal Nations
have increasingly entered into 105(l) lease agreements as an immediate
solution to the ongoing issue of insufficient funding for maintaining,
repairing, and reconstructing facilities.
However, including accounts such as contract support costs and
105(l) leases that are mandatory in nature under discretionary spending
caps has led to a decrease in the amount of funding provided for other
tribal programs. This carries a negative impact on the federal
government's capacity to fulfill its commitments to Tribal Nations.
Tribal Nations fully support requests that all the IHS and BIA budgets
be provided as mandatory spending, but that contract support costs and
payments for 105(l) Tribal Leases be immediately reclassified as
mandatory.
The CSC & 105(l) leases within the BIA have increased from 9
percent in FY2 015 to 18 percent in the FY2025 President's Budget
Request. The BIA's 105(l) lease program received a 53 percent increase
in the FY 2024 enacted budget. In FY 2019, there were a total of 2, 105
(l) leases and by FY 2023, the number of 105(l) lease renewals and
requests increased to 562.
Given current 105(l) lease program trends in IHS and BIA, Tribal
Nations have concerns that 105(l) costs could have a detrimental impact
on overall increases for IHS and BIA, including funds for patient care
and trust services. It is with this in mind that the IHS Workgroup and
Tribal Interior Budget Council (TIBC) continues to urge that all the
IHS and Bureau of Indian Affairs budgets be classified as mandatory
spending. Furthermore, they strongly urge that contract support costs
and payments for 105(l) be immediately transitioned to mandatory
spending. These national tribal advisory groups urge this immediate
action to ensure that spending for IHS and BIA under discretionary caps
can prioritize addressing Indian Country inequities made worse by
inadequate budgets.
E. Hold Harmless for DOI--Indian Affairs, IHS and Other Programs for
the Benefit of Tribal Nations
The DOI-Indian Affairs and IHS budgets represent only a small
portion of overall Congressional spending compared to the national
budget. While spending cuts or other budget control measures, such as
discretionary spending caps, may severely affect tribal programs, they
would have minimal impact on total federal spending. If Congress
considers funding reductions in FY 2026, it is crucial that the DOI-
Indian Affairs, IHS, and other programs benefiting Tribal Nations be
protected from cuts.
II. Public Safety and Justice
A. Funding for Safer Communities
Among the essential components of the federal government's treaty
and trust responsibilities to Tribal Nations is the obligation to
protect public safety on tribal lands. Congress has long acknowledged
this obligation, which Congress reaffirmed in the Tribal Law and Order
Act (TLOA) expressly ``acknowledging the federal nexus and distinct
federal responsibility to address and prevent crime in Indian
Country.'' \4\
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\4\ Tribal Law and Order Act, 34 U.S.C. 10381(j).
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In March of 2024, the Bureau of Indian Affairs--Office of Justice
Services released its 2021 Report to the Congress on Spending,
Staffing, and Estimated Funding Costs for Public Safety and Justice
Programs in Indian Country. \5\ The report fulfills the Bureau of
Indian Affairs (BIA) reporting requirements within the Tribal Law and
Order Act of 2010 by documenting the existing and needed spending,
staffing, and estimated costs for BIA-funded Public Safety and Justice
Programs in Indian Country. The 2018 report identified that public
safety and justice in Indian Country was funded at a mere 14 percent of
need (a $2.33 billion shortfall). According to the 2021 estimates, this
has fallen further to 12 percent (a $3.06 billion shortfall). The $3.06
billion dollar shortfall equates to approximately 25,655 additional
personnel required to adequately serve Indian country.
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\5\ U.S. Dep't of the Interior, Bureau of Indian Affairs, Office of
Justice Serv., Report to the Congress on Spending, Staffing, and
Estimated Funding Costs for Public Safety and Justice Programs in
Indian Country, 2021 (Feb. 2024), https://www.bia.gov/sites/default/
files/media_document/2021_tloa_report_final_508_compliant.pdf
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This inadequate funding for tribal criminal justice and public
safety has resulted in staggering rates of violent crime and
victimization on many Indian reservations. Congress acknowledges that a
longstanding public safety crisis in America has contributed to an
ever-growing drug crisis and specifically to a public safety and law
enforcement emergency in Indian Country. \6\
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\6\ The United States Senate Committee on Indian Affairs. (2009,
June 9). Senate Indian Affairs Committee to conduct hearing on law and
order in Indian Country--Indian Affairs Committee. Indian Affairs
Committee. https://www.indian.senate.gov/newsroom/press-release/
democratic/senate-indian-affairs-committee-conduct-hearing-law-and-
order-indian-country/
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A Department of Justice (DOJ) study found that more than four in
five American Indian and Alaska Native (AI/AN) adults have experienced
some form of violence in their lifetime. \7\ Among AI/AN women, 55.5
percent have experienced physical violence by intimate partners in
their lifetime, and 56.1 percent have experienced sexual violence. \8\
NCAI appreciates Congress' enactment of the Violence Against Women Act
(VAWA) Reauthorization Act of 2022, which has helped address violent
crime in Indian Country, reinstating Tribal Nations' authority to
address crime in their communities and providing resources to make up
for lost time. Going forward, robust funding for these VAWA-related
programs and tribal police departments and justice systems is
absolutely essential to improve public safety on the ground in tribal
communities.
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\7\ U.S. Department of Justice, Violence Against American Indian
and Alaska Native Women and Men: 2010 Findings from the National
Intimate Partner and Sexual Violence Survey, 2, (2016), https://
www.ncjrs.gov/pdffiles1/nij/249736.pdf.
\8\ Ibid.
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Because BIA base funding is so inadequate, Tribal Nations often
seek short-term, competitive grants to try to make up a portion of the
shortfall. This is especially true with regard to funding for justice
systems, such as tribal courts, which are even more severely
underfunded than policing and detention. Between 2021 and 2024 the DOJ
awarded an average of $84.3 million through its Coordinated Tribal
Assistance Solicitation (CTAS) grant program to Tribal Nations. \9\
While this funding remains as a critical resource to tribal governments
it still falls dramatically short of the estimated need identified in
the 2021 OJS report to Congress stated above.
---------------------------------------------------------------------------
\9\ ``Coordinated Tribal Assistance Solicitation (CTAS) Awards,''
(October 2024), https://www.justice.gov/tribal/awards.
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In 2018, the U.S. Commission on Civil Rights (USCCR) found that
there continues to be ``systematic underfunding of tribal law
enforcement and criminal justice systems, as well as structural
barriers in the funding and operation of criminal justice systems in
Indian Country'' that undermine public safety. Tribal justice systems
must have resources so they can protect women, children, and families,
address substance abuse, rehabilitate first-time offenders, and put
serious criminals behind bars--no matter where those criminals are
from. Well-functioning criminal justice systems, basic police
protection, and services for victims are fundamental priorities of any
government andTribal Nations are no different.
B. Criminal Jurisdiction
The public safety crisis confronting Indian Country is not a result
of happenstance, but rather the outcome of a series of jurisdictional
challenges created by regulations, statutes, and the Supreme Court over
the past century and a half. Together, this legal framework puts lives
at risk because it prevents Tribal Nations from effectively policing,
arresting, trying, and sentencing bad actors and dangerous criminals.
Congress should work to remove as many barriers as possible from
Tribal Nation law enforcement officers and justice systems. Allowing
Tribal Nations to fully take the actions necessary to ensure the
public's safety is a cost-effective tactic to reduce crime in America
while respecting and strengthening tribal sovereignty.
III. Infrastructure
A. Housing
Housing infrastructure in Indian Country continues to lag behind
the rest of the United States. \10\ In what is still the most
comprehensive review of housing needs within Tribal Nations, over 70
percent of existing housing stock in tribal communities is in need of
upgrades and repairs, many of them extensive. \11\ In 2017, the U.S.
Department of Housing and Urban Development (HUD) reported that ``the
lack of housing and infrastructure in Indian Country is severe and
widespread, and far exceeds the funding currently provided to tribes.''
\12\
---------------------------------------------------------------------------
\10\ U.S. Department of Housing and Urban Development Office of
Public and Indian Housing, Native American Programs, FY25 Congressional
Justifications 13-2,(2024) https://web.archive.org/web/20240930155324/
https://www.hud.gov/sites/dfiles/CFO/documents/2025_CJ_Program_-
_Native_American_Programs.pdf, last accessed February 10, 2025.
\11\ U.S. Department of Housing and Urban Development, Fiscal Year
2017 Congressional Justifications, 11-12, (2016), https://
web.archive.org/web/20241225104440/https://www.hud.gov/sites/documents/
FY_2017_CJS_COMBINED.PDF, last accessed February 10, 2025.
\12\ Broken Promises Report, at 137, (2018), https://www.usccr.gov/
pubs/2018/12-20-Broken-Promises.pdf.
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The lack of affordable housing contributes to homelessness and
overcrowding. Tribal communities experience overcrowded homes at a rate
of 16 percent, roughly eight times the national average. \13\ HUD
research also shows that such overcrowding has a negative effect on
family health and contributes to the ongoing problems of domestic
violence and poor school performance in Indian Country. \14\ Funding
new construction across the board will help alleviate issues of
overcrowding, but Tribal Nations find that they must spend an ever
larger portion of Federal dollars (and their own matched funding) on
trying to maintain and operate existing stock instead of expanding to
meet needs. \15\ In addition to the historic funding shortfalls, the
location of many tribal communities increases the material and labor
costs of home construction and impose additional housing development
costs upon communities already confronting enormous economic
challenges. \16\ Building materials must often be brought into tribal
communities from miles away over substandard roads or even by air, and
the availability of ``qualified and affordable contractors'' is
limited. \17\ Given these extensive funding needs, it is critical that
Congress (1) support the reauthorization of NAHASDA; (2) permanently
reauthorize the Tribal HUD-VASH Program; and (3) introduce and pass
legislation that aims to increase homeownership rates in Indian
Country.
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\13\ U.S. Department of Housing and Urban Development, Housing
Needs of American Indians and Alaska Natives in Tribal Areas: A Report
From the Assessment of American Indian, Alaska Native, and Native
Hawaiian Housing Needs, (2017), https://www.huduser.gov/portal/sites/
default/files/pdf/HNAIHousingNeeds.pdf.
\14\ Department of Housing and Urban Development (HUD), Fiscal Year
2017 Congressional Justifications, 11-4, https://web.archive.org/web/
20241225104440/https://www.hud.gov/sites/documents/
FY_2017_CJS_COMBINED.PDF.
\15\ U.S. Department of Housing and Urban Development Office of
Public and Indian Housing, Native American Programs, FY25 Congressional
Justifications 13-3, (2024) https://web.archive.org/web/20240930155324/
https://www.hud.gov/sites/dfiles/CFO/documents/2025_CJ_Program_-
_Native_American_Programs.pdf, last accessed February 10, 2025.
\16\ Broken Promises Report, at 138, (2018), https://www.usccr.gov/
pubs/2018/12-20-Broken-Promises.pdf.
\17\ Ibid.
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1. Support for the reauthorization of the Native American Housing and
Self-
Determination Act of 1996 (NAHASDA).
The Native American Housing Assistance and Self-Determination Act
of 1996 (NAHASDA) is intended to help bridge the gap in housing needs
in Native communities and allow Tribal Nations to exercise self-
determination at the local level. Annual funding for the Native
American Housing Block Grant (NAHBG, also known as ``Indian Housing
Block Grants'' or IHBG)--the key source of funding under NAHASDA--has
remained flat at around $650 million since FY 2010 while housing needs
continue to grow.
NAHASDA expired on September 30, 2013. Since 2013, NAHASDA
reauthorization legislation has been introduced and has been reviewed
to some degree in each Congress leading up to the 119th Congress, but
unfortunately none of those bills were ever signed into law. NAHASDA
was created to offer flexibility in tribal housing planning, execution
of funds, and the administration of individual housing programs. Under
NAHASDA, Indian tribes and tribally designated housing entities (TDHEs)
can conduct new construction, rehabilitation, and acquire affordable
housing, as well as provide infrastructure updates and various support
services. The Indian Housing Block Grant funds can also be used for
certain types of community facilities. Since its creation, almost
41,500 affordable homes have been built or acquired and an additional
105,000 affordable homes have been restored on tribal lands and in
Alaska Native communities.
Reauthorization provides more certainty for future appropriations
and better assists TDHEs in developing successful housing options. We
strongly urge you to make your support known to other members of
Congress. We must work together to uphold tribal sovereignty and self-
determination.
NAHASDA authorizes housing programs such as the IHBG and the Indian
Community Development Block Grant, which enables Tribal Nations and
their housing authorities to design and implement their own housing,
community development, and infrastructure programs. This authorization
has resulted in the construction of tens of thousands of housing units
in Indian Country. As it rests on tribal decisionmaking, NAHASDA has
also resulted in an increase in tribal capacity to address housing and
other needs. It is most important that this Congress enact robust
increases in Native American Programs at HUD.
2. Rollback burdensome Build America, Buy America (BABA) requirements
for
tribal housing projects.
The Build America, Buy America Act (BABA) establishes a domestic
content procurement preference--the ``Buy America Preference'' (BAP)--
which mandates that products purchased for infrastructure projects
funded by federal grants must be produced in the United States. This
legislation was enacted on November 15, 2021, as part of the
Infrastructure Investment and Jobs Act. Tribal Nations and TDHE's have
voiced concerns with BAP and the implications concerning cost
increases, prolonged project timelines, and costly and onerous
compliance burdens. BABA is a bureaucratic unfunded mandate which
undoes the recent funding increases for NAHASDA programs that took a
whole generation to achieve.
HUD's updated guidance on the Build America, Buy America Act (BABA)
includes waivers and exceptions, such as the ``De Minimis'' waiver,
which allows for a portion of project costs to be exempt from BABA
requirements. Even so, many projects will still face significant cost
increases due to the need to source materials domestically, which are
more expensive and less readily available, especially in rural and
remote areas.
IV. Farm Bill
Agriculture is a major economic, employment, and nutrition sector
in Indian Country. According to the 2022 Census of Agriculture, nearly
60,000 American Indian or Alaska Native (AI/AN) producers \18\ on more
than 55 million acres for the production of crops, livestock, or both.
\19\ These farms and ranches sold over $3.8 billion of agricultural
products. Agriculture remains the second leading employer in Indian
Country and is the backbone of the economy for many Tribal Nations.
---------------------------------------------------------------------------
\18\ United States Department of Agriculture, 2022 Census of
Agriculture, Table 52 (2024), https://www.nass.usda.gov/Publications/
AgCensus/2022/Full_Report/Volume_1,_Chapter_1_US/usv1.pdf
\19\ USDA, 2022 Census of Agriculture, Table 61.
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NCAI is a founding and executive committee member of the Native
Farm Bill Coalition, along with the Intertribal Agriculture Council,
the Shakopee Mdewakanton Sioux Community, and the Indigenous Food and
Agriculture Initiative. NCAI fully supports the Native Farm Bill
Coalition, who will also be testifying, and we want to emphasize the
need for more opportunities for self-governance, co-management, funding
flexibility, and direct management and implementation of programs.
The nutrition title is of particularly high importance to Indian
Country. With 24 percent of AI/AN households receiving Supplemental
Nutrition Assistance Program (SNAP) benefits, 276 Tribal Nations
administering the Food Distribution Program on Indian Reservations
(FDPIR), 68 percent of AI/AN children qualifying for free and reduced
price lunches, and American Indians and Alaska Natives making up more
than 12 percent of the participants in the Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC), the
importance of food assistance in Indian Country cannot be overstated.
Any cuts to SNAP, FDPIR, WIC, or school lunch programs directly
diminish the food available toNative children, pregnant women, elders,
and veterans--who in some cases rely on these programs as their only
source of meals.
Additionally, food assistance programs like FDPIR must be provided
the means and support to purchase traditional, locally grown food in
their food packages. Traditional and locally grown foods from Native
American farmers, ranchers, and producers promote healthy living,
cultural sustainability, and a revival of traditional practices, all
while fostering economic development. NCAI urges Congress to promote
the expansion and permanent establishment of the Food Distribution
Program on Indian Reservations (FDPIR), grant tribal eligibility to
administer the Supplemental Nutrition Assistance Program (SNAP), and
allow the dual use of both SNAP and FDPIR. To realize many of these
priorities there needs to be an expansion of 638 authority under the
Indian Self-Determination and Education Assistance Act (ISDEAA) broadly
across the Department of Agriculture (USDA) and its programs, as well
as the reduction and elimination of match requirements.
Conclusion
NCAI appreciates the opportunity to present Indian Country's
priorities for the 119th Congress to the Committee. We look forward to
working with the Indian Affairs Committee and its members during this
Congress to advance the interests of Tribal Nations in accordance with
the federal trust responsibility.
The Chairman. Well summed up. Thank you, President Macarro.
Next, we will go to Chief William Smith, Chief Bill.
STATEMENT OF HON. WILLIAM SMITH, ALASKA AREA
REPRESENTATIVE; CHAIRMAN, NATIONAL INDIAN HEALTH BOARD
Mr. Smith. Chairwoman Murkowski, Ranking Member Schatz, and
distinguished members of this Committee, on behalf of the
National Indian Health Board and the 574-plus sovereign
federally recognized American Indian and Alaska Native Tribal
Nations we serve, thank you for the opportunity to provide
testimony on the Tribal Health Priorities for the 119th
Congress.
My name is Wiliam Smith. I am Eyak, and I am a veteran of
the United States Army. I serve as the Alaska Area
Representative and Chairman of the National Indian Health
Board. I also serve as the Chairman of the Alaska Native Health
Board and the Vice President of the Valdez Native Tribe of
Alaska.
The U.S. Constitution recognizes three sovereigns: the
Federal Government, States governments and Indian tribes. As
sovereigns, tribes predate the United States and retain the
rights of self-government. The Supreme Court has upheld Indian-
specific legislation determining that it is political in
nature, rather than based on an unconstitutional racial
classification.
Recent executive orders and guidance have unintentionally
impacted the Indian Health System. We commend the Chairwoman on
her letter to the administration urging the need to meet the
trust and treaty obligation of the Federal Government to
tribes. We concur that the Department of Health and Human
Services should issue a secretarial order that acknowledges the
political status of the tribal nations and their citizens.
Plainly stated, the Federal trust and treaty responsibility
to tribes exempts all tribal departmental programs from the
impacts of recent executive orders and guidance. Further, we
urge the Committee and Congress to continue to educate and work
with the new administration to fulfill its legal obligations to
tribal nations.
The Indian Health System continues to be dramatically
underfunded,. Providing the Indian Health Service with full and
mandatory funding will ensure the Federal Government is meeting
its trust and treaty responsibilities and obligations to the
tribal nations for health.
The Indian Health Service National Tribal Budget
Formulation Workgroup has estimated that full funding for 2026
would be $63 billion. Congress further authorized the Indian
Health System to bill Medicare and Medicaid and the Children's
Health Insurance program to address funding needs.
As Congress considers Medicare reform, it is essential that
the Federal trust responsibility for Indian health care be
honored at 100 percent FMAP for the services received through
the Indian Health Service and exempting Indian Health Service
is preserved. Exempting Indian Health Service American
beneficiaries from the reforms, including work requirements, is
consistent with the United States' trust and legal
responsibility to tribes.
Medicare reforms must be delivered and understood for its
impact to Indian Health programs, even though those changes to
not immediately appear to do so. These resources are critical
to address the needs of Indian Country, including behavioral
health. The strain on the available resources for Indian Health
System cannot meet the demand of the rising behavior and health
issues nationwide.
Using the grant as the primary vessel to deliver behavioral
health funding or any funding limits a tribe's ability to
deliver critical services and can deter patients from accessing
care and lack of access, culture, providing treatment, all
components of the behavioral health crisis in Indian Country.
We ask Congress to strengthen tribal behavioral health
treatments and programs by increasing resources, providing the
flexibility and self-governance and funding to support
expanding access to tribal traditional healing services.
Historical trauma combined with social, political and
environmental factors has impacted the health status of
American Indian and Alaska Native mothers and infants. Further,
lack of investment has resulted in a higher rate of maternal
and infant mortality.
Congress should support improving maternal and infant
outcomes for Native mothers and children to provide the funding
set aside in the Maternal and Child Health Service block
grants. Investing in a robust maternal and birth health
workforce will improve data for American Indians and Alaska
Native mothers and infants.
Many of these recommendations have been highlighted in two
recent reports. The first, the Way Forward Report by Alyce
Spotted Bear and Walter Soboleff Commission on Native Children
and the National Indian Health Board Tribal Prenatal to Three
Policy Agenda.
Congress should adopt the 2024 health care package
introduced in the 118th Congress. This package includes a
number of tribal priorities, including reauthorization of the
Special Diabetes Program for Indians for two years for $200
million per year and Medicare tribal flexibility.
Indian Health Service provides scholarships and loan
repayment opportunities incentives for the medical profession
to work in Indian Country. Any tax reform legislation
considered in the 119th Congress should make Indian Health
scholarships and loan programs tax-exempt and be a priority
with other similar programs.
Tribal sovereignty and the success of self-determination
and self-governance through the adoption of demonstration and
pilot programs. We stand ready to work with this Committee on
this endeavor.
In conclusion, the Federal Government made promises in
tribal treaties to provide for, among other things, health care
of tribal citizens. These priorities are each a step to meet
those promises and fulfill the trust and treaty responsibility.
I want to thank this Committee for the opportunity to
speak. The bottom line is, Congress has the ability to look at
the broken promises and see how every treaty was broken. And
they have an obligation to fulfill those deals, because those
like one chief said, we have already paid. We have paid and
paid and paid. We have paid with our land; we have paid with
our lives. And we paid the deals. We have given up our lands,
and the United States has promised they would take care of our
health and education. So, paid in full, that is what we are
looking for.
Thank you.
[The prepared statement of Mr. Smith follows:]
Prepared Statement of Hon. William Smith, Alaska Area Representative;
Chairman, National Indian Health Board
Chairwoman Murkowski, Ranking Member Schatz, and distinguished
members of the Committee, on behalf of the National Indian Health Board
(NIHB) and the 574+ sovereign federally recognized American Indian and
Alaska Native Tribal Nations we serve, thank you for this opportunity
to provide testimony on the Tribal Health Priorities for the 119th
Congress. My name is William Smith. I am Eyak and I am a veteran of the
United States Army. I serve as the Alaska Area Representative and
Chairman of the National Indian Health Board (NIHB). I also serve as
the Chairman of the Alaska Native Health Board and the Vice President
of the Valdez Native Tribe, of Valdez, Alaska.
Trust and Treaty Obligation
The U.S. Constitution recognizes three sovereigns: the Federal
government, States, and Indian Tribes. As sovereigns, Tribes predate
the United States, and retain rights of self-government. \1\ When the
United States was established, the Constitution's Indian Commerce
Clause granted Congress the authority to pass legislation specific to
Indian Affairs. \2\ The Supreme Court has upheld Indian-specific
legislation, determining that it is political in nature, rather than
based on an unconstitutional racial classification. \3\ Health care
reform legislation that reflects the unique federal trust
responsibility to provide health care for American Indians and Alaska
Natives is subject to rational basis review and does not violate the
equal protection clause so long as it is ``tied rationally to the
fulfillment of Congress' unique obligation toward the Indians.'' \4\
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\1\ Worcester v. State of Ga., 31 U.S. 515, 559 (1832).
\2\ U.S. CONST., art. I, 8, cl. 3; see also Morton v. Mancari,
417 U.S. 535, 552-55 (1974).
\3\ Morton, 417 U.S. at 555; see also Moe v. Confederated Salish &
Kootenai Tribes of Flathead Reservation, 425 U.S. 463, 479-80 (1976);
Washington v. Washington State Commercial Passenger Fishing Vessel
Ass'n, 443 U.S. 658, 673 n.20 (1979); United States v. Antelope, 430
U.S. 641, 645-47 (1977); Am. Fed'n of Gov't Employees, AFL-CIO v.
United States, 330 F.3d 513, 520-21 (D.C. Cir. 2003).
\4\ Morton, 417 U.S. at 555.
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Congress has the constitutional authority and responsibility to
provide for Indian health care. Tribes signed treaties and negotiated
other agreements with the United States in which they ceded vast
amounts of territory in exchange for certain solemn promises. These
promises include protecting Tribal self-government and providing for
the health and well-being of Indian peoples. \5\ Indian treaties are
the supreme law of the land, and in carrying out these treaty
obligations, the United States has ``moral obligations of the highest
responsibility and trust.'' \6\
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\5\ See United States v. Winans, 198 U.S. 371, 380-81 (1905).
\6\ Seminole Nation v. United States, 316 U.S. 286, 296-97 (1942);
see also U.S. CONST., art. VI, cl. 2; Worcester, 31 U.S. at 539.
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Congress has passed numerous Indian-specific laws to provide for
Indian health care, including establishing the Indian health care
system and passing the Indian Health Care Improvement Act (IHCIA), 25
U.S.C. 1601 et seq. In the IHCIA, for instance, Congress found that
``Federal health services to maintain and improve the health of the
Indians are consonant with and required by the Federal Government's
historical and unique legal relationship with, and resulting
responsibility to, the American Indian people.'' Id. 1601(1).
Congress has also legislated to provide Indians with access to general
health programs, such as Medicaid, while creating Indian-specific
protections within those programs that reflect this unique political
relationship.
Congress has full constitutional authority to legislate with regard
to Indian health care, and should continue to promote Tribal
sovereignty and uphold the government-to-government relationship
between the United States and Tribes in fulfillment of its trust and
legal responsibilities in any health care reform proposal it considers.
Tribal Impacts of Recent Executive Orders and Guidance
Recent Executive Orders and guidance have had inadvertent impacts
on the Indian health system. From the recent hiring freeze, deferred
resignation solicitation, and pause on federal financial assistance,
the Indian health system trying to understand how these orders and
guidance impact the system while continuing to meet the federal
government's trust and treaty obligations. For example, the Office of
Management and Budget (OMB) memorandum (M-25-13) put an immediate halt
on federal financial assistance, including grants and loans to Tribal
programs. Despite the memorandum being rescinded under OMB M-25-14, the
risk of immediate implementation of administrative policies like this
harm the operation of the Indian health system by restricting critical
resources. During the pause of federal funding, many Indian healthcare
clinics were immediately impacted, delaying and pausing services so
individuals had to be rescheduled. The halt in funding brought many
back to an era before advance appropriation, readying plans to furlough
program staff, reduce program hours, and temporarily close specific
programs. During previous periods of financial pause, staff and
providers left the Indian health system, seeking job security
exacerbating clinics which are already understaffed. The Indian health
care clinic cannot risk any harmful changes during this Administration
that negatively impact our operations and our ability to serve our
citizens.
Our workforce is also being compromised by the Executive Order
instituting a federal hiring freeze for civilian employee positions and
instructing the creation of the plan to reduce the size of the federal
workforce. This has been accompanied by a deferred resignation
solicitation which went out to federal employees in Tribal programs and
the IHS. Currently, IHS has a workforce gap of 30 percent and a 36
percent vacancy rate for physicians, that hinders our ability to
provide timely care to American Indian and Alaska Native (AI/AN)
beneficiaries. \7\ On January 31, 2025, NIHB, along with three other
national Tribal organizations, sent a letter requesting exemptions for
IHS from any plans, policies, or incentives that freeze hiring or seek
to decrease the federal workforce, including any planned federal
layoffs, attrition, or reduction quotas. While we understand that 600-
series providers may still be hired, there are conflicting reports
whether this is being honored at present. The Indian health system must
have the ability to onboard, administer, and operate its programs with
the staffing necessary to meet accreditation standards and keep
facility doors open. IHS operations need to be able to bring in staff
in behavioral health, clinical administration and oversight, community
health representatives, scheduling, and billing. The Department of
Veterans Affairs has issued a list of staff exempt from the hiring
freeze which goes beyond the 600-series of providers. The IHS needs at
least the same exemptions and more. As the United States has a
responsibility to care to AI/AN people, it also has a responsibility to
ensure clinics have their needs met \8\--this includes having the
appropriate workforce to improve the health status of AI/AN
beneficiaries.
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\7\ 25 U.S.C. 1601.
\8\ U.S. Government Accountability Office, Indian Health Service:
Agency Faces Ongoing Challenges Filling Provider Vacancies, GAO-18-580,
published August 15, 2018, available at: https://www.gao.gov/products/
gao-18-580, accessed on: January 27, 2025.
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We commend the Chairwoman for her letter of February 4, 2025 to the
Administration urging the need to continue to meet the trust and treaty
obligations of the federal government to Tribes. We concur that the
Department of Health and Human Services should issue a secretarial
order which acknowledges the political status of Tribal Nations and
their citizens, plainly states the federal trust and treaty
responsibilities to Tribes, and exempts all Tribal departmental
programs from the impacts of recent Executive Orders and guidance.
Further, we urge this Committee and Congress to continue to educate and
work with the new Administration to fulfill its legal obligations to
Tribal Nations.
The Indian Health Service Funding
AI/ANs experience worse health outcomes compared with the rest of
the U.S. population. AI/ANs continue to experience historical trauma
from damaging federal policies, including those of forced removal,
boarding schools, and taking of Tribal lands, and continuing threats to
culture, language, and access to traditional foods. These compounding
events have resulted in AI/AN populations experiencing high rates of
poverty, high unemployment rates, barriers to accessing higher
education, poor housing, lack of transportation, geographic isolation,
and lack of economic mobility which all contribute to poor health
outcomes. Historic and persistent under-funding of the Indian health
system has resulted in problems with access to care and has limited the
ability of the Indian health system to provide the full range of
medications and services that could help prevent or reduce the
complications of chronic diseases.
IHS exists to serve the health care needs of AI/ANs and to address
those disparities. Despite the efforts of IHS, the Centers for Disease
Control and Prevention (CDC) reported that the life expectancy for AI/
ANs has declined by nearly 7 years, such that the life expectancy for
our People is only 65.2 years, which is the same life expectancy of the
total U.S. population in 1944. This is 11.2 years less than the non-
Hispanic White population's life expectancy of 76.4 years. Today the
Indian health system includes 43 Indian hospitals (51 percent of which
are Tribally operated) and 650 Indian health centers, clinics, and
health stations (86 percent of which are Tribally operated). \9\ When
specialized services are not available at these sites, health services
are purchased from public and private providers through the IHS-funded
purchased/referred care (PRC) program. Additionally, 41 urban Indian
programs offer services ranging from community health to comprehensive
primary care.
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\9\ Indian Health Service. (2024). The Indian Health Care System--
Fact Sheet. Retrieved from: https://www.ihs.gov/sites/newsroom/themes/
responsive2017/display_objects/documents/factsheets/IHSProfile.pdf
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Year after year, the federal government has failed AI/ANs by
drastically underfunding the IHS far below the demonstrated need. For
example, in 2023, IHS spending for medical care per user was only
$4,078, while the national average spending per user was $13,493. This
correlates directly with the unacceptable higher rates of premature
deaths and chronic illnesses suffered throughout Indian communities.
This is despite years of statements to this effect. In 2018, the U.S.
Commission on Civil Rights found that: ``Federal funding for Native
American programs across the government remains grossly inadequate to
meet the most basic needs the federal government is obligated to
provide. Native American program budgets generally remain a barely
perceptible and decreasing percentage of agency budgets.'' \10\
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\10\ U.S. Commission on Civil Rights. ``Broken Promises: Continuing
Federal Funding Shortfall for Native Americans.'' December 2018.
Available at: https://www.usccr.gov/files/pubs/2018/12-20-Broken-
Promises.pdf
---------------------------------------------------------------------------
During the last four years, bipartisan collaboration between
Congress and the Administration has resulted in just a 11.6 percent
increase to the IHS budget, although actual inflation has been
significantly higher. In reality, many of the increases in funding over
the past several years have barely supported population growth, rising
medical inflation, staffing funding for specific new/expanded
facilities, and the rightful funding of legal obligations such as
Contract Support Costs (CSC). For example, based on the House and
Senate budgets drafted for consideration for FY 2025, CSC and section
105(l) leases made up 87-93 percent of the increase assessed. These
costs will continue to grow following the Becerra v. San Carlos Apache
Tribe and Becerra v. Northern Arapaho Tribe Supreme Court rulings. A
more significant funding increase, including necessary investments in
adequate facilities, modernized infrastructure, and a qualified
workforce, is needed so that quality healthcare services can be
delivered in a safe manner within all AI/AN communities. Only then will
we expect to see a noticeable correlating improvement in health
outcomes for our people.
The IHS National Tribal Budget Formulation Workgroup has estimated
that full funding for the Indian health system should be $63 billion in
FY 2026. Providing full and mandatory funding will ensure the federal
government is meeting its trust and treaty obligations to Tribal
Nations for health care. As a step toward achieving this goal, we
request Congress to make common sense budgetary changes to help advance
the IHS budget by immediately reclassifying CSC and section 105(l)
lease payments to mandatory appropriations. We further request Congress
support and enact full and mandatory funding for the Indian Health
Service.
Maintaining Federal Funding for Medicaid Provided Through the Indian
Health System
As Congress approaches Medicaid reform, it should ensure that any
reform proposal honors the federal responsibility for Indian health
care, rather than passing that obligation on to the states through per
capita allocations, block grants, mandatory work requirements, or other
mechanisms that may be under consideration. The United States has a
unique trust responsibility to provide Tribal health care, founded in
treaties and other historical relations with Tribes, and reflected in
numerous statutes. In recognition of that federal obligation, Congress
amended the Social Security Act over 40 years ago in 1976 to authorize
Medicare and Medicaid reimbursement for services provided in IHS and
Tribally operated health care facilities. \11\ The House Report
explained that ``These Medicaid payments are viewed as a much-needed
supplement to a health care program which has for too long been
insufficient to provide quality health care to the American Indian. [.
. .]''
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\11\ 42 U.S.C. 1395qq and 1396j
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At the same time to meet the trust responsibility, Congress acted
to ensure that States would be reimbursed at a 100 percent federal
medical assistance percentage (FMAP) for Medicaid services to American
Indians and Alaska Natives that are received through the Indian health
system. The House Committee observed that since the United States
already had an obligation to pay for health services to Indians as IHS
beneficiaries, it was appropriate for the U.S. to pay the full cost of
their care as Medicaid beneficiaries. The Committee noted that because
the 100 percent FMAP provision was limited to services provided by or
through the Indian health system, it was being provided for IHS
eligible Indians and Alaska Natives for whom the United States has an
obligation and who are already eligible for ``full Federal funding of
their services.'' \12\ This key provision ensures that the
responsibility to pay for Medicaid services to AI/ANs remains with the
federal government, and is not shifted onto the States. The Committee
recognized that many States with large native populations also have
large amounts of public land, and thus a limited tax base for providing
health services, making it doubly unfair to shift the federal health
obligation to them.
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\12\ H.R. REP. No. 94-1026, pt. III, at 21 (1976), as reprinted in
1976 U.S.C.C.A.N. 2782, 2796.
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Medicaid reimbursements are critically important in filling the gap
created by chronic underfunding of IHS and are a critical source of
funding for Tribes seeking to take over IHS hospital systems through
self-governance agreements. Medicaid funds provide $1.2 billion to the
IHS, \13\ and provides coverage for 36 percent of non-elderly AI/ANs
and over half of AI/AN children. \14\
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\13\ FY 2025 Congressional Justification, Indian Health Service.
\14\ ``Medicaid's Role in Health Care for American Indians and
Alaska Natives'', MACPAC. February 2021. Accessed 1/28/25, https://
www.macpac.gov/wp-content/uploads/2021/02/Medicaids-Role-in-Health-
Care-for-American-Indians-and-Alaska-Natives.pdf
---------------------------------------------------------------------------
As important as Medicaid is to the Indian health system, Medicaid
reimbursements received through the Indian health system only represent
a fraction of one percent of total Medicaid funding. For instance, IHS
Medicaid spending in 2025 is projected to be only 0.21 percent of total
Medicaid spending. As a result, preserving full federal funding for
Medicaid services received through the Indian health system will not
adversely affect the overall effort to cap and control federal Medicaid
spending. Per capita caps and changes to FMAP, even when limited to the
general population or Medicaid expansion, can cause States to reduce
eligibility requirements or services levels, which also impact Indian
health programs adversely.
It is critical that Congress maintain full federal funding of
Medicaid services provided in IHS and Tribal healthcare facilities.
Tribal healthcare delivery systems need Medicaid funding to be
financially viable, as many of their patients are low income and have
no other form of coverage. Indian health facilities see anywhere from
30 to 60 percent of their funding from Medicaid alone. Tribal
healthcare delivery systems are the only systems that can ensure
coordinated, quality of care for the beneficiaries they serve, and the
only providers with the incentive to ensure that care is not
fragmented. Tribal healthcare providers reinvest in their communities,
and Tribal healthcare delivery systems are essential to local Tribal
communities and economies. Ensuring full federal funding for Medicaid
services received through the Indian health system is also essential to
Tribal self-governance. Self-governance Tribes have achieved some
remarkable health care improvements and efficiencies, but without the
ability to bill Medicaid, those systems are not financially viable.
As Congress considers Medicaid reform, it is essential that the
federal trust responsibility for Indian health care be honored and 100
percent FMAP for services received through the Indian health system is
preserved. This policy position has been previously been supported by
the National Governor's Association during past Medicaid reform
efforts. \15\ Exempting AI/AN beneficiaries from such reforms,
including work requirements, is consistent with the United States trust
and legal responsibilities to Tribes. Medicaid reform must be
deliberative and understand that it will impact Indian health programs,
even when those changes do not immediately appear to do so.
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\15\ National Governors Association, Resolution HHS-18, ``Indian
Health Services,'' March 1, 2006.
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Address the Behavioral Health Crisis in Indian Country
American Indian and Alaska Native populations carry generations of
historic trauma which continue to impact our communities through myriad
medical and behavioral health. The removal of Tribal nations from their
lands, the breaking of cultural and familial bonds through removal of
AI/AN children to boarding schools, and the broken promises of the
federal government have contributed to some of the greatest disparities
in mental health and substance use disorder diagnoses in our
communities. AI/AN populations experience the highest rate of misuse
for opioids, prescription pain relievers and other medication misuse.
Since 2018, AI/AN opioid overdose deaths have increased by 174 percent.
Despite an increase in Tribal Opioid Response (TOR) awards, competitive
funding is difficult for many Tribes to acquire. The strain of readily
available resources for the I/T/U system cannot meet the demand of
rising behavioral health issues nationwide.
Use of grants as the primary vehicle to deliver behavioral health
funding, or any other funding, limits Tribal providers' ability to
deliver clinical services, reporting requirements deter patients from
accessing care, and lack of access to culturally competent providers
and treatments all compound the behavioral health crisis in Indian
Country. We ask Congress to strengthen Tribal behavioral health
treatment and programs by increasing resources, providing for
flexibility and self-governance of funding, and support expanded access
to Tribal traditional healing services.
HHS/IHS should invest in culturally centered and Tribally driven
behavioral health programming and facilities. For example, HRSA can
support infrastructure outside of state-awards to support aging and
dilapidated behavioral health facilities that are Tribal and Native-
operated. IHS can expand the types of projects eligible under the Joint
Venture Construction Program (JVCP) to include standalone behavioral
health and substance use disorder (SUD) treatment facilities. Provide
additional and proactive technical assistance to Tribal Nations to
access and apply for available funding to treat and prevent SUD and
modify existing standards for cultural considerations such as extending
timelines and allowing for non-evidence-based practices as our cultural
models are often underreported.
Allow for behavioral health funding to be flexible and broadly
applicable to behavioral health conditions. Current grants silo funding
and prevent its use in treating mental health and SUD conditions
together, limit integrated care with medical teams, and prevent
polysubstance treatment or culturally informed approaches.
Investment in critical workforce development is essential to moving
forward by ensuring HHS Divisions support AI/AN workforce development
by authorizing and expanding additional provider types like behavioral
health aides and tax exemption the IHS Scholarship and Loan Repayment
programs as an incentive for participation. Also, midlevel providers
should receive equal compensation with other provider types under
Medicare and Medicaid.
Finally, we recommend reduce federal bureaucracy by allowing SAMHSA
programs to be available to Tribal Nations by amending access to the
Alcoholic and Substance Abuse Block Grant (SUBG), under SAMHSA, to be
available to Tribal Nations. Further, make common sense reforms to the
Government Performance and Results Act (GPRA) to allow Agencies to
lower reporting barriers for access to behavioral health services.
Protecting the Next Generation
Congress should support improved maternal and infant outcomes for
Native mothers and children by providing a funding set-aside in the
Maternal Child Health Services Block Grant, investing in a robust
maternal and birthing health workforce, and improving data on AI/AN
mothers and infants.
Historical trauma compounded with social, economic, political, and
environmental factors have impacted the health status of AI/AN mothers
and infants. The lack of federal investments, culturally appropriate
workforce, and quality data on AI/AN maternal and infant health stifle
effective programming to improve health outcomes for our next
generation.
Many Native women miss prenatal care visits due to lack of
accessible services and lack of trust with their provider. Giving birth
in Indian Country frequently means leaving your family, home, and
support system to travel hundreds of miles to the nearest birthing
center or hospital. For Native mothers with complicated pregnancies,
this could mean months away from home. When expecting mothers have to
travel so far from home to give birth, it can immediately complicate a
pregnancy. Many times, new mothers may begin labor, drive hundreds of
miles to reach their birthing hospital and then be turned away because
they are not far enough along in labor to be admitted. Other times,
Native women are stereotyped in their prenatal visits causing them to
avoid necessary services. Due to preconditions like diabetes and
hypertension, untreated conditions during pregnancy can increase a
women's risk of maternal mortality.
As a result, AI/AN women are three times more likely to die from
pregnancy-related causes than non-Hispanic White women. Further, AI/AN
infants are born prematurely, underweight, and twice as likely to die
before the age of one.
To address these disparities, HHS must create set-asides for Tribal
and Native-led organizations, invest in a robust maternal health
workforce, and improve data on AI/AN mothers and infants to address
socioenvironmental factors that inhibit healthy outcomes for our next
generation of AI/AN populations. The funding in the MCH Block grant can
be used to increase mid-wife and doula training to support a larger
birthing workforce in Native and rural communities. Improving access to
the birthing workforce can also help Native moms-to-be also stay in
their communities to deliver, which supports cultural traditions and
keeps mothers and newborns closer to supportive networks which can
improve infant health outcomes.
We must provide Tribal set-aside for the Maternal Child Health
Services Black Grant. Today, this funding goes to state governments and
leaves out Indian Country. There is a need for expanded prenatal health
education. This extra funding can provide screening for suicide, SUD,
and intimate-partner violence during prenatal and perinatal care. This
funding would also improve continuum of care coordination with
medication assisted treatment (MAT) providers. It would also provide
health promotion efforts to reduce maternal and infant mortality.
Congress and the Administration should invest in workforce
development for maternal health. Create a temporary set-aside in the
IHS Loan Repayment Program for doulas and midwives. Require cultural
humility training for providers who regularly engage with AI/AN
populations. Work with Tribal Colleges and Universities to build a
pipeline of AI/AN practitioners.
Maternal and child health data is often inaccurate or incomplete,
leading to underrepresentation of the true impact of AI/AN maternal and
child health needs. IHS and state data systems should report on
maternal and child health. Additionally, mandate the collection of race
and ethnicity data from IHS awardees.
Many of these recommendations have been highlighted in two recent
reports, the first The Way Forward: Report of The Alyce Spotted Bear &
Walter Soboleff Commission on Native Children and the NIHB's Tribal
Prenatal-3 Policy Agenda. Further, the care for our children does not
stop at birth, post-natal care for new mothers is critical for
providing education and access to beahvioral health resources that help
mothers and their children. As children age, many of them access health
care through school-based clinics. More should be done to meet
children's needs by providing care where they are and by providing
access to behavioral health services that help them understand the
links of historical trauma to suicide and other behavioral health
indicators and seek to connect them with cultural traditions which can
strengthen their identities and links to community.
Adoption of the 2024 Healthcare Package
An early iteration of the Further Continuing Appropriations and
Disaster Relief Supplemental Appropriations Act of 2025 (H.R. 10455),
introduced in the 118th Congress on December 17, 2024, included a
series of popular and critically important healthcare legislation. Many
of the proposals included long-time requests and priorities of Indian
Country.
The Special Diabetes Program for Indians (SDPI) would have received
a two-year extension at $200 million per year. Until last year, SDPI
had been flat-funded for over 20 years at $150 million per year. This
program is the only public health program to have reduced the instances
of diabetes, and has to date save $520 million for Medicare in the
prevention of end stage renal disease. The piecemeal, short-term
extensions of this valuable public health program jeopardize program
stability and make it difficult to plan for staffing and programmatic
activities. Adopting a long-term extension with an increase is a long-
standing request of Tribal Nations.
Medicare telehealth flexibilities would have been extended through
December 31, 2026. Among other important Medicare flexibilities
included in the package, Medicare telehealth has become a significantly
important tool to provide health care services for Elders. Because
Indian Country exists across vast expanses of rural and frontier,
having access to telehealth services, particularly audio-only services,
can improve access to distant site specialty care and supports better
monitoring of chronic conditions. Extension of these flexibilities will
continue to support improved health outcomes for our Elders.
Additional legislative reauthorizations and policy changes were
included in the initial legislation. These reauthorizations are
critical to providing services to our Elders, our nation's and Indian
Country's readiness for future public health crises, and supporting
behavioral health, and more. Among the legislation and policy changes:
Medicaid pharmacy payment reform, reauthorization the Older Americans
Act, the Pandemic and All-Hazards Preparedness Act (PAHPA), and the
SUPPORT Act. Without adoption or reauthorization, these programs will
continue to be in limbo.
Expand Tribal Self-Governance Beyond IHS at the U.S. Department of
Health and Human Services
Fifty years ago, Congress passed the Indian Self-Determination and
Education Assistance Act (ISDEAA), 25 U.S.C. 5301 et seq. Through the
passage of ISDEAA, Congress enabled Tribes to contract and compact to
run their own health care programs while also preserving Tribes' right
to choose that services continue to be provided directly by the Indian
Health Service. ISDEAA has proven to be one of the most important
policy choices that has restored to Tribes their rightful sovereignty
to determine and improve the health and well-being of our People.
In 2000, P.L. 106-260, included a provision directing HHS to
conduct a study to determine the feasibility of a demonstration project
extending Tribal Self-Governance to HHS agencies other than the IHS.
The HHS Study, submitted to Congress in 2003, determined that a
demonstration project was feasible. In the 108th Congress, Senator Ben
Nighthorse Campbell introduced S. 1696, the Department of Health and
Human Services Tribal Self-Governance Amendments Act, that would have
allowed these demonstration projects. The legislation unfortunately did
not advance out of that Congress, but it continued an important
discussion on the success and feasibility of Tribal self-determination
and self-governance beyond IHS. A second study was completed in 2011 by
the U.S. Department of Health and Human Services Self-Governance Tribal
Federal Workgroup which reiterated the feasibility and underscored the
need for legislation. Since 2024, the HHS Secretary's Tribal Advisory
Committee Tribal Self-Governance Expansion Workgroup has worked to
build momentum for a demonstration proposal and proposed legislative
language. On the 50th anniversary of ISDEAA, it is time to reaffirm
Tribal sovereignty and the success of self-determination and self-
governance.
Indian Health Service Scholarship and Loan Repayment Program Reforms
IHS provides scholarship and loan repayment opportunities as an
incentive for medical professionals to work in the Indian health system
due to chronic short staffing issues. Unlike other similar federal
programs, these payments are taxable. This means, that the agency is
paying taxes on top of the loan and scholarship payments, which means
fewer providers are able to be given loan repayment and scholarship
under the current appropriations. In the IHS's FY 2025 Congressional
Justification, it estimated that if the scholarship and loan repayment
programs were tax exempt, it could have awarded an additional 218 loan
repayment contracts. Further, this program does not provide for part-
time commitments or include mid-level providers which could further
extend the reach and bring more providers in to help address the
chronic provider shortage at Indian health facilities. Any tax reform
legislation considered in the 119th Congress should make reforms to the
IHS scholarship and loan repayment programs to increased their success
in support of an adequate workforce for Indian health.
Conclusion
The above highlighted Tribal priorities are not exhaustive, but
they can be accomplished in the 119th Congress. These priorities, if
enacted by Congress, will bring us a step closer to meeting the trust
and treaty obligation of the federal government to Tribal Nations. The
federal government made promises in its Tribal treaties to provide for,
among other things, the healthcare of Tribal citizens. The policies and
legislation outlined throughout this testimony will help repair one
portion of the broken promises of the federal government and will
support a step towards healthier Tribal communities.
The Chairman. Thank you, Chief Smith.
Welcome, Mr. Butler.
STATEMENT OF HON. RODNEY BUTLER, CHAIRMAN, MASHANTUCKET PEQUOT
TRIBAL NATION; PRESIDENT,
NATIVE AMERICAN FINANCE OFFICERS ASSOCIATION
(NAFOA)
Mr. Butler. [Greeting in Native tongue] Chairman Butler,
Mashantucket Pequot, President of NAFOA. Good afternoon, my
friends. My name is Chairman Butler, and I am from the
Mashantucket Pequot Tribe, and I am also here as the president
of NAFOA.
Chair Murkowski, Vice Chair Schatz, and distinguished
members of the Senate Committee on Indian Affairs, I thank you
for the opportunity to testify today as the president of NAFOA,
founded as the Native American Finance Officers Association, on
our economic priorities for the 119th Congress. This hearing on
the needs of tribal communities is crucial now, with a new
administration, a new Congress, and new opportunities and
challenges.
For over 40 years, NAFOA has worked to grow tribal
economies and strengthen tribal finance through advocacy,
education, and policy development. Our member tribes and tribal
enterprises represent the diversity of Indian Country's
economic landscape, including tribal gaming, energy projects,
agricultural ventures, Federal contracting, and many, many
more.
First, we will continue to emphasize that the relationship
between the Federal Government of the United States and tribal
nations is rooted in a political relationship between
sovereigns, not a racial or any other classification. The
Supreme Court unanimously affirmed this in Morton v. Mancari
and has consistently upheld this tenet. This political
relationship, recognized within the United States Constitution,
forms the foundation for modernizing the Federal treatment of
tribal governments and their enterprises.
The recent issuance of executive orders and subsequent
funding pause raised significant concern among tribal nations.
Tribes across the Country reported challenges with access to
critical systems, a lack of information from Federal agencies,
and considerable uncertainty about the potential impacts of
such actions.
Regardless of the percentage of the total budget, a pause
in Federal funding, whether temporary, prolonged, or permanent,
impacts the ability of tribes to offer crucial programs and
services to our tribal citizens. To this end, I want to thank
you in particular, Chair Murkowski, for the letter that you
sent to OMB recognizing our unique status and requesting a
government-wide exemption that acknowledges that tribal nations
must not be impacted by executive orders related to DEI.
At NAFOA, we remain committed to monitoring the impacts of
Federal actions and helping our member tribes with tools and
resources to navigate adverse Federal policies. We urge
Congress and the administration to ensure all tribal programs
and Federal offices serving tribal nations remain fully
operational and adequately staffed. This includes recognition
that tribal program funding fulfills legal obligations,
protection of funding streams supporting tribal economic
development, and maintenance of Federal staffing levels needed
for program delivery.
The continuation of vital technical assistance programs,
preservation of agency expertise in tribal matters, and
protection of tribal-specific program offices are essential for
supporting tribal economic growth.
It is important to mention that tribally-owned entities
under the umbrella of the tribal government are critical to
create jobs and to supplement funding for tribal programs that
are underfunded in the Federal budget.
In addition to protecting trust and treaty obligations, we
urge Congress to advance tribal tax parity legislation that was
introduced by our good friend, Senator Cortez Masto, with
tremendous bipartisan support. Over the past several
Congresses, the NAFOA has worked with both the Senate and the
House on legislation to address longstanding disparities in the
treatment of tribal governments and tax policy.
Based on feedback from Congress and our tribes, we have
made important revisions to our legislative proposals that we
are confident will allow for inclusion of key provisions in the
upcoming tax package that will be considered by Congress.
Congress must address longstanding disparities between
State and tribal governments, and ensure that tribal
governments are treated under the same provisions as States for
key tax purposes, including excise taxes, bond issuance,
pension plans, general welfare benefits and charitable
organizations. Unfortunately in recent years the disparity
between States and tribes has only increased. According to the
Brookings Institute, from 2014 to 2020, State governments
issued $47 billion annually in non-taxable municipal bonds,
compared to only $84 million by tribal governments.
Finally, empowering tribal governments by providing them
full parity with State and local governments in accessing tax-
exempt bond financing will enhance job creation, generate
sorely-needed governmental revenue for social services,
stimulate infrastructure and business development on tribal
lands, and accelerate the diversification and resiliency of
tribal economies, particularly in private sectors.
Another critical provision in our legislative
recommendation is the creation of the annual $175 million New
Market Tax Credit for low-income tribal communities. The New
Market Tax Credit program attracts private capital to
economically distressed communities by providing tax credits to
investors. Unfortunately, tribes are too often unable to access
these credits. Our recommendation is a set-aside for these
credits for Indian Country.
Finally, we recommend that any tax legislation considered
by Congress include tribal Low-Income Housing Tax Credits. This
program provides tax incentives for developers to create
affordable housing, but credits are often unavailable to
tribes.
We recommend these and other tax priorities be included in
the larger tax framework being considered by Congress this
year. By modernizing the tax code's treatment of tribal
governments and providing targeted economic development
incentives, tribal tax legislation will help tribes generate
governmental revenue and deliver essential services to build
stronger reservation economies.
We also urge Congress to make sure the Treasury
Department's Office of Tribal and Native Affairs become
permanent and continue the Tribal Treasury Advisory Committee.
These entities are essential partners for tribal governments
and their business entities. They allow for efficient and
effective consultation, communication and ensuring that tribes
can access tax incentives and economic development tools.
We also support the effort to reclassify both contract
support costs for the Tribal 105(l) lease program, to
mandatory, which is consistent with the statutory language in
court decisions. This reclassification will allow tribal
governments to continue to exert tribal control over the
provisions of programs within their communities and exercise
self-determination over tribal government infrastructure.
Lastly, NAFOA encourages Congress to increase the amount
available to tribes through the Department of Interior's Indian
Loan Guarantee Program and authorizing language that would
allow it to work with the New Market Tax Credits. As currently
written, tribes cannot take advantage of the New Market Tax
Credits if going through the Indian Loan Guarantee Program.
This simple fix will have a significant impact on the ability
of tribal nations to access capital.
In closing, the Federal Government's trust and treaty
responsibility and obligations must be upheld through concrete
action to support tribal economic development and financial
sovereignty. NAFOA's recommendations represent an important
step toward fulfilling these obligations, and creating
sustainable tribal economies that benefits both the Federal
Government and tribal governments.
I thank you again for your time today. [Phrase in Native
tongue.] Thank you all.
[The prepared statement of Mr. Butler follows:]
Prepared Statement of Hon. Rodney Butler, Chairman, Mashantucket Pequot
Tribal Nation; President, Native American Finance Officers
Association (NAFOA)
Introduction
Greetings Chairwoman Murkowski, Vice Chair Schatz, and Members of
the Senate Committee on Indian Affairs. Thank you for the opportunity
to testify today on behalf of NAFOA, founded as the Native American
Finance Officers Association, on our organization's priorities for 2025
and the 119th Congress. This hearing on the needs of tribal communities
is crucial now, with a new Administration, a new Congress, and new
opportunities and challenges. For over 40 years, NAFOA has worked to
grow tribal economies and strengthen tribal finance through advocacy,
education, and policy development. Our member tribes and tribal
enterprises represent the diversity of Indian Country's economic
landscape, including tribal gaming, energy projects, agricultural
ventures, federal contracting, and more.
Trust and Treaty Obligations
First, we will continue to emphasize that the relationship between
the Federal Government of the United States and the Tribal Nations is
rooted in a political relationship, not a racial or any other
classification. The Supreme Court unanimously affirmed this in Morton
v. Mancari and has consistently upheld his tenet. This political
relationship, recognized within the U.S. Constitution, forms the
foundation for modernizing the federal treatment of tribal governments
and their enterprises.
The recent issuance of executive orders and subsequent funding
pause raised significant concern among Tribal Nations. Tribes across
the country reported challenges with access to critical systems, a lack
of information from federal agencies, and considerable uncertainty
about the potential impact of such actions. We recognize there are
varying degrees of effect on Tribal Nations regarding federal funding--
where a substantial portion of some tribes' budgets are federal funds,
and others have limited federal funding. Regardless of the percentage
of the total budget, a pause in federal funding, whether temporary,
prolonged, or permanent, impacts the ability of tribes to offer crucial
programs and services to tribal citizens. At NAFOA, we remain committed
to collecting and sharing stories of impact and helping our member
tribes with tools and resources to navigate future federal funding
issues.
We recognize the challenges that lie ahead for the federal budget.
We urge Congress and the Administration to ensure all tribal programs
and federal offices serving Tribal Nations remain fully operational and
adequately staffed. This includes recognition that tribal program
funding fulfills legal obligations, protection of funding streams
supporting tribal economic development, and maintenance of federal
staffing levels needed for program delivery. The continuation of vital
technical assistance programs, preservation of agency expertise in
tribal matters, and protection of tribal-specific program offices are
essential for supporting tribal economic growth.
Tax Parity
In addition to protecting Trust and Treaty obligations, we urge
Congress to advance Tribal Tax Parity legislation. During the 117th
Congress, Senator Cortez Masto introduced S. 5048, the Native American
Tax Parity and Relief Act, and last year NAFOA worked with her office
and Congresswoman Gwen Moore to introduce H.R. 8318, the Tribal Tax
Investment and Reform Act. I want to express our support for the
proposed legislation that would create vital tax parity between tribal
governments and state governments while strengthening tribal economic
development opportunities. I would like to highlight three of H.R.
8318's critical changes.
First, Section 3 of 8318 addresses longstanding disparities by
treating tribal governments under the same provisions as states for key
tax purposes, including excise taxes, bond issuance, pension plans,
general welfare benefits, and charitable organizations. As the Treasury
Tribal Advisory Committee aptly states in its 2020 Subcommittee on Dual
Taxation Report, Tribal Nations ``pre-date the formation of the United
States and possess inherent and treaty-recognized sovereignty. As a
fundamental aspect of that sovereignty, Tribal Nations possess immunity
from being taxed by the United States federal and state governments.
Moreover, Tribal lands subject to the jurisdiction of Tribal
governments are not subject to direct taxation by outside
governments.''
Unfortunately, in recent years, the disparity between states and
tribes has only increased. According to the Brookings Institution, from
2014 to 2020, ``state governments issued $47 billion annually in non-
taxable municipal bonds, compared to a total of $84 million by tribal
governments. This equates to a 559-fold gap in using tax-exempt
government bonds.''
Finally, ending this discriminatory treatment of tribal governments
by providing them full parity with state and local governments in
accessing tax-exempt bond financing will enhance job creation, generate
sorely needed governmental revenue for social services, stimulate
infrastructure and business development on tribal lands, and accelerate
the diversification and resiliency of tribal economies, particularly in
their private sectors. In addition, restoring parity would ``create
spillover benefits for non-tribal citizens in those areas.''
The cost to the federal government would be low. According to the
Congressional Budget Office, ``increasing tax-exempt bond access for
tribes would reduce federal tax revenue by an estimated $77 million
over 10 years. In comparison, the estimated total cost of the federal
tax exemption for municipal bonds was $27 billion in fiscal year
2022.''
Another critical change 8318 makes is creating an annual $175m New
Market Tax Credit (NMTC) for low-income Tribal Communities. NMTC
Program attracts private capital to economically distressed communities
by providing tax credits to investors. Unfortunately, tribes are too
often unable to access these credits. Since the NMTC program's
inception, Native CDEs have had to compete against non-Native CDEs in
what has proven to be an unlevel playing field for NMTC allocations.
This section addresses the low rate of NMTC availability in Indian
Country by creating a credit set aside. Establishing this set aside
will enable more Tribal Nations and communities to grow the proven
benefits that those who have already leveraged this important financing
tool have generated.
Finally, Section 9 of this legislation increases the effectiveness
of Tribal Low-Income Housing Tax Credits (LIHTC). The LIHTC program
provides tax incentives to developers to create affordable housing, but
credits are often unavailable to tribes. This section modifies the
definition of a difficult development area to include an Indian area to
determine eligible basis, thereby explicitly including Tribes in the
LIHTC program criteria. A good example of the success of this program
is the Knik Homes #1 project in Wasilla, Alaska. Developed by the Knik
Tribe the project includes the construction of 32 new elder townhome
units. The total project costs are $18.7 million--almost $7 million of
which was covered by LIHTC equity and an AHP grant.
Congress should pass this legislation to fulfill its trust and
treaty obligations and support tribal economic sovereignty. The
legislation recognizes tribal governments face unique challenges in
accessing capital and developing sustainable economies due to
historical disadvantages and statutory restrictions. By modernizing the
tax code's treatment of tribal governments and providing targeted
economic development incentives, this legislation would help tribes
generate governmental revenue, deliver essential services, and build
stronger reservation economies. The provisions are carefully crafted to
respect tribal sovereignty while creating practical tools for tribal
governments to meet their citizens' needs. With strong bipartisan
support from Indian Country, this legislation represents an important
step toward tax fairness and tribal self-determination.
NAFOA's staff has been collecting and recording examples of the
practical, on-the-ground impact that the Tribal Tax Parity bill would
make. I would be happy to share those examples with Members of the
Committee, as NAFOA understands it is essential to demonstrate why
these changes matter, how they impact our communities, and the
potential impact of inaction.
Treasury Matters
NAFOA strongly urges Congress to make the Treasury Department's
Office of Tribal and Native Affairs permanent and to continue the
Tribal Treasury Advisory Committee (TTAC). These entities are essential
for providing technical assistance and guidance, supporting tribes in
accessing tax incentives and economic development tools, and developing
guidance on general welfare programs and tribal enterprises. They also
play a crucial role in ensuring appropriate tribal consultation on tax
and economic policies and facilitating government-to-government
engagement. Additionally, authorizing changes need to be made that
would allow the IRS to give in-depth information and technical
assistance to tribes, similar to the types of technical assistance
available with many other tribal programs, as well as a place where
tribes can receive guidance and clarification on tax, particularly tax
credit, issues.
NAFOA strongly encourages the Treasury to complete regulations on
tribal entities with the abovementioned improvements and asks the
Treasury to finalize general welfare benefit regulations with enhanced
guidance on trust arrangements and program interactions. We also ask
the Committee to protect funding and staffing for programs supporting
tribal economic development, support the modernization of tax
provisions affecting tribal governments and enterprises, and ensure
tribal consultation requirements are maintained and strengthened.
To help ensure that tribal voices are heard at the Treasury, NAFOA
urges this Committee to advance legislation making the Office of Tribal
and Native Affairs (OTNA) permanent with dedicated funding and
staffing, as the OTNA is one of the best examples of federal outreach
and assistance. Established in 2022, the OTNA's mission is (1) to
advise on Tribal policy and program implementation, (2) to coordinate
Tribal consultations, and (3) to manage the Treasury Tribal Advisory
Committee (TTAC). Currently, the office has a budget of $2 million and
employs 8 staffers, and even in a short time, it has already had a
positive impact that far exceeds its cost.
General Welfare Exclusion Rulemaking
The proposed regulations implementing the Tribal General Welfare
Exclusion Act require finalization with several critical improvements.
We need supplemental guidance on trust arrangements and deferred
benefits to help tribes develop sophisticated benefit structures. Clear
standards for using trusts to provide general welfare benefits and
guidance on the interaction between tribal general welfare benefits and
other federal program eligibility are essential. The development of
detailed training plans in consultation with tribes and TTAC, the
establishment of formal transition periods when lifting audit
suspensions, and the focus on prospective enforcement rather than
challenging past tribal programs will ensure smooth implementation.
Tribally Chartered Corps Rulemaking
The proposed Treasury regulations regarding wholly-owned tribal
entities represent significant progress but require completion with
several key provisions. We need explicit confirmation that tax
treatment extends to all subsidiary entities wholly owned through
tribal parent entities and clear guidance that tribally chartered
entities can assert the same excise tax benefits as their owning
tribes. Additionally, the Treasury must provide guidance on entities
owned in part by persons other than tribes and recognize diverse tribal
corporate structures beyond Section 17 corporations.
Appropriations Reclassification
Unfortunately, the federal funding and appropriations cycles have
lacked consistency in recent years. With the current challenges facing
federally funded programs, NAFOA recommends changing tribally funded
programs under the discretionary classification to the mandatory
classification. Reclassifying programs would help tribes with financial
planning and make budget forecasting far more accurate, something that
is very important to the business development of tribes that have an
oversized reliance on federal programs and funds. One of the programs
that NAFOA strongly supports for reclassification is the Contract
Support Costs and Payments for Tribal Leases. For the last two years,
the President's Budgets has called for reclassification of these
programs and Congress's S. Rept. 118-83.
Tribal Energy Development
Tribal Nations are poised to contribute significantly to energy
development in the United States. It is critical that tribes can fully
participate in the clean energy transition through their tribally
chartered entities and have access to the Inflation Reduction Act (IRA)
Elect/Direct Pay energy credits as Congress intended. This requires
addressing administrative burdens in current elective pay systems for
clean energy tax credits and creating clear pathways for tribal-private
partnerships in renewable projects. The economic potential for tribes
in this sector is substantial, but we need proper structures to access
these opportunities.
Access to capital remains a fundamental challenge for tribal
economic development. Implementing set-asides within the New Markets
Tax Credit program for tribal projects, recognizing tribal areas as
difficult development areas for housing credit purposes, and
modernizing the Indian Employment Tax Credit would significantly
enhance tribes' ability to finance crucial projects and create
sustainable economies.
Indian Loan Guarantee Program
NAFOA encourages Congress to increase the amount available to
tribes through the Department of Interior's Indian Loan Guarantee
Program (ILGP) and an authorizing fix that would allow it to work with
the NMTC. NAFOA knows the issues and challenges Tribal Nations
encounter when accessing capital for economic development projects. As
currently written, tribes cannot take advantage of the NMTC if going
through the Indian Loan Guarantee Program. This is a major oversight
with a simple fix that would cost almost nothing to remedy and would
have a significant impact on the ability of Tribal Nations to access
capital.
Carcieri
Lastly, NAFOA supports bipartisan legislation that addresses and
fixes the Carcieri decision. To quote the recent intertribal
organization letter, ``It must be acknowledged and understood that at
its core, the Carcieri decision is an attack on the Indian
Reorganization Act (IRA) of 1934, which Congress enacted to stop the
massive loss of Tribal homelands inflicted by the General Allotment Act
of 1887 (Allotment Act).'' It is our hope that this Congress will enact
the fix.
Closing
The federal government's trust and treaty obligations must be
upheld through concrete action to support tribal economic development
and financial sovereignty. These recommendations represent an important
step toward fulfilling these obligations and creating sustainable
tribal economies.
Thank you for your attention to these vital matters affecting
tribal economies and sovereignty. I am happy to answer any questions.
The Chairman. Thank you.
We go to Mr. Kerry Bird.
STATEMENT OF KERRY D. BIRD, BOARD PRESIDENT, NATIONAL INDIAN
EDUCATION ASSOCIATION
Mr. Bird. Chair Murkowski, Vice Chair Schatz, esteemed
members of the Committee, good afternoon. My name is Kerry
Bird, and I am President of the National Indian Education
Association. I am a citizen of the Sisseton Wahpeton Oyate of
South Dakota and a descendant of the Lumbee Tribe of North
Carolina.
On behalf of the students, educators, and tribal nations
NIEA serves, I appreciate the opportunity to testify today on
the critical issues surrounding Native education and the
Federal Government's trust and treaty obligations to American
Indians, Alaska Natives and Native Hawaiians.
Sovereignty is the foundation of effective education in
Indian Country. The Federal Government's trust responsibility
to Native education is a foundational obligation firmly
established through treaties, laws, and legal precedents. But
today, Native students in both BIE schools and public schools
face chronic underfunding and deteriorating infrastructure.
Worse yet, Federal policies often fail to support the inherent
sovereignty of tribal nations in managing their own educational
systems, leaving communities stuck in bureaucratic red tape.
To address these issues, we urge Congress to take decisive
action in five key areas. First and foremost, Congress must
affirm the political status of Native students. The Federal
trust and treaty obligations to tribal nations for education
and the Federal trust obligations to Native Hawaiian education
are not discretionary commitments. They are legal obligations.
This duty has been reaffirmed through centuries of
legislation, beginning with the Civilization Fund Act of 1819,
codified as a Federal directive in the Snyder Act, and later
strengthened under the Indian Self-Determination and Education
Assistance Act as well as the Tribally Controlled Schools Act
of 1988.
The trust responsibility to individual Native students in
public schools has also been reinforced through the Johnson-
O'Malley Act of 1935, Title VI of the Elementary and Secondary
Education Act of 1965, and the Native Hawaiian Education Act of
1988.
Tribal nations and Native communities should be empowered
to design educational systems that reflect their values,
traditions, and economic priorities. These programs are not
simply a matter of cultural pride, but also critical to the
future and economic success of our communities.
Second, we need stable and adequate funding. Our schools
require consistent investment, not fluctuating annual budgets
that create uncertainty. Advance Appropriations would ensure
that Native education programs are shielded from budgetary
disruptions, allowing for long-term planning and success.
Additionally, Congress must protect Title VI, Johnson-O'Malley
and Impact Aid programs, ensuring Native students in public
schools receive the resources they are owed.
Third, we must expand self-governance and education and
empower tribal nations to control their education systems.
Extending Public Law 477 and 638 across more Federal programs
would give tribes greater autonomy over education.
Additionally, 105(l) lease funding should be moved to
mandatory appropriations to assure tribes can build, repair and
maintain schools independently while ensuring the Federal
Government meets its fiduciary responsibilities.
Fourth, early childhood education is a critical foundation
for lifelong success. The Alyce Spotted Bear Commission on
Native Children has emphasized the urgent need for culturally
relevant early childhood programs that address the unique needs
of Native communities. The report highlighted the importance of
improving access to Head Start and other early education
services that are responsive to Native languages, culture, and
values.
Congress must prioritize implementing the Commission's
recommendations, which are vital for providing Native children
with crucial developmental and educational opportunities.
Finally, I want to highlight the urgent need to improve BIE
school facilities. Unlike DOE or Department of Defense schools,
which receive significant investment, many BIE schools are
operating in unsafe, outdated buildings. To ensure that Native
students have safe learning environments, tribal nations must
have access to consistent funding for construction and
renovation, whether through direct appropriations, the Great
American Outdoors Act, or expanded 105(l) lease agreements.
Members of the Committee, the stakes are high. By
supporting Native education, you are not only investing in the
future of our youth, but also strengthening the resilience and
sovereignty of tribal nations, and ultimately, the success of
the United States. I urge you to act now to uphold trust and
treaty obligations and ensure that Native students receive the
education they deserve.
Thank you, and I look forward to your questions.
[The prepared statement of Mr. Bird follows:]
Prepared Statement of Kerry D. Bird, President, National Indian
Education Association
On behalf of the National Indian Education Association (NIEA), and
the students, educators, and Tribal Nations we serve, thank you for
this opportunity to provide testimony regarding the critical issues
surrounding Native education and the Federal government's trust and
treaty obligations to American Indians and Alaska Natives and the
Federal trust obligation to Native Hawaiians. Sovereignty is the
cornerstone of effective education in Indian Country, and the federal
trust responsibility to Indian education is one of the most fundamental
commitments the United States government has made. This responsibility,
deeply embedded in over 150 years of treaties, statutes, and cases, has
been integral to ensuring that Native students receive the support and
resources needed for educational success. Education is not merely a
tool for individual success it is the foundation for the future of our
Nations.
Native students in Bureau of Indian Education (BIE)-funded schools,
as well as those in public schools serving Native populations, are
subjected to overcrowded classrooms, deteriorating facilities, and that
does not respond to the needs of the local communities or cultures. In
many instances, Federal policies do not sufficiently recognize or
support the inherent sovereignty of Tribal Nations in managing their
own educational systems, often leaving Native communities at the mercy
of bureaucratic red tape and restrictive federal oversight. This
oversight results in a lack of agency for Native peoples over their own
educational systems, which should be driven by cultural, linguistic,
and community-specific priorities.
NIEA urges this Committee to act on these critical issues. By
making meaningful investments in Native education, updating outdated
policies, and recognizing the inherent sovereignty of Tribal Nations,
we can begin to close the gaps in educational opportunity and outcomes
for Native students. This includes prioritizing funding and flexibility
for BIE schools and Tribal Education Agencies, protecting the status of
Native education programs across the government, and removing
administrative barriers that hinder Native communities from fully
controlling and shaping their educational systems. The stakes are high,
not just for Native students but for the future of our communities and
our shared future as a Nation. By supporting Native education, we are
not only investing in the future of our youth but in the strength and
vitality of Tribal Nations and the United States as a whole.
I. Affirming the Political Status of Native Students
The first step in improving Native education is affirming the
political status of Native students. The political status of Native
students--whether American Indian, Alaska Native, or Native Hawaiian--
is deeply intertwined with their communities' sovereignty and their
relationship with the U.S. government. These communities have a unique
and complex legal and political standing that must be recognized and
respected in the development of federal education policy. Native
students face unique challenges, and their education must be designed
with their cultural heritage and future economic success in mind. The
federal trust responsibilities to American Indians, Alaska Natives, and
Native Hawaiians, are an essential part of this relationship,
obligating the U.S. government to protect the resources, lands, and
rights of Tribal Nations and Native communities, including ensuring
access to education.
Congress has long understood this unique duty, reaffirming the
political status of Native students through centuries of legislation,
beginning with the Civilization Fund Act of 1819, codified as a Federal
directive in the Snyder Act of 1921, and later revised under the Indian
Self-Determination and Education Assistance Act of 1975 (ISDEAA), P.L.
93-638, and the Tribally Controlled Schools Act of 1988, P.L. 100-297.
Meanwhile, the trust responsibility to individual Native children in
public schools has been reinforced in federal law since the Johnson
O'Malley (JOM) Act of 1935, followed by P.L. 81-874 (1950), Title VI of
the Elementary and Secondary Education Act of 1965, the Indian
Education Act of 1972, and the Native Hawaiian Education Act of 1988.
Congress must continue to advocate for policies that reaffirm the
political status of Native students. This can be achieved by providing
greater flexibility and control to Tribal communities in areas such as
curriculum development, governance, teacher recruitment, and funding
allocation. Tribal Nations should be empowered to make decisions that
reflect their values, traditions, and educational priorities. These
programs are not simply a matter of cultural pride but also critical to
the future economic success of Native communities, as they help to
preserve and promote valuable skills and traditions.
II. Ensuring Stable and Adequate Funding for Native Education
A critical element of fulfilling the federal government's trust
responsibility, the Federal government must ensure that funding for
Native education is adequate, stable, and protected. The Federal
government must commit to long-term, consistent funding that supports
Native education programs and ensures that Native students have access
to the resources they need to succeed. This includes support for Tribal
Education Agencies (TEAs), which play a crucial role in operation of
Tribally Controlled Schools, Tribal charter schools, and the
development and implementation of education programs for Native
students, as well as funding for programs like Head Start, Johnson-
O'Malley, and Native language revitalization efforts. TEAs provide
invaluable resources that help close educational gaps for Native
students, but they cannot operate effectively without adequate funding.
The financial stability of Tribal education programs is a
foundational element of ensuring longterm success for Native students.
To achieve this, it is critical that Congressional appropriations for
Tribal education remain stable and predictable through Advance
Appropriations. Advance Appropriations provide guaranteed, consistent
funding for federal programs, allowing Tribal governments and
educational institutions to plan and implement long-term projects
without the uncertainty of fluctuating annual budgets. This stability
is particularly crucial in education, where programs rely on
predictable funding to address the unique needs of Native students.
Without stable, guaranteed funding, Native communities often face
interruptions in services, delays in programming, and difficulty in
maintaining quality educational standards. Advance Appropriations would
protect these programs from the uncertainty of the annual budget cycle
and ensure that Tribes can meet the educational needs of their youth
without disruption.
In addition, funding for Native education programs should protected
across the entire Federal government. Funds for programs like Title VI,
Title I grants, and the Johnson-O'Malley program must be fully funded
to addresses the unique needs of Native students who do not attend BIE
schools but still maintain a political relationship with the Federal
government. These programs are critical to closing the achievement gap,
but their effectiveness is undermined when funding is not consistent
and when there are no guarantees that resources will be allocated where
they are most needed.
III. Expanding Self-Governance in Education Through P.L. 477 and 638
Authorities
One of the most effective ways to empower Tribal Nations in
managing educational programs is to expand self-governance authority
through P.L. 477 and 638. These policies allow Tribes to take on
greater control and responsibility over federal programs that impact
their communities, creating more flexible and culturally relevant
solutions for Native students.
Under P.L. 102-477, Tribes have the ability to consolidate multiple
federal programs under a single compact or contract, offering a
streamlined approach to service delivery. Expanding this authority
throughout the Administration for Children and Families (ACF) would
allow for better integration of education programs such as Head Start
and Native language revitalization efforts under the Administration for
Native Americans (ANA). By consolidating funding streams and reducing
the administrative burden of navigating multiple federal requirements,
Tribes can tailor these programs to meet the specific needs of their
communities, fostering greater community involvement and long-term
sustainability.
Similarly, fully extending 638 authority to more federal programs--
particularly those within the U.S. Department of Agriculture (USDA),
like Child Nutrition Services--will provide Tribes with the autonomy to
design and administer programs that are culturally appropriate and
responsive to their community's unique needs. This would enable Tribes
to manage their own nutrition services for students, ensuring that the
meals provided are nutritious and reflective of cultural preferences,
which directly impacts student health and academic success.
By expanding both P.L. 477 and 638 authority, Tribes can exercise
greater sovereignty and selfdetermination in the administration of
education-related programs, leading to more efficient, effective, and
culturally relevant services. These efforts will help bridge the gap in
educational disparities and support the success of Native students by
ensuring that educational programs are aligned with community values
and priorities.
IV. Improving BIE Facilities and Resources
The Bureau of Indian Education is a primary mechanism through which
the federal government provides education to Native students. Unlike
Department of Defense (DOD) schools, which receive significant funding
for modern facilities and ongoing renovations, BIE schools are often
operating in buildings that are outdated and, in some cases, hazardous
for students and staff. In many cases, BIE schools lack basic
infrastructure, such as heating and ventilation, and face ongoing
challenges with building maintenance and teacher recruitment.
In 2019, a study by the Department of the Interior estimated that
addressing the most critical maintenance issues in BIE schools would
require more than $639 million. However, even after this immediate
funding is provided, BIE schools would still face a funding shortfall
of over $1 billion to address the full scope of the infrastructure
needs. This disparity is an ongoing injustice, as Native students
should have access to the same quality of education facilities as their
peers in other parts of the country.
Tribal Nations often face significant barriers in securing and
maintaining funding for school facility construction, repair, and
renovation through traditional funding mechanisms. We urge Congress to
consider providing additional funding for the BIE school facilities,
including through the reauthorization of the Great American Outdoors
Act (GAOA) Legacy Restoration Fund, and streamlining the process for
accessing these funds. Investing in facilities is an investment in the
future of Native students and their communities.
V. Enhancing Tribal Control Over Education Infrastructure: 105(l)
Leases
Making 105(l) leases mandatory appropriations offers Tribes an
alternative model for improving school infrastructure. Under Section
105(l) of ISDEAA, Tribes can lease school facilities to the federal
government as part of self-governance compacts or contracts. This
allows Tribes to build, repair, and maintain schools independently
while ensuring the federal government meets its fiduciary duties. The
leases are essentially payment agreements between Tribes and the BIA,
BIE, or IHS, compensating Tribes based on the ``fair market value'' of
their facilities for use in federal programs. However, because these
payments are currently discretionary, they increasingly face the
possibility of being offset by cuts to other Tribal programs. To
encourage Tribal participation in 105(l) leasing and give Tribes more
control over their facilities, these payments should be made mandatory.
Doing so would reduce bureaucratic delays, empower Tribes with self-
determination over education infrastructure, and address the current
backlog in school maintenance.
VI. Tribal Head Start, Early Childhood Education, and the Alyce Spotted
Bear Report
Early childhood education is a critical foundation for Native
students' future success, yet Tribal Head Start and other early
childhood education programs often face chronic underfunding and
barriers to full participation. The Alyce Spotted Bear and Walter
Soboleff Commission on Native Children, through its 2019 report,
highlighted the urgent need for culturally relevant early childhood
education programs that are responsive to the unique needs of Native
communities. The report underscored the importance of improving access
to Head Start programs and other early education services, ensuring
they reflect Native languages, cultures, and values.
To address these needs, Congress must increase funding for Tribal
Head Start programs, which provide crucial developmental and
educational opportunities for Native children. Additionally, enhancing
access to early childhood education by supporting Tribally operated
programs and ensuring they meet the specific needs of Native
communities will help improve the overall educational outcomes for
Native students. Many of these programs were outlined in the final
Alyce Spotted Bear Commission Report and should be fully implemented.
Federal investment in these programs not only prepares children for
academic success but also strengthens the cultural fabric of Native
communities by providing children with a connection to their heritage
from a young age.
VII. Ensuring Culturally Relevant Education and Teacher Retention
In order to create an education system that is truly responsive to
the needs of Native students, it is essential that Tribal Nations have
the ability to develop their own curricula and educational assessments.
Currently, many BIE schools are required to use standardized
assessments that do not take into account the cultural and linguistic
backgrounds of Native students. This often leads to unfair evaluations
of student achievement and reinforces disparities in academic outcomes.
By allowing BIE-funded schools to develop and use their own
assessments, we can better support Native students in their educational
journey.
Furthermore, it is crucial to invest in teacher retention and
professional development programs across all levels of education. The
Native American Teacher Retention Initiative (NATRI) has been
successful in increasing the number of Native teachers and providing
ongoing support to those in the profession. Continued support for NATRI
and similar programs will help address the teacher shortages in Native
communities and ensure that Native students have educators who
understand and respect their cultural backgrounds. Programs such as
this should be expanded to include recruitment and retention programs
for Early Childhood Education (ECE), where typical teacher shortages
are exacerbated even further. These programs should include mentoring,
leadership development, and professional growth opportunities to
support teachers' long-term success in the classroom.
VIII. The Other 93 Percent: Addressing the Educational Needs of Native
Students in Public Schools
While BIE schools serve a significant portion of Native students,
the majority--about 93 percent--attend public schools. Title VI of the
Elementary and Secondary Education Act (ESEA) is a vital resource for
Native students in public schools. Title VI programs play a crucial
role in addressing the unique educational needs of Native students.
Title VI grants fund vital resources for Native students, including
after-school programs, academic support, dropout prevention
initiatives, and assistance with college access testing. Equally
important is the inclusion of Native Hawaiian Education and Alaska
Native Education programs, which aim to address the specific needs of
Native Hawaiian and Alaska Native students.
Additionally, Title I grants, which target disadvantaged students,
are particularly vital for Native students who often face socioeconomic
challenges in schools across the Nation. BIE Schools also receive this
funding. There have been many recent conversations regarding the future
and the structure of these grants. It is essential that the role these
grants play in fulfilling the trust and treaty obligations to Native
education are not redirected to the States. Here, TEAs again play an
important role and should be eligible to receive the funding directed
at their students, similar to State Education Agencies (SEAs) or Local
Education Agencies (LEAs).
Maintaining robust funding for these programs is critical, as they
provide essential resources and services that public schools might
otherwise lack. Programs such as Title VI are essential because they go
above and beyond what the BIE and JOM can serve, including descendants
of federally recognized tribes, as well as state-recognized tribes,
ensuring that more Native students can benefit from these programs and
also affirming the Federal government's commitment to meeting the
unique needs of Native communities within the broader public education
system.
IX. Protecting Impact Aid and Supporting Tribally Controlled Schools
Impact Aid is a federal program designed to support school
districts that serve students whose families live on federal lands or
who are military dependents. For many Native communities, Impact Aid is
a critical funding source that helps bridge the gap between what local
districts can raise through taxes and what is required to provide
quality educational services. However, the current structure of the
program does not adequately account for Tribally controlled schools,
which do not have access to traditional tax revenue. Additionally,
while Native students living on federal lands are eligible for Impact
Aid, Native Hawaiians are not, even though they face similar
challenges.
NIEA advocates for expanding the Impact Aid program to include
Tribally Controlled Schools, as these schools are in a unique position.
They are run by Tribal Nations, which do not have the same access to
tax revenue as other school districts. Allowing these schools to
benefit from Impact Aid would provide essential funding that could be
used to improve educational opportunities for Native students.
Furthermore, while American Indians and Alaska Natives are
recognized as federally impacted children, Native Hawaiians, even those
living on Hawaiian Homesteads, are excluded from these benefits. This
is a significant gap in the system, and it is essential that Congress
take steps to ensure that Native Hawaiians are not excluded from
federal educational support.
X. Expanding Educational Opportunities Through Charter Schools and
Self-Determination
Charter schools have become a valuable tool for Native communities
seeking to regain control over the education of their children.
Tribally run charter schools offer Native students a culturally
relevant curriculum, focused on language revitalization, cultural
identity, and the educational priorities of their communities. Charter
schools also allow for innovative approaches to education, such as
project-based learning and community partnerships, which are essential
for the success of Native students. Allowing Tribal Nations and TEAs to
be recognized as authorizers for Native charter schools on their lands
or within their communities will help provide an education system that
aligns with the values and needs of Native students, while also
offering flexibility to adapt to the diverse educational needs across
Indian Country.
This is especially so, given the 1995 moratorium on additional BIE
schools, and the lack of funding which exists even if the moratorium
were to be lifted. For all of the Tribes who do not have BIE schools in
their communities, and even for those that do, supporting and expanding
access to charter schools for Native students is an important step
toward promoting selfdetermination and create additional choice in
Native education.
Conclusion
The federal government has a sacred trust responsibility to Native
peoples, particularly when it comes to education. By honoring the
commitments made to Native students and strengthening sovereignty in
education, we can ensure that Native students receive an education that
will not only improve economic outcomes but also strengthen the
resilience of Native communities for generations to come.
The Chairman. Thank you, Mr. Bird.
Now we go virtually to Hawaii. Mr. Lewis, welcome.
STATEMENT OF KUHIO LEWIS, CEO, COUNCIL FOR NATIVE HAWAIIAN
ADVANCEMENT
Mr. Lewis. Aloha, mahalo nui loa to Chair Murkowski and to
our very own Senator and Vice Chair Schatz, as well as esteemed
members of the Committee. I am Kuhio Lewis; I am the Chief
Executive Officer of the Council for Native Hawaiian
Advancement. I want to extend a deep mahalo to you, Chair
Murkowski, for your steadfast support for our Native people
across America.
For background, our organization is actually the sister or
the mirror to AFN, or the Alaska Federation of Natives. We
gather community, we identify priorities to them, and we
elevate them. We have 1,600 members as part of our
organization's network. We are a HUD-certified counseling
agency. We are the largest Native CDFI in Hawaii and we manage
large-scale workforce programs, housing projects, financial
aid, and we also help manage tourism in our islands. Currently,
we are playing a pivotal role in helping Maui recover from the
devastating wildfires.
CNHA also operates a policy center, and we help connect
people with decision makers.
Just by way of our comments, the Federal Government has a
special political and trust relationship with the Native
Hawaiian community following the overthrow of our Queen and the
annexation of the kingdom, the illegal annexation of our
kingdom of Hawaii, and the seizure of our trust lands. These
are the same trust principles that Congress has recognized and
it owes the Native people of the United States. In lieu of a
government-to-government relationship, the Federal Government
fulfills this trust obligation to Native Hawaiians by working
with Native Hawaiian organizations like ours and many others
out there, as well as the Native Hawaiian community at large.
Compared to other groups in Hawaii, Native Hawaiians face
some of the greatest disparities. We have the shortest life
expectancy, we are the most likely to live below the poverty
line, we experience significantly higher rates of unemployment,
we are the most incarcerated. And one unfortunate statistics
is, recently there are more Native Hawaiians now living outside
of our homeland of Hawaii than in our homeland.
So we are losing more and more. We already lost our
monarchy, our lands, our culture, and now we are losing our
people. The cost of living, the unaffordable housing prices,
the lack of career opportunities, have pushed our Native
Hawaiian people out of their homeland.
While great strides have been made, more work needs to be
done to support our Native people. The inclusion of Native
Hawaiians in programs like the Office of Indian Energy,
increased funding to support programs like NAHASDA so we can
build housing, ensuring that trust principles are met and
Native Hawaiians can stay in their homelands is critical. These
funding mechanisms allow us to leverage private funds as well,
so that we can further support our people.
In closing, similar to what others have said, NAHASDA funds
are critical to our advancement. There have been tremendous
happenings in recent years with respect to NAHASDA. So as well
as for our Native Hawaiian education funds, it has helped to
perpetuate and cultivate the continuation of our Hawaiian
language programs, which was something that was lost. And our
Native Hawaiian support that we get from Congress is also
critical.
So what we are asking for is the continued recognition and
support of our Native Hawaiian people in Hawaii. We will do our
part to continue to support our people.
Thank you, Chair, thank you Committee members. I am
available for questions.
[The prepared statement of Mr. Lewis follows:]
Prepared Statement of Kuhio Lewis, CEO, Council for Native Hawaiian
Advancement
Mahalo nui loa, Chair Murkowski, Vice Chair Schatz, and esteemed
members of the Senate Committee on Indian Affairs for convening this
hearing on Native priorities.
Founded in 2001, the Council for Native Hawaiian Advancement (CNHA)
is a member-driven, 501(c)(3) nonprofit organization dedicated to
advancing the cultural, economic, political, and community development
of Native Hawaiians throughout the United States. As a Native Community
Development Financial Institution, a HUD-Certified Housing Counseling
Agency, and a National Intermediary, CNHA fosters greater opportunities
for economic growth and self-sufficiency through three primary
divisions: Community Programs, Kako`o Maui, and Kilohana, a tourism-
focused initiative.
CNHA takes pride in advocating for some of the most pressing issues
facing the Native Hawaiian Community today, including the rising cost
of living, lack of affordable housing, access to economic prosperity,
and disaster resiliency in light of the 2023 Maui wildfires.
Additionally, we are deeply concerned about these issues contributing
to the increasing outmigration of Native Hawaiians from their homeland.
CNHA is honored to provide insight into the needs of the Native
Hawaiian Community and our federal trust responsibility. Mohala i ka
wai ka maka o ka pua--Unfolded by the water are the faces of the
flowers. \1\ Just as flowers thrive where there is water, so do
communities flourish when they have necessary resources and support.
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\1\ Mary Kawena Pukui, `Olelo No`eau: Hawaiian Proverbs & Poetical
Sayings #2178 (1983).
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We respectfully urge the Committee to support equitable funding and
programmatic opportunities for the Native Hawaiian Community; permanent
reauthorization of existing Native Hawaiian legislation; and
development of meaningful consultation policies that ensure Native
Hawaiian voices are heard in federal decision-making.
Overview of the Native Hawaiian Community
Native Hawaiians are the Indigenous people of the Hawaiian Islands
with a unique culture, language, and tradition. Estimates of up to one
million Native Hawaiians built a thriving, complex society capable of
sustainably supporting itself in one of the most remote locations in
the world. Contact with European settlers beginning in 1778 devastated
the Native Hawaiian population due to the introduction of illnesses
such as measles, smallpox, polio, tuberculosis, and venereal diseases.
By 1920, the Native Hawaiian population had dwindled to just under
24,000. \2\ This rapid decline, coupled with a loss of culture,
language, land, and political leadership, pushed Native Hawaiians to
the lowest socioeconomic levels in their homeland. After generations of
revitalization efforts, community resilience, and political advocacy,
the Native Hawaiian Community has been slowly recovering from the
impacts of these travesties. Yet, there is still much work to be done
to overcome past, present, and future struggles.
---------------------------------------------------------------------------
\2\ Sara Kehaulani Goo, ``After 200 years, Native Hawaiians Make a
Comeback'' Pew Research Center. (Apr. 6, 2015), https://
www.pewresearch.org/fact-tank/2015/04/06/native-hawaiianpopulation/.
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Compared to other groups, Native Hawaiians face some of the
greatest disparities. In Hawai`i, Native Hawaiians have the shortest
life expectancy, are the most likely to live below the poverty line,
and experience significantly higher rates of unemployment, impoverished
conditions, and incarceration. \3\ Native Hawaiians are the only ethnic
group in Hawai`i with consistently more people leaving than entering
the islands over the past fifteen years. \4\
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\3\ Noreen Mokuau et al., Challenges and Promises of Health Equity
for Native Hawaiians (2016).
\4\ Shawn Malia Kana`iapuni et al., Ka Huaka`i Native Hawaiian
Education Assessment (2021) https://www.ksbe.edu/ka_huakai/.
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Today, there are over 650,000 Native Hawaiians living across the
globe. The highest concentration of Native Hawaiians is in Hawai`i,
with more than 20 percent of Hawai`i residents identifying as Native
Hawaiian. \5\ The 2020 Census identified that, for the first time, a
majority of Native Hawaiians live outside of Hawai`i. \6\ As shown in
the table below, Nevada, California, Washington State, and Utah all
have large concentrations of Native Hawaiians. \7\
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\5\ America Counts Staff ``Hawaii Added More Than 94,000 People
Since 2010'' U.S. Census Bureau (Aug. 25, 2021) https://www.census.gov/
library/stories/state-by-state/hawaii-population-change-between-census-
decade.html#race-ethnicity.
\6\ Native Hawaiian Research Hui ``New census data confirms more
Native Hawaiians reside on the continent than in Hawai`i'' Office of
Hawaiian Affairs (Sep. 22, 2024) https://www.oha.org/news/new-census-
data-more-native-hawaiians-reside-continent/.
\7\ Brittany Rico, Joyce Key Hahn, and Paul Jacobs ``Chuukese and
Papua New Guinean Populations Fastest Growing Pacific Islander Groups
in 2020'' U.S. Census Bureau (Sep. 21, 2023) https://www.census.gov/
library/stories/2023/09/2020-census-dhc-a-nhpi-population.html.
Selected Counties with Large Populations of Native Hawaiian Residents
------------------------------------------------------------------------
County Number of Native Hawaiians
------------------------------------------------------------------------
Honolulu County, HI 200,455
Hawaii County, HI 59,320
Maui County, HI 39,592
Clark County, NV 23,192
Los Angeles County, CA 15,983
San Diego County, CA 10,965
King County, WA 7,867
Pierce County, WA 6,648
Sacramento County, CA 5,378
Salt Lake County, UT 3,846
------------------------------------------------------------------------
Federal Trust Responsibility for the Native Hawaiian Community
Congress has consistently and expressly acknowledged a special
political and trust relationship with Native Hawaiians based on our
status as the Indigenous, once-sovereign people of Hawai`i. These are
the same trust principles that Congress has recognized is owed to all
Native peoples of the United States. The federal trust relationship
with the Native Hawaiian Community was established through the illegal
annexation of the Kingdom of Hawai`i \8\ and reaffirmed by the 1959
Admission Act. \9\ The federal trust responsibility has been included
in more than 150 legislative measure, including but not limited to:
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\8\ Joint Resolution to Provide for Annexing the Hawaiian Islands
to the United States, H.R.J. Res. 55-51, 55th Cong., 30 Stat. 750
(1898).
\9\ Admission Act of 1959, Pub. L. No. 86-3, 73 Stat. 4.
Hawaiian Homelands Homeownership Act (HHHA) \10\
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\10\ Codified as Title VIII of the Native American Housing and
Self-Determination Act (NAHASDA) (25 U.S.C. 4221 et seq.) (2000). Finds
that ``the United States has a special responsibility for the welfare
of the Native peoples of the United States, including Native
Hawaiians'' and ``under the treatymaking power of the United States,
Congress had the constitutional authority to confirm a treaty between
the United States and the government that represented the Hawaiian
people, and from 1826 until 1893, the United States recognized the
independence of the Kingdom of Hawaii, extended full diplomatic
recognition to the Hawaiian Government, and entered into treaties and
conventions with the Hawaiian monarchs to govern commerce and
navigation in 1826, 1842, 1849, 1875, and 1887.''
Native Hawaiian Health Care Improvement Act (NHHCIA) \11\
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\11\ Native Hawaiian Health Care Improvement Act (42 U.S.C. 11701
et seq.) (1988). Establishes a program to maintain and improve Native
Hawaiian health ``[i]n furtherance of the trust responsibility for the
betterment of the conditions of Native Hawaiians'' and acknowledges
that ``[t]his historical and unique legal relationship has been
consistently recognized and affirmed by the Congress through the
enactment of Federal laws which extend to the Hawaiian people the same
rights and privileges accorded to American Indian, Alaska Native,
Eskimo, and Aleut communities.''
Native Hawaiian Education Act (NHEA) \12\
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\12\ Native Hawaiian Education Act (20 U.S.C. 7511-7517) (1988).
Recognizes that ``Congress does not extend services to Native Hawaiians
because of their race, but because of their unique status as the
indigenous people of a once sovereign nation as to whom the United
States has established a trust relationship'' and ``the political
status of Native Hawaiians is comparable to that of American Indians
and Alaska Natives.''
Native American Graves Protection and Repatriation Act
(NAGPRA) \13\
---------------------------------------------------------------------------
\13\ Native American Graves Protection and Repatriation Act (25
U.S.C. 3001 et seq.).
National Historic Preservation Act (NHPA) \14\
---------------------------------------------------------------------------
\14\ National Historic Preservation Act (16 U.S.C. 470 et seq.).
Native American Languages Act (NALA) \15\
---------------------------------------------------------------------------
\15\ Native American Languages Act (25 U.S.C. 2901 et seq.).
Native American Tourism and Improving Visitor Experience
(NATIVE) Act \16\
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\16\ Native American Tourism and Improving Visitor Experience
(NATIVE) Act (25 U.S.C. 4351 et seq.).
Congress determines which Native groups are receive a formal trust
responsibility, while the Executive Branch administer the enacted
programs and policies to fulfill this obligation. American Indians and
Alaska Natives have tribal governments to help the federal government
to administer these programs. In lieu of a central Native Hawaiian
government, the federal government works with Native Hawaiian
Organizations and the Native Hawaiian Community.
Congress has defined the term ``Native Hawaiian'' in multiple
statutes. The Native American Housing Assistance and Self-Determination
Act (NAHASDA) defines Native Hawaiian as ``any individual who is (A) a
citizen of the United States; and (B) a descendant of the aboriginal
people, who, prior to 1778, occupied and exercised sovereignty in the
area that currently constitutes the State of Hawaii, as evidenced by
(i) genealogical records; (ii) verification by kupuna (elders) or
kama`aina (long-term community residents); or (iii) birth records of
the State of Hawaii.'' \17\
---------------------------------------------------------------------------
\17\ 25 U.S.C. 4221(9)
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Native Hawaiian Organizations often refers to any organization that
serves and represents the interests of the Native Hawaiian Community;
has a primary and stated purpose for the provision of service to the
NHC; and has expertise in Native Hawaiian affairs. Native Hawaiian
Community often refers to the distinct Native Hawaiian indigenous
political community that Congress has recognized and for which Congress
has implemented a special political and trust relationship.
Importantly, none of these definitions have a geographic restriction to
the State of Hawai`i. Federal policies must take into account that the
Native Hawaiian Community exists throughout the country and Native
Hawaiians live in every state.
Federal Priorities that Advance the Cultural, Economic, and Political
Well-Being of the Native Hawaiian Community
Consistent with the special and political trust relationship, the
federal government owes a duty of care to the Native Hawaiian
Community. As detailed below, the Council for Native Hawaiian
Advancement respectfully urges the Committee to support equitable
funding and programmatic opportunities for the Native Hawaiian
Community; permanent reauthorization of existing Native Hawaiian
legislation; and development of meaningful consultation policies that
ensure Native Hawaiian voices are heard in federal decisionmaking.
Equitable Funding and Programmatic Opportunities for the Native
Hawaiian
Community
Congress has authorized a patchwork of programs to deliver and
coordinate services to Native Hawaiian communities. However, our
experience is that when Native Hawaiians are not specifically
identified and funding is not set aside, the needs of our communities
are more likely to be overlooked or excluded. We urge this Committee to
strengthen and expand legislation to achieve parity with other Native
American groups and further support the advancement of cultural,
economic, and political well-being of Native Hawaiians. Native
Hawaiian-serving organizations should be empowered and utilized as an
effective service-delivery system to the extent possible. If certain
funding must ultimately pass through State and County agencies, the
trust responsibility to Native Hawaiians should be specifically
identified and acknowledged.
One example of existing equitable funding is the Native American
Languages Act (NALA). Language revitalization is a cornerstone to
cultural perpetuation for Indigenous communities. NALA established
federal policy in support of the survival of, and use as the medium of
education, all Native American languages including `Olelo Hawai`i.
Through Hawaiian language funding, programs like `Aha Punana Leo have
been able to successfully provide immersion programs growing the next
generation of fluent `Olelo Hawai`i speakers. We urge this Committee to
increase funding for Native languages and enable Native American
language medium pathways in all federally supported educational
programs.
One opportunity for increased funding equity is programs that
affect the economic well-being of Native Hawaiians. There are several
economic development and access to capital programs that serve Native
Hawaiians, including the Department of the Treasury, Native American
Community Development Financial Institutions, Minority Depository
Institutions, and the Native Hawaiian Revolving Loan Fund. The Native
Hawaiian Community has also benefitted from the Treasury's Emergency
Rental Assistance, Homeowner Assistance Fund, Capital Projects Fund and
Small Business Credit Initiative, Emergency Capital Investment Program,
Rapid Response Program, and Native American CDFI Assistance Program. We
urge this Committee to support expanded funding for these critical
initiatives integral to improving economic opportunities for Native
Hawaiians.
Another opportunity for greater programmatic equity is the
inclusion of Native Hawaiians in existing protections for Indigenous
women and girls. Native Hawaiian women and girls experience violence at
disproportionate rates. \18\ Hawai`i has the eighth highest rate of
missing persons per capita, with the reported cases of missing children
being 77 percent female and 84 percent Native Hawaiian. \19\ However,
Native Hawaiians have largely been left out of the federal policy
discourse and resource allocation to address violence against
Indigenous communities. 2022 was the first year Native Hawaiians were
formally recognized by a U.S. President as belonging to Indigenous
populations disproportionately impacted by interpersonal and systemic
violence that leads to Native women and girls going missing and being
murdered. We urge the Committee to include Native Hawaiians in federal
policy initiatives, funding, and legislation aimed at responding to the
crisis of missing and murdered Indigenous women and girls and violence
against women.
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\18\ Missing and Murdered Native Hawaiian Women and Girls Task
Force Report. https://www.oha.org/wp-content/uploads/MMNHWG-
Report_Web.pdf.
\19\ Id.
---------------------------------------------------------------------------
Finally, it is critical that Native Hawaiians are included in data
disaggregation efforts throughout all federal government initiatives.
Native Hawaiians are often grouped alongside Asian Americans and Other
Pacific Islanders in a way that obfuscates relevant Native Hawaiian
statistics. This is also true when a catch-all multiracial category is
used, as Native Hawaiians are more likely than other groups to identify
with an additional race or ethnicity group. \20\ We urge this Committee
to promote data disaggregation efforts across federal race and
ethnicity standards.
---------------------------------------------------------------------------
\20\ Joshua Quint et al., ``The Hawai'i NHPI Data Disaggregation
Imperative: Preventing Data Genocide Through Statewide Race and
Ethnicity Standards'' Hawaii Journal of Health & Social Welfare (Oct.
2023). https://pubmed.ncbi.nlm.nih.gov/37901675/.
---------------------------------------------------------------------------
Permanent Authorization of Existing Native Hawaiian Legislation
In addition to the inclusion on Native Hawaiians in larger bills,
Congress has also utilized programs specific to the Native Hawaiian
Community through federally funded Native Hawaiian-serving
organizations, such as the Office of Hawaiian Affairs, the Department
of Hawaiian Home Lands,
Papa Ola Lokahi, the Native Hawaiian Health Care Systems, and the
Native Hawaiian Education Council to deliver and coordinate services to
Native Hawaiian communities. Over the past several decades, the HHA,
the NHHCIA, and the NHEA has provided resources to the Native Hawaiian
community through a variety of programs and services. We urge this
Committee to permanently reauthorize all of these Acts.
Firstly, the Department of Hawaiian Home Lands (DHHL) is a state
agency created by federal statute with the mission to develop and
deliver land and housing to Native Hawaiians. In 2000, Congress enacted
the Hawaiian Homelands Homeownership Act (HHHA) in 2000, establishing
the Native Hawaiian Housing Block Grant program and the Section 184A
Loan Guarantees for Native Hawaiian Housing through NAHASDA. These
programs deliver funds for new construction, rehabilitation,
infrastructure, and various support services. DHHL has also been able
to use these funds for emergency rental assistance for eligible Native
Hawaiians; rental subsidies for lower-income elderly, rehabilitation of
homes primarily for elderly or disabled residents; homeownership
opportunities for lower-income working families; and homeownership and
rental counseling to address barriers experienced by Native Hawaiians.
These is a growing housing crisis in Hawai`i. The average price for
a single-family home in Hawai`i is $843,185. \21\ In 2022, home buyers
needed to earn nearly 180 percent of the state's median income (or
$150,000 per year) to afford the median home. \22\ Of the 28,155 Native
Hawaiians in rental united in Hawai`i, 54.9 percent of them are cost-
burdened and paying more than 30 percent of their income to rent. On
O`ahu, 42 percent of individuals included in the annual Point-in-Time
count of unsheltered homeless were Native Hawaiians.
---------------------------------------------------------------------------
\21\ Hawaii Housing Market, Zillow. https://www.zillow.com/home-
values/18/hi/.
\22\ Stewart Yerton, ``It's Actually More Expensive To Buy A Home
In Hawaii These Days Than You Thought'' Honolulu Civil Beat (June 28,
2023) https://www.civilbeat.org/2023/06/its-actually-more-expensive-to-
buy-a-home-in-hawaii-these-days-than-you-thought/.
---------------------------------------------------------------------------
The housing crisis is also true for many DHHL beneficiaries.
According to DHHL's recently completed 2020 Beneficiary Study, 56.8
percent of the nearly 10,000 lessees or beneficiary families who
received homestead awards are currently below the 80 percent HUD AMI.
Of applicants or beneficiary families waiting to receive a homestead
award, 51 percent of the over 28,000 applicants are below the 80
percent HUD AMI, an increase from 45 percent in 2014. In addition,
about 16 percent of applicants below the HUD's 80 percent of Area
Median Income (AMI). reported that they receive Section 8 and 7 percent
reported that they received rental assistance. The impacts of the
pandemic are expected to further exacerbate these needs. We urge this
Committee to support permanent authorization, increased funding for,
and expansion of the NHHBG and 184A Loan Guarantee programs.
Secondly, similar to our Indigenous relatives on the continent,
these are significant health disparities amount Native Hawaiian
populations. In response to these disparities, Congress enacted the
Native Hawaiian Health Care Improvement Act (NHHCIA) in 1988. The
NHHCIA established the Native Hawaiian Health Care program, which funds
the Native Hawaiian Health Care Systems administered by Papa Ola
Lokahi. The Systems provide primary health care, behavioral health, and
dental services on Kaua`i, O`ahu, Maui, Moloka`i, and Hawai`i, as well
as health education, health-related transportation, and other services.
The NHHCIA also established the Native Hawaiian Health Scholarship
Program, which has awarded more than 300 scholarships to Native
Hawaiians pursuing careers in designated health care professions,
supported culturally appropriate training, placed scholars in
underserved Native Hawaiian communities.
There is also an urgent need for several amendments to the NHHCIA.
This includes:
Removing the matching requirements applied to the Systems
for parity with other Native health care providers;
Making the NHHCSs eligible for 100 percent of the Federal
Medial Assistance Percentage (FMAP) as well as the Prospective
Payment System (PPS) reimbursement rate;
Expanding Federal Tort Claims Act to Papa Ola Lokahi, the
Systems, and their employees in parity with other Native health
care providers;
Allowing federal program funding to be used to collect and
analyze health and program data which currently falls under the
ten percent administrative cost cap for the program;
Allowing the Systems to be a specific eligibility group for
supplemental federal funding streams; and
Providing a tax exemption for the Native Hawaiian Health
Scholarship Program.
We urge the Committee to support permanent reauthorization of,
increased funding to, and technical amendments to the NHHCIA to address
avoidable inequalities and health care disparities.
Finally, the Native Hawaiian Education Act has been monumental in
providing resources to a collective of educational organizations
supporting the unique needs of Native Hawaiian students. The program
has helped address gaps in funding that state and private sources have
historically been unable to adequately meet. A 2021 profile analysis of
NHEP grantees from 2010 through 2018 cohorts reported data from grantee
programs and services to Native Hawaiian communities are student,
parent, and teacher focused. In 2017 and 2018, NHEP grants served
98,996 participants (including 77,808 students, 18,429 parents, and
2,759 teachers). 100 percent of grantee programs have been targeting
Native Hawaiians and 42 percent target low-income populations. NHEA-
funded programs have been agile and innovative to provide a continuum
of services for students and their families despite receiving little to
no supplemental funding from the Coronavirus Aid, Relief, and Economic
Security Act via the State.
There is also an urgent need for several amendments to the NHEA.
This includes:
Clarification that the 5 percent limitation in section
6205(b) of the Elementary and Secondary Education Act on the
use of funds for administrative purposes shall apply only to
direct administrative costs.
Authorization to use NHEA funds for construction,
renovation, and modernization of any public elementary school,
secondary school, or structure related to a public elementary
school or secondary school that serves a predominantly Native
Hawaiian student body.
Priority funding recommendations to enable the U.S.
Department of Education to provide grant funding aligned with
the needs and priorities for improving educational outcomes for
Native Hawaiians by: (a.) determining funding priorities for
each grant competition based on the data-driven priority
recommendations submitted to the Department by the Native
Hawaiian Education Council through its annual report; (b.)
identifying educational needs that remain unmet through a
transparent, evidence-based process; and c. developing a peer
review process for each grant competition, including
identifying reviewer criteria and culturally-appropriate
training, and developing an application scoring rubric.
Fulfillment of these requests would enable Native Hawaiian
Education Program (NHEP) recipients to further bolster Native
Hawaiian education.
We urge the Committee to support permanent reauthorization of,
increased funding to, and technical amendments to the NHEA.
Development of Meaningful Consultation Policies
Executive Order 13175 outlines the underlying principles for
formulating or implementing policies with implications for a native
community. \23\ In application to the Native Hawaiian Community, this
policy recognizes that the United States (1) respects and furthers its
special political and trust relationship with the Native Hawaiian
Community; (2) must continue to work with the Native Hawaiian Community
on a government-to-sovereign basis to address concerns related to self-
governance, Native Hawaiian trust resources, and other Native Hawaiian
rights; and (3) recognizes the right of the Native Hawaiian Community
to self-government and supports Native Hawaiian sovereignty and self-
determination. \24\
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\23\ Executive Order 13175, Consultation and Coordination with
Indian Tribal Governments, Nov. 6, 2000.
\24\ ``Requirement to Consult with the Native Hawaiian Community''
U.S. Department of the Interior Office of Native Hawaiian Relations,
https://www.doi.gov/hawaiian/requirement-consult-native-hawaiian-
community.
---------------------------------------------------------------------------
Although the Native Hawaiian Community has not yet reorganized a
central government, Congress' thoughtful inclusion of Native Hawaiians
in legislation like NAGPRA and NHPA demonstrates that Native Hawaiians
can be effectively included in the consultation process. However,
Native Hawaiians are still largely omitted from consultation policies
and processes across many federal agencies. While it is important for
all agencies to develop consultation policies, we want to highlight the
importance of meaningful dialogue with the Department of Defense.
The U.S. military is a prominent part of Hawaiian history and daily
life. Approximately 46,500 acres of land across the State of Hawai`i is
being used by the U.S. military, including Army, Navy, and Air Force
bases and installations, with the largest being the 23,000 acres of
Pohakuloa Training Area on Hawai`i Island. Numerous events have made
the Native Hawaiian Community dubious of the U.S. military's role as
caretakers and stewards of the land they occupy. In recent memory, the
2004 Kaho`olawe UXO Clearance Project left 25 percent of the island
with unexploded ordinances and unescorted access to these areas remains
unsafe; the U.S. Navy Red Hill Bulk Fuel Tanks stored up to 250 million
gallons of fuel and documented multiple leaks in O`ahu's major aquifer;
and U.S. Space Force announced an estimated 700 gallons of diesel fuel
spilled at the summit of Haleakala. Multiple military land leases will
be expiring this decade, providing the opportunity to renegotiate and
improve the relationship between the Native Hawaiian Community and the
U.S. Military. Given the significant historical and ongoing presence of
military operations and activities in Hawai`i, we urge this Committee
to support meaningful consultation between the Native Hawaiian
Community and the U.S. military for any proposed undertakings that
would impact the land or the people. This includes but is not limited
to further study and remediation, oversight authority to ensure
accountability and consultation, and increased funding to support
clean-up efforts.
Finally, we would like to emphasize the importance of broad
inclusion for the Native Hawaiian Community. Native Hawaiian migration
to the continental United States has been happening for over two
hundred years. Some Native Hawaiians were documented in the Pacific
Northwest as early as 1787. \25\ Another group of Native Hawaiians
settled in a community near Salt Lake City in the 1880s called Iosepa.
\26\ The federal trust responsibility extends throughout the country.
Given the increasing Native Hawaiian population throughout the United
States, it is important that neither consultation policies nor
definitions of Native Hawaiian Community are geographically bound to
Hawai`i. We urge the Committee to support consultation policies
inclusive of all Native Hawaiians.
---------------------------------------------------------------------------
\25\ Jean Barman and Bruce McIntyre Watson, Leaving Paradise:
Indigenous Hawaiians in the Pacific Northwest, 1787-1898 (December
2021).
\26\ Benjamin C. Pykles, ``Iosepa: Utah's Pacific Islander
Pioneers'' Utah Historical Society. https://history.utah.gov/iosepa-
utahs-pacific-islander-pioneers/.
---------------------------------------------------------------------------
The Council for Native Hawaiian Advancement appreciates the
opportunity to present priorities for the Native Hawaiian Community for
the 119th Congress to the Senate Committee on Indian Affairs. We look
forward to working with the Committee and its members during this
session to advance the interests of the Native peoples in accordance
with the federal trust responsibility.
The Chairman. Mahalo, Mr. Lewis, thank you. And thank you
all for your comments this afternoon.
We will now turn to questions from the respective members
of the Committee. You have all reminded us of the trust
responsibility that the Federal Government owes to our Native
peoples. Regardless of where you live, that trust
responsibility is something that we hold. And it is with regard
to economic opportunity, education, health care, housing, as we
have heard here today.
So when we think about the priorities going into this new
Congress and areas that we can focus, I think you have given us
a lot to consider.
I want to start my questions here this afternoon directed
to you, Chief Bill, on the health aspects of this
responsibility. You have mentioned in your comments the
alarmingly high maternal mortality rates that we see for
indigenous women. I find the statistics just really shocking.
Pregnancy-related deaths at a rate more than three times that
of white women, American Indian and Alaska Native infants born
prematurely, underweight, twice as likely to die before the age
of one.
We know that some of these statistics are related to access
to health care and to socio-economic challenges. But you
suggested in your comments that there are some recommendations
that have been outlined in a couple of different reports, one
of which is the Native Children's Commission. This Committee is
going to be working to build that out.
Can you expand a little bit more on any specific
recommendations that you would like to see the Committee
address when it comes to maternal mortality and infant health?
Mr. Smith. Thank you for the question. I have five of them
here, it says protect tribal sovereignty and self-
determination, emphasize the importance of tribal nation's
right to self-govern as a function of our health equity. We
know how to take care of our own. We proved that in Alaska with
COVID, we took care of the whole village instead of just taking
care of specific people.
Invest in equity resources and funding, advocate for
significant investment in tribal communities to improve
outcomes for the children and prenatal to age three. The other
part of that program was address trauma and strengthen
connections to culture. Focus on the healing from trauma and
building resiliency through culture connections.
As you know, there is all kinds of trauma starting with the
boarding schools and even in isolated areas, our lower villages
over there. It is far away from all kinds of supermarkets,
playgrounds, and everything else that is needed to make sure
that the kids can have a place to grow up after they do turn
three.
So, enhance access to quality health services, ensure that
Alaska Native and American Indian families have access to
competent, high quality health services. I put this to, when I
was born in Alaska and went to the Indian Health Service's
hospital on Fourth Avenue, Fourth and Third, I was scared to
death to go there.
This new hospital we have in Anchorage, the Medical Center,
welcomes you and everything else. But it was like a death
sentence to go into that other one, and for the dental work, as
you were growing up as a kid. So I can just imagine, I never
recognized the one through three, because I don't remember that
part. But Mom does.
[Laughter.]
Mr. Smith. Support also an intergenerational approach,
promote policies and consider the [indiscernible] and
intergenerational needs from Alaska Natives and American
Indians.
All these recommendations aim to create a path forward
toward a healthy outcome for American Indians and Alaska Native
infants, the toddlers, and for their mothers.
The Chairman. I think what we want to do here on the
Committee is look at the various reports that are out there. It
is one thing to task a commission and have them put together a
great report. It is another thing to actually have us implement
on that. I think we want to do that.
I want to direct a couple of questions to you, Mr. Butler,
with NAFOA. I appreciate that you have given us some concrete
suggestions here to look at from the financing perspective, New
Market Tax Credits, tribal low income tax credits, focusing on
the Indian Loan Guarantee Program, some real specifics here.
You have also mentioned priority of making Treasury's
Office of Tribal and Native Affairs permanent and continuing
the Tribal Treasury Advisory Committee. That is good to hear,
because oftentimes, we don't hear good reports coming out of
some of these tribal liaisons that we have established within
agencies. What you are telling me is that this is one where we
are seeing good outcomes and it is working and it needs to be
continued. Is that a fair summation?
Mr. Butler. Absolutely. Absolutely, Chair. And selfishly,
one of the many hats I wear is actually as a member of the
Treasury Tribal Advisory Committee as well. So I saw first-hand
in a very short period of time how the impact of having tribal
leaders engaging directly with leadership in a specific
department, in this case Treasury, leads to great results.
The rulings that were put out on GWE and all these wholly
tribally chartered corporations is monumental. For the tribally
chartered corporations, that ruling was 30 years in the making.
Having the Office of Native Affairs there as well as the TTAC
there allowed us to progress that, and constantly be in the ear
of Treasury and IRS, working hand in hand collaboratively to
solve those issues that tribes have been waiting on for
decades, quite frankly.
So it is a great example of success in the Department of
Treasury, and one that should be replicated in other
departments as well.
The Chairman. Good. I appreciate that.
Let's go to the Vice Chair.
Senator Schatz. Thank you, Chair, thank all of you for your
testimony.
Mr. Lewis, thank you for your work. Can you help me to
understand, help the Committee to understand what are the
barriers to success? Any needed changes or improved
flexibilities that could help the Council for Native Hawaiian
Advancement to access more Federal dollars?
Mr. Lewis. Aloha, Senator, and thanks for the question.
I think the immediate challenge is the uncertainty that
currently exists. We have active grants and awards from the
Federal Government, some which we can't even draw down on. And
what that does is it creates a lot of instability in our
organization, not knowing the future of some of the programs
that are actively implementing.
So that is a current challenge for us, there is a lot of
uncertainty. Also our ability to plan going forward and how we
can address some of the long-term needs of our people that we
have been working toward for a while. I would say we of course
are looking at how we can diversify ourselves. But the Federal
Government has been an important part in how we develop
programs and work collaboratively with the government to
support the needs of our people.
Senator Schatz. Thank you.
Just one thought for everybody watching. I understand the
principle here that when you are dealing with Native peoples
you are dealing in treaty and trust and statutory
responsibilities, and that you are not dealing with particular
ethnic groups. So this sort of dragnet of calling everything
DEI should not apply. I get that. I agree with that.
But we need a little solidarity too, all of us together, to
say that if what someone is talking about when they say DEI is
the consultant coming in and showing a PowerPoint and dividing
up the workplace by race and developing quotas and refereeing
the kinds of words that people are trying to use, that is one
thing.
But understand that when they say DEI, they are rolling
back basic protections for women, for Native people, for Black
people, for Asians, for Latinos, for immigrants. So when they
go, when these kids, frankly, go into agencies and literally
CTRL-F to find words like ``gender'' or ``climate'' or
``equity'' or ``inclusion,'' they are sweeping up recruitment
for the Navy, they are sweeping up recruitment for FBI
officers. They are disallowing NIH research into pregnant
women.
So I understand the need, if you are in charge of an
organization, if you represent a tribal community, the need to
just survive this moment. But we need to understand, what is
happening right now is unlawful. And it is not our job in a
democracy to petition the king for mercy. It is our job in a
democracy to stand up and say, this is impermissible under the
law, not, I know this is impermissible, but would you please
make an exception for me? That was not a question.
[Applause.]
Senator Schatz. Mr. Bird, tell me about the impact that the
executive order on school choice for BIE and tribally
controlled BIE schools is impacting the work that you do and
the organization that you oversee?
Mr. Bird. Sure. School choice, tribal nations believe in
school choice and local control of their schools. However,
tribally controlled schools are our choice, and we feel that
school students learn best when the tribe has control of those
schools, and are determining what is being taught. Our
curriculum includes tribal values from the community. They
include curriculum that is related to that particular tribe as
well as Natives in other tribal communities.
We are concerned about the possibility that a school choice
model that relates to schools being under BIA control, that
would take away funding from BIE controlled schools. So any
school choice model for Native students must be made with
tribal nations at the table helping to assist in making those
determinations.
I know looking at my father's tribe, the Sisseton Wahpeton
Oyate, they have a tribally controlled school, Tiospa Zina. It
is located in an area very close to the heart of the tribe, it
is close to senior centers, close to tribal administration,
close to the pow-wow grounds. So it has all those components
that make it more of a success, because it is so centered in
that community, and it has the parents' involvement, it has the
seniors' involvement, it has language providers in that school.
So the curriculum is very much focused on the needs of the
students in that school system. They wouldn't have that same
opportunity at the public high school in Sisseton, where there
are no or very limited Indian teachers in that community, in
that school system. It wouldn't have the same types of
encouragement or pride as being an Indian student in that
community.
So the school choice being a tribally controlled school is
so important because of what it brings to the student and to
the tribal member and the involvement of those within the
community.
Senator Schatz. Thank you.
The Chairman. Senator Smith?
Senator Smith. Thank you so much, Chair Murkowski, and
thanks to all of you for being here.
I want to just say that Vice Chair Schatz, I appreciate
your comments. I am thinking about how earlier today I was
addressing an issue with the Catholic University in Minneapolis
that had a grant to train special education teachers frozen,
because it was all caught up in this DEI nonsense.
So that is going to hurt the ability of my State to respond
to the deep shortage of special education teachers. It is going
to hurt kids, it is going to hurt Black kids, it is going to
hurt Brown kids, it is going to hurt White kids. It hurts
everybody. So I appreciate your comments.
I want to touch on first something that I know is really
important and certainly in the tribal nations in Minnesota and
I believe around the Country, which is the impact of this
devastating opioid and fentanyl crisis. Certainly, it is an
issue all over the Country.
But I think it has a particularly devastating impact on
many tribal nations, because of the ways in which tribal
members are targeted for these crimes. I see this as both a
public health crisis and also as a public safety crisis.
President Macarro, I am going to ask you first about this.
Last year, Senator Daines and I partnered to introduce a bill
called the PROTECT Act, which would basically expand the
special tribal criminal jurisdiction which has been so
successful with issues around trafficking, expand that special
criminal jurisdiction to include drug crimes and gun crimes
that are committed as part of drug crimes. This would get at
the challenge that so many tribes have in addressing when non-
Native people come onto tribal land and commit drug and gun
crimes.
President Maccaro, would you talk about this a bit and give
me your perspective on whether something like this would
address some of those jurisdictional challenges you were
talking about in your testimony?
Mr. Macarro. Thank you for the question. I appreciate the
softball. Yes, it is something, tribes need jurisdiction back.
The ability to not only arrest, detain, but to prosecute those
who commit crimes on our reservation lands and our reservation
communities is going to be important going forward, to be able
not only to stem the flow of drugs but to create safe
communities. The status quo right now is really unacceptable is
a circumstance where drug dealers, they know what the laws are,
they know they can't be prosecuted, they know they will get
away with the crime.
Senator Smith. It creates a revolving door.
Mr. Macarro. It is a revolving door. There is a
circumstance where, if they will come on, maybe the tribe is
lucky enough to have a police force that they will get arrested
and they might even be detained for 72 hours. But then they
have to be released at 72 hours and one minute. They take them
to the county line and if the tribal police are lucky, there
will be county police or county sheriffs to accept the
criminals, but maybe not, and they just go away and come back
within hours sometimes, sometimes within a day, and do it all
over again. And it doesn't end.
It is a scourge. The solution is ultimately the full fix
for Oliphant. But I know we are taking baby steps, incremental
steps toward that, getting to that goal. But the sooner we get
there, I think the better things will be in the long term.
Let me add this, though. If you were to wave a wand right
now and Congress would, in a bipartisan fashion, create that
kind of a jurisdictional fix, the condition of not having
enough funding, creating a fix without the funding is also not
going to help.
Senator Smith. Right.
Mr. Macarro. So both parts need to happen.
Senator Smith. I appreciate that. I think that is a really
great point. It is a tool that if you don't have the funding to
use the tool, then the tool is not going to be that valuable.
As I said, and I think all of us do see, this is both a
public health crisis as well as a public safety crisis. So
Chair Smith, I want to ask you, in your testimony, you talked
about the Special Diabetes Program as a model for bringing both
funding and autonomy to tribes so that tribal knowledge and
medicine and healing can be brought together to solve issues
around diabetes. The same model, I believe, could also be used
really effectively to address behavioral health issues.
I am wondering if you could comment on that. I am really
grateful to NIHB for your assistance in moving my Native
Behavioral Health Access Improvement Act, that is a mouthful,
but what it would do is take that learning from the Special
Diabetes Program and apply it to behavioral health.
Mr. Smith. Thank you for that question. My answer would be
to you, education of our health workers so we can help the
person that is stuck on these drugs to get them off and get
them in a safe place. But that is not going to solve it until
they do get tougher on the crimes and put the perpetrators
away. You might not like this, but I think they should take
their own medicine.
I know when I was growing up in Alaska, in the old days, we
had what you called blue chip. When you wanted to blue chip
somebody that was being not correct in your community, you sent
them to Seattle, which means you put them back on the boat. And
that just puts the problems in Seattle.
The problem is the courts just let them get away with it.
We need to stop that.
But on the health part of that, and that is the part that
the National Indian Health Board can help with, with education
and how to recover from a fentanyl overdose. Because a lot of
them don't. Once the brain gets scrambled, sometimes you just
can't unscramble it. Preventive maintenance, education,
everything else is what the health part of it is.
The other part of it is like working with the National
Congress of American Indians where we can stress to be tougher
on the criminals, quit giving them the revolving door, quit
letting them in and out, and knowing that they can get away
with it. Even in my State of Alaska, they are really happy they
found a bunch of fentanyl coming into Alaska. How much didn't
they find? How much came in that they didn't? Because it is
coming in every which way. We just need to figure out how to
stop it, enforcement.
The education part is trying to educate the young ones to
just stay away and the ones that are hooked how to get off. One
thing is teaching grandmas and grandpas and parents how to save
that person with Narcan or whatever it takes.
Senator Smith. Thank you. I know I am way over time. Thank
you very much, Chair Murkowski. Thank you so much to all of you
for your testimony.
The Chairman. Thank you, Senator Smith.
STATEMENT OF HON. CATHERINE CORTEZ MASTO,
U.S. SENATOR FROM NEVADA
Senator Cortez Masto. Thank you, Madam Chair. And thank you
all for being here and for the continued work on all of these
issues that we are constantly trying to address here. It almost
feels like Groundhog Day, because we are back saying the same
things.
But let me just say this. Because of, and I hope you take
this away, because of your work and advocacy, there is
legislation and there is bipartisan legislation. This is going
to be a priority for us in this Congress to get it passed, as
you all know. And we are going to continue to need your
advocacy.
So I appreciate your being here, because there are many of
us working together to get it done.
And let me start with this, the BADGES Act. My colleague,
Senator Hoeven, and I have reintroduced that again. It is so
important for the very reasons, President Macarro, and everyone
else that I am hearing from about the law enforcement piece and
the underfunding of law enforcement in Indian Country.
I also know that for our BIA officers in Indian Country, it
is hard to not only recruit them but retain them. As part of
the challenge that we have in the BADGES Act, we will work to
address that. So it is good to see you again, President
Macarro, and thank you for your work on the BADGES Act.
I do want to touch on one thing, because we always talk
about BIA officers, we talk about law enforcement. We forget
tribal courts. Tribal courts are just as important. And there
are challenges in our tribal courts right now. Let me just give
you an example, and this is what I hear in my State.
Tribal courts and communities are often denied access to
funding and law enforcement tools that their non-tribal
counterparts regularly use. For example, I have introduced the
Tribal Access to Electronic Evidence Act. This would give our
tribal courts the same access as their non-tribal counterparts
to electronic evidence for criminal investigations.
It sounds so simple, but it is important for us to make
sure that our tribal courts have access to all the information
that our non-tribal courts do if we are going to hold these
predators and people in our communities accountable.
So President Macarro, let me ask you this. Can you talk a
little bit about the importance of tribal courts in Indian
Country? But also as you talk about it, can you address the
lack of resources for tribal courts and the impact on public
safety that provides if we don't have resources for tribal
courts?
Mr. Macarro. I wish we had enough time to go into depth on
that question. Can you focus it just a bit? It is broad-
ranging.
Senator Cortez Masto. Let me ask you this. Because at the
end of the day, for our tribal courts, there are a lot of
challenges there. But if we were to forget the jurisdictional
issues, because we need a challenge, we need to address those
jurisdictional issues, but if we were to give tribal courts
access to the same information, electronic information, access
to maybe national Federal data bases that non-tribal courts
have, how would that improve public safety?
Mr. Macarro. It would improve it tremendously. There isn't
necessarily a problem or an issue with tribal courts having
capacity or competence or things like that. We know that from
the daily work that tribal courts do throughout Indian Country.
There are problems, I think, with outside courts and
entities having, I think the term is comity, accepting as valid
the work that tribal courts do. That attitude, I know, is still
there. I know it is still there in Indian child welfare work
and also other subject matter arenas.
It feels like that would be helpful in moving the ball
considerably. In the way that, with law enforcement, having
access to data bases, for tribal law enforcement agencies to
have access to NCIC for officers in the field and other data
bases like that, so that the quality of the work going on, for
the people doing the actual work, meets those standards, and
there is no question about it.
Senator Cortez Masto. I appreciate that. Let me just
highlight this, because this is just one piece of it, right?
You are always having to come to us to try and figure out even
what crimes tribal courts can go after and hold people
accountable for. This is crazy in the sense that if we are
going to recognize that sovereignty and give tribal courts the
authority that they need to go after and hold individuals
accountable, we shouldn't hamstring them. It is not just a lack
of resources; it is actually some areas where you need access
to information that you are not getting that other courts are
getting that are non-tribal.
Mr. Macarro. Absolutely. Can I just add one more element to
this? One of the reasons why I said this goes a lot deeper, I
think there is a missing infrastructure piece to the question
you are asking. The infrastructure that is needed within the
Department of Justice, there is no bona fide tribal desk, there
is no place of a clearinghouse of all tribal issues and there
should be and there needs to be.
This is not to discount the tremendous work that those who
are doing Native American work in the Department of Justice are
doing. But there aren't enough, for instance, there aren't
enough attorneys to handle tribal work within the Department of
Justice. So I think there needs to be ultimately some
restructuring so there can be a focus on this. Then all things
tribal, all things Indian Country could flow through that desk.
For a long time, it just has seemed to be more ad hoc than
truly structural and grounded. In all things, tribal
sovereignty.
Senator Cortez Masto. Thank you. I know I am over my time.
I want to thank you all again for your comments. President
Butler, thank you for highlighting the Tax Parity Act, the
importance of it. That act and that legislation, again, was
driven by all of you. What I was hearing, what we were hearing,
the chairwoman is working with me on that as well. She
understands the issues that are important. I think this is
another opportunity for us to move the ball forward here and
get something done.
Thank you again for all of your advocacy.
The Chairman. Thank you, Senator Cortez Masto.
A lot of good discussion here about everything from housing
to how we can move out on economic development. Obviously,
education, health care, drugs, public safety, all very key.
When we think about tribal self-determination and what that
really means, there are so many opportunities for us,
particularly within 638, with compacting. There is a big
efficiency effort going on by some folks outside this building,
you may have noticed it. I can't think of a greater
demonstration of empowerment of our tribes, of the people on
the ground, than how we are able to build things out or
facilitate efforts through compacting; 638 holds such promise
for us.
We have a measure that I have talked a lot about when it
comes to forest management. When you think about those who are
closest to the land, those who we have a real appreciation of
understanding when you have low rains and low snow pack, you
are going to have a greater propensity for fire.
How do we handle this, how do we address it? Those who are
literally on the ground who are the stewards of these areas
know better than anyone else. So how can we really work to do
more in this area is something that I am going to challenge us
as a Committee to work on.
Mr. Bird, I know that USDA soliciting feedback from tribes
right now regarding the child nutrition programs, the tribal
pilot projects. I understand that there either was or is a
listening session later today at the NIEA conference to allow
tribe and tribal organizations to administer nutrition
programs, whether it is the school lunch program, the school
breakfast program, summer food services, the child and adult
care food program.
Can you share with me how that is coming? Have we
identified barriers to standing up some of these programs? I
think about specifically like the summer food programs, where
you don't have the kids in the school necessarily, and they are
just going to disperse over.
But how we can implement in a more efficient, a more
effective way that gives the value, if you will, to the
children in terms of nutritious opportunities for food during
the summer or during the school year, we can do more on this.
Have we identified the barriers? What do we need to do?
Mr. Bird. It is not so much identifying the barriers, well,
it is about giving the tribes control of the whole institution.
They already have control of the school itself, but not the
lunch component that is the mid-day of the students' existence
there at school.
I was talking to a tribal member back in Sisseton, and he
said that one of the things they have is a bison herd. Their
goal is, or they are planning to process the meat. So they have
a meat processing plant that they have implemented, that they
have purchased. Their goal is to purchase the meat from their
bison herd through the meat processing and then use that to
feed the kids at their school.
It becomes basically a whole tribal involvement in the
school as well as with the students. They are going back to
eating traditional foods. That is what control of the lunch
program will give those tribes the ability to do, so they can
incorporate more traditional foods, whether it is bison or
blueberries or other things that are grown in the community.
Basically, the whole process of taking back some of the
traditional ways of the tribal community and then teaching that
to the kids in their student lives and their daily existence.
I think also with the school lunch program during the
summer, these kids often go without meals. The daily meals that
they would get during school time, they miss those during the
summer. I have been back to Sisseton, I know what my cousins
eat. They rely on snacks and non-nutritious foods, potato chips
and other things that they get.
So having a food program that actually puts together a food
bag or a food lunch program for the kids, for the kids to come
to an after school program or summer school program where they
actually get food that is a balanced meal, nutritious meal for
those kids.
So it is a mix of things where during the school year, they
are actually fed more traditional foods. But during the summer,
when they can do bag lunches for the kids to take or come to a
summer program, they can get those foods as well, I think are
the benefits to having tribal involvement with the USDA program
that provides for that community.
The Chairman. It all comes back to health. We can provide
our kids with nutritious food, and again, food that they will
eat, whether it is bison or in Alaska it might be salmon. It is
important to make sure that we have those healthy food options
there.
I am actually going to be meeting in just about an hour
here with the nominee to be Secretary of Agriculture. I want to
talk to her about programs like FDIPR and what more we can be
doing again to making sure that we are getting some of our
traditional foods into these menus again. So they are healthy
and the kids will eat them.
I am going to give everybody a little bit of a homework
assignment, only because I can. And it is not just for those of
you who are part of our panel today. Mr. Lewis, we haven't
forgotten you there in Hawaii.
I mentioned the Alyce Spotted Bear and Walter Soboleff
Commission on the Native Children. Chief Smith mentioned it as
well. It is something that, again, as a committee we are going
to be looking at this report. The report has identified some of
the systematic challenges that face our Native children. What
we want to do is now take some of the recommendations that are
in the report. I would like you to take a look at it. It is not
that long, it is 80.
[Laughter.]
The Chairman. There is a lot of index to it.
[Laughter.]
The Chairman. There is a summary. But I want you to go
beyond the summary. I would like you to take a look at that.
Then within your portfolios, whether it is education or finance
or health care or housing or public safety, kind of provide us,
if you will, some of the recommendations that you would like to
see implemented from this to again, it is focusing on our
Native children, but when our children do well, we all do well.
So I welcome your input as we develop this broader package
of initiatives focused on healthy Native children. For those
who are part of our listening audience, don't think that,
again, we only want to hear from those who we have invited to
testify today.
There has been much discussion about the impact of the
recent actions as the administration has been stood up. The
freeze on many of these programs, again, we have tried to make
sure that it is clear that it should not impact our Federal,
our Indian and our tribal programs. But in fact we know that
there are all holdups, there are areas that we are seeing a
spillover that should not be happening.
So we need to hear from you on that. I hear what my Vice
Chair says. I take it to heart, because I too believe that you
don't have to petition the king. This is our responsibility
here in the Legislative Branch to make sure that we are
representing those who we serve. When something is not within
process, it is not within the rule or the law, we need to be
there to speak for you as well.
So the more that we can receive from you in terms of, this
portal is not opening, this funding source is not coming
through, please let us know. We have an in-box on our website
that welcomes these very specific initiatives. So let us try to
make this a little bit easier. I know it has been hard.
The last point that I will make on this is that even though
we may be able to release funds that have been delayed or
halted, and we get those moving, we are seeing very clearly
what is happening with the push for a reduction in employees
throughout Federal service. Those are your programs. Those are
programs that impact you.
So we can help you get the money released. But if there is
nobody then to help execute these through the programs because
they were either asked to leave or just decided that this was
not the environment for them, then we are no further ahead.
So know that I take very, very carefully this as an issue,
that it is not just about the funding for the programs. It is
also about the ability to execute under the programs. We need
to have these people in place. And for far too long within our
tribal programs, we have had workforce shortages. We see it
within our schools, we see it within health care, we see it in
all aspects. Certainly public safety, we hear over and over and
over again.
So this is yet another challenge for us. Know that we take
this up. We are here to listen, to learn, and to act.
So thank you for working with us, and with this Committee.
With that, I thank everyone for your time this afternoon.
The Committee stands adjourned.
[Whereupon, at 3:40 p.m., the hearing was adjourned.]
A P P E N D I X
Prepared Statement of Francys Crevier, CEO, National Council of Urban
Indian Health (NCUIH)
My name is Francys Crevier, I am Algonquin and the Chief Executive
Officer of the National Council of Urban Indian Health (NCUIH), a
national representative advocating for the 41 Urban Indian
Organizations (UIOs) contracting with the Indian Health Service (IHS)
under the Indian Health Care Improvement Act (IHCIA) and the American
Indians and Alaska Native patients they serve. On behalf of NCUIH and
these 41 UIOs, I would like to thank Chairman Murkowski, Vice Chairman
Schatz, and Members of the Committee for your leadership to improve
health outcomes for urban Indians and for the opportunity to provide
testimony. We respectfully request the following:
Protect Funding for the Indian Health Service and fund Urban
Indian Health at $100 million for FY26
Maintain Advance Appropriations for the Indian Health
Service, until mandatory funding is achieved, and protect IHS
from sequestration.
Ensure Federal Policies Uphold Trust Obligations to American
Indian and Alaska Native Communities.
Reauthorize the Special Diabetes Program for Indians at $250
million.
Appropriate $80 million for Behavioral Health and Substance
Use Disorder Resources for Native Americans.
Protect Medicaid and Authorize Permanent 100 percent Federal
Medical Assistance Percentage for services provided at UIOs.
Allow U.S. Public Health Service Commissioned Officers
detailed directly to UIOs
Fund the Initiative for Improving Native American Cancer
Outcomes at $10 million for FY26.
A Brief History on Urban Indian Organizations
As a preliminary issue, ``urban Indian'' refers to any American
Indian or Alaska Native (AI/AN) person who is living in an urban area,
either permanently or temporarily. UIOs were created by urban AI/AN
people with the support of Tribes, starting in the 1950s in response to
severe problems with health, education, employment, and housing. \1\
Congress formally incorporated UIOs into the Indian Health System in
1976 with the passage of the Indian Health Care Improvement Act
(IHCIA). Today, over 70 percent of AI/AN people live in urban areas.
UIOs are an integral part of the Indian health system, comprised of the
Indian Health Service, Tribes, and UIOs (collectively I/T/U), and
provide essential healthcare services, including primary care,
behavioral health, and social and community services, to patients from
over 500 Tribes in 38 urban areas across the United States. UIOs also
work closely with Tribal and law enforcement partners to address the
Missing and Murdered Indigenous People's (MMIP) crisis.
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\1\ Relocation, National Council for Urban Indian Health, 2018.
2018_0519_Relocation.pdf
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Request: Protect Funding for the Indian Health Service and fund Urban
Indian Health at $100 million for FY26
The federal government owes a trust obligation to provide
healthcare services to AI/AN people no matter where they live. In fact
it is the national policy of the United States ``to ensure the highest
possible health status for Indians and urban Indians and to provide all
resources necessary to effect that policy.'' \2\ This requires that
funding for Indian health be significantly increased if the federal
government is to finally fulfill its trust responsibility. At a
minimum, funding must be maintained and protected as budget-cutting
measures are being considered.
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\2\ 25 U.S.C. 1601(1)
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Without an increase to the urban Indian health line item, UIOs will
continue to be forced to operate on limited and inflexible budgets,
that limit their ability to fully address the needs of their patients.
A lack of federal funding is deeply impactful for UIOs who are on the
front lines in working to provide for the health and well-being of
American Indians and Alaska Natives living outside of Tribal
jurisdictions. While UIOs historically only receive 1 percent of the
IHS budget, they have been excellent stewards of the funds allocated by
Congress and are effective at ensuring that increases in appropriations
correlate with improved care for their communities.
We thus request Congress honor its trust obligation by
appropriating the maximum amount possible for IHS and appropriating at
least $100 million for Urban Indian Health, which is in line with the
House proposed amount for FY25. As the Tribal Budget Formulation
Workgroup (TBFWG) report states, ``Only a significant increase to the
Urban Indian Health line item will allow UIOs to increase and expand
services to address the needs of their American Indian and Alaska
Native patients, support the hiring and retention of culturally
competent staff, and open new facilities to address the growing demand
for UIO services.'' Increased investments in Urban Indian Health will
continue to result in the expansion of health care services, increased
jobs, and improvement of the overall health in urban American Indian
and Alaska Native communities.
Request: Maintain Advance Appropriations for the Indian Health Service
until Mandatory Funding is Enacted and Protect Against
Sequestration
The inclusion of advance appropriations in the FY24 Omnibus and
maintaining advance appropriations for FY25, is a crucial step towards
ensuring long-term, stable funding for IHS. Previously, the I/T/U
system was the only major federal health care provider funded through
annual appropriations. It is imperative that Congress maintain advance
appropriations for the IHS in the final spending bill for FY26 and
beyond. It is also imperative to protect IHS from sequestration.
Advance appropriations improve accountability and increase staff
recruitment and retention at IHS. When IHS distributes their funding on
time, our UIOs can consistently pay their doctors and providers.
It is also imperative to shield and protect the IHS from cuts or
funding freezes that force Indian health-providers to make difficult
decisions about the scope of healthcare services they can offer to
American Indian and Alaska Native patients. For example, the
sequestration of $220 million in IHS' budget authority for FY 2013
resulted in an estimated reduction of 3,000 inpatient admissions and
804,000 outpatient visits for American Indian and Alaska Native
patients. \3\ A recent survey from the National Council of Urban Indian
Health, over half of surveyed UIOs report they would be unable to
sustain operations beyond six months without federal funding. \4\ UIOs
provide essential healthcare services to their patients, including
primary care, urgent care, and behavioral health services, and are on
the front lines in working to provide for the health and well-being of
American Indian and Alaska Native people living in urban areas, many of
whom lack access to the health care services that it is the federal
government's trust responsibility to provide. Any reduction or pause in
funding would reduce UIOs' ability to provide these essential services
to their patients and communities, delaying care and reducing UIO
capacity to take on additional patients.
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\3\ Contract Support Costs and Sequestration: Fiscal Crisis in
Indian Country: Hearings before the Senate Committee on Indian
Affairs.(2013) (Testimony of The Honorable Yvette Roubideaux)
\4\ Impact of Federal Funding Pauses on Urban Indian Organizations.
National Council of Urban Indian Health. 2025. https://ncuih.org/wp-
content/uploads/Fed-Funding-Pause_NCUIH-D562_F3.pdf
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Therefore, we request that you exempt IHS from sequestration in an
amendment to Sec. 255 of the Balanced Budget and Emergency Deficit
Control Act. We also request that IHS funding be protected from
impoundment and other budget-cutting measures as is required by the
trust responsibility.
Finally, while advance appropriations are a step in the right
direction to avoid disruptions during government shutdowns and CRs,
mandatory funding is the only way to assure fairness in funding and
fulfillment of the trust responsibility. Until authorizers act to move
IHS to mandatory funding, we request that Congress continue to provide
advance appropriations to the Indian health system to improve certainty
and stability.
Request: Ensure Federal Policies Uphold Trust Obligations to American
Indian and Alaska Native Communities
We acknowledge and appreciate the recent steps taken by the
Departments of Health and Human Services (HHS), Interior, and the
Office of Personnel Management (OPM) to clarify that actions should not
interfere with the United States' commitment to fulfilling its trust
obligations to American Indian and Alaska Native communities. However,
we remain concerned that potential future actions may fail to
adequately consider this unique relationship.
Therefore, we respectfully request that the Congress take necessary
steps to ensure these directives are implemented in a manner consistent
with the unique political status of American Indian and Alaska Native
people under U.S. law, as well as the federal government's legal
obligation to uphold its trust responsibilities. Specifically, we
request that Congress pass legislative text that explicitly exempts IHS
from similar policies being applied across the federal government to
safeguard the delivery of critical services to American Indian and
Alaska Native people.
Request: Appropriate $80 Million for Behavioral Health and Substance
Use Disorder Resources for Native Americans
In response to these chronic health disparities, Congress
authorized $80 million to be appropriated for the Behavioral Health and
Substance Use Disorder Resources for Native Americans Program for
fiscal years 2023 to 2027. Despite authorizing $80 million for the
Program, Congress has failed to appropriate funds for this program.
We request that the authorized $80 million be appropriated to the
Behavioral Health and Substance Use Disorder Resources for Native
Americans Program for FY25 and each of the remaining authorized years.
Until Congress appropriates funding for this program, critical
healthcare programs and services cannot operate to their full
capability, putting American Indian and Alaska Native lives at-risk.
This is an essential step to ensure our communities have access to the
care they need.
Request: Reauthorize the Special Diabetes Program for Indians at $250
Million.
SDPI's integrated approach to diabetes healthcare and prevention
programs in Indian country has become a resounding success and is one
of the most successful public health programs ever implemented. SDPI
has demonstrated success with a 50 percent reduction in diabetic eye
disease rates, drops in diabetic kidney failure, and 50 percent decline
in End State Renal Disease. \5\ Additionally, the reduction in end
stage renal disease between 2006 and 2015 led to an estimated $439.5
million dollars in accumulated savings to the Medicare program, 40
percent of which, of $174 million, can be attributed to SDPI. \6\
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\5\ 2020 SDPI Report to Congress, Indian Health Service, 2020, 2020
SDPI Report to Congress (IHS.gov)
\6\ The Special Diabetes Program for Indians: Estimates of Medicare
Savings, DHHS ASPE Issue Brief (May 10, 2019). Available at:
SDPI_Paper_Final.pdf (HHS.gov)
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Currently 31 UIOs are in this program and are at the forefront of
diabetes care. Facilities use these funds to offer a wide range of
diabetes treatment and prevention services, including but not limited
to exercise programs and physical activity, nutrition services,
community gardens, culinary education, physical education, health and
wellness fairs, group exercise activities, green spaces, and youth and
elder-focused activities.
The incredibly successful Special Diabetes Program for Indians
(SDPI) has repeatedly been reauthorized in Continuing Resolutions and
is now set to expire on March 14, 2025. We request that the committee
work with authorizers to permanently reauthorize SDPI at a minimum of
$250 million with automatic annual funding increases tied to the rate
of medical inflation, to continue the success of preventing diabetes-
related illnesses for all of Indian Country.
Request: Protect Medicaid and Authorize Permanent 100 percent Federal
Medical Assistance Percentage for services provided at UIOs.
The Medicaid program plays a vital role in providing essential
healthcare services to American Indian and Alaska Native communities,
serving as a critical lifeline for those who rely on it. In fact,
Medicaid is the largest source of funding for Urban Indian
Organizations (UIOs) outside of the Indian Health Service (IHS). In
2021 alone, UIOs received over $137 million in Medicaid reimbursements
for services delivered to Medicaid beneficiaries, underscoring the
program's significance in sustaining healthcare access for American
Indian and Alaska Native populations.
NCUIH Board Vice President Angel Galvez recently emphasized the
profound impact of Medicaid, stating, ``The services we provide are
services [our patients] can't afford otherwise. . . What you're doing
is saving someone's life.'' \7\ This sentiment highlights the life-
saving role Medicaid plays in ensuring that vulnerable populations
receive the care they need.
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\7\ Catie Edmonson, Medicaid Cuts Pose Budget Conundrum for Valadao
and Republicans Nationwide, N.Y. Times, Feb. 21, 2025. https://
www.nytimes.com/2025/02/21/us/politics/medicaid-republicans-
budget.html?unlocked_article_code=1.zk4.bCdx.cjxuKW_H25do&smid=nytcore-
ios-share&referringSource=articleShare
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Protecting and strengthening the Medicaid program is essential to
maintaining support for UIOs and the 59 percent of American Indian and
Alaska Native patients they serve who depend on Medicaid for their
healthcare. Safeguarding this program ensures that UIOs can continue to
deliver critical services, ultimately improving health outcomes and
quality of life for American Indian and Alaska Native communities.
A top Medicaid legislative priority for UIOs is providing 100
percent federal medical assistance percentage (FMAP) for services
provided at UIOs. The FMAP refers to the percentage of Medicaid costs
covered by the federal government and reimbursed to states. States have
received 100 percent FMAP for services provided to IHS/Medicaid
beneficiaries at Indian Health Service and Tribal facilities for
decades, and UIOs have advocated for parity through legislation since
1999. Extending 100 percent FMAP to UIOs will require the federal
government, not states, to bear the cost of Medicaid services provided
to AI/AN people no matter which facet of the Indian health system they
utilize, as is required by the trust responsibility.
Ultimately, permanent 100 percent FMAP will bring fairness to the
I/T/U system and increase available financial resources to UIOs and
support them in addressing critical health needs of urban American
Indian and Alaska Native patients.
Request: Allow U.S. Public Health Service Commissioned Officers
detailed directly to UIOs
Due to chronic underfunding, many UIOs continue to grapple with
hiring and retaining skilled health service providers. Detailing Public
Health Service Commissioned Officers (PHSCOs) to UIOs would help
address workforce shortages and increase collaboration across the
federal healthcare system.
Section 215 of the Public Health Service Act (PHSA) authorizes the
Secretary of Health and Human Services (HHS) to detail officers to
federal agencies and state health or mental health authorities. While
UIOs have requested that officers be detailed to them to fill many
roles related to the functions of the Public Health Service, subsection
(c) of Section 215 (42 U.S.C. 215(c)) prevents UIOs from receiving
detailed officers because they do not fall within the requirement that
non-profits eligible for detailing be educational or research non-
profits, or non-profits ``engaged in health activities for special
studies and dissemination of information''.
With this being said, subsection (b) has been interpreted to allow
HHS to detail an officer to a state health authority, which may then
designate the UIO as the officer's duty station. The officer is
authorized to perform work at a UIO that is related to the functions of
the Service, including health care services and support functions. This
process is completely dependent on the availability of a State or local
health authority that is capable and willing to enter into such an
arrangement. The process can be burdensome and time-consuming for all
involved, leaving many State health authorities reluctant to
participate.
Amending the law would provide IHS with the discretionary authority
to detail officers directly to a UIO to perform work related to the
functions of the Service. Therefore, we request full support for this
proposal to allow UIOs to continue engaging in critical health care
services for urban American Indian and Alaska Native communities.
Request: Fund the Initiative for Improving Native American Cancer
Outcomes at $10 million for FY26
Rising cancer rates has become an increasingly alarming issue in
Indian Country. In fact, cancer is the leading cause of death among
American Indian and Alaska Native women and the second leading cause of
death among American Indian and Alaska Native men. \8\ The rising
cancer rates has been described by some UIO leaders as the ``new
diabetes'' in Indian Country, with one clinic alone diagnosing 15-20
cases a month.
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\8\ Elizabeth Arias, Kenneth Kochanek, & Farida B Ahmad,
Provisional Life Expectancy Estimates for 2021, Vital Statistics Rapid
Release, Report 23, August 2022. Vital Statistics Rapid Release, Number
023 (August 2022) (CDC.gov)
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This is why specific funding for cancer in Indian Country is
critical. The FY24 LHHS spending bill appropriated $6 million in few
funding to address American Indian and Alaska Native cancer outcomes,
by creating the Initiative for Improving Native American Cancer
Outcomes, the Initiative will support efforts including research,
education, outreach, and clinical access to improve the screening,
diagnosis, and treatment of cancers among American Indian and Alaska
Native people. The purpose of this Initiative is to ultimately improve
screening, diagnosis and treatment of cancer for American Indian and
Alaska Native patients.
This initiative will be critical to addressing cancer-related
health disparities in Indian Country. We request that the Committee
continue to support the appropriation of funds for the Initiative in
FY26 and increase funding to $10 million.
Conclusion
These requests are essential to ensure that urban Indians are
appropriately cared for, in the present and in future generations. The
federal government must continue to work towards its trust and treaty
obligation to maintain and improve the health of American Indians and
Alaska Natives. We urge Congress to take this obligation seriously and
provide the I/T/U system with all the resources necessary to protect
the lives of the entirety of the American Indian and Alaska Native
population, regardless of where they live.
______
Prepared Statement of Aaron Hines, Chair, Northwest Portland Area
Indian Health Board
Chair Murkowski, Vice Chair Schatz and members of the Senate
Committee on Indian Affairs (Committee): My name is Aaron Hines and I
serve as the Chief Executive Officer at the Yellowhawk Tribal Health
Center, the Tribal clinic of the Confederated Tribes of the Umatilla
Indian Reservation. Today, I provide my testimony in my role as Chair
of the Northwest Portland Area Indian Health Board (NPAIHB or Board). I
thank Committee for the opportunity to provide this testimony on Native
Communities Priorities for the 119th Congress.
NPAIHB was established in 1972 and is a Tribal organization under
the Indian Self-Determination and Education Assistance Act (ISDEAA),
P.L. 93-638. NPAIHB provides support to the 43 Federally-recognized
Indian Tribes in Idaho, Oregon, and Washington (Portland Area Tribes or
Portland Area) on specific health care issues. The Board's mission is
to eliminate health disparities and improve the quality of life for
American Indians and Alaska Natives (AI/ANs) by supporting Portland
Area Tribes in the delivery of high-quality health care. ``Wellness for
the seventh generation'' is the Board's vision. This Committee is
critical to making this a reality.
I write today to urge the Committee to consider the below-listed
priorities for the 119th Congress, and to utilize the lens of Tribal
Sovereignty, the Trust Responsibility and Treaty Obligations, and
Tribal Self-Determination and Tribal Self-Governance in all its
legislative activities in the 119th Congress.
Respect for Tribal Sovereignty
The sovereignty of Tribal Nations predates the formation of the
United States \1\ and the Constitution. This Committee has always
acknowledged this history and has upheld Tribal sovereignty in
legislation impacting Tribal Nations. As recognized by the Supreme
Court, Tribal Nations are distinct political bodies with the inherent
right to regulate their internal affairs according to their laws and
customs, which includes addressing the health and well-being of our
people. The Supreme Court upholds Indian-specific legislation,
recognizing the political status of Tribes rather than a racial
classification. \2\
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\1\ Worcester v. Georgia, 31 U.S. 515, 581 (1832).
\2\ Morton v. Mancari, 417 U.S. 535, 555 (1974); see also Moe v.
Confederated Salish & Kootenai Tribes of Flathead Reservation, 425 U.S.
463, 479-80 (1976); Washington v. Washington State Commercial Passenger
Fishing Vessel Ass'n, 443 U.S. 658, 673 n.20 (1979); United States v.
Antelope, 430 U.S. 641, 645-47 (1977); Am. Fed'n of Gov't Employees,
AFL-CIO v. United States, 330 F.3d 513, 520-21 (D.C. Cir. 2003).
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Portland Area Tribes, and Tribal Nations across the Nation, rely on
this Committee to ensure that Congress and the Administration protect
Tribal interests and the government-to-government relationship.
Honor Federal Trust and Treaty Obligations
The Trust responsibility has been defined in numerous Supreme Court
cases, Executive Orders, Statutes, Regulations and other policies.
According to this doctrine, the United States has legal, moral and
ethical obligations to Tribal Nations. Treaty obligations are contracts
between the United States and Tribal Nations that mandate the United
States to provide healthcare to American Indians/Alaska Natives, among
other agreements. We look to this Committee to support, promote, and
include legislative language that recognizes and honors Federal trust
and treaty obligations during the 119th Congress.
Preserve and Expand Tribal Self-Determination and Tribal Self-
Governance
Portland Area Tribes support Tribal self-determination and Tribal
self-governance through the ISDEAA. ISDEAA provides Tribes with the
flexibility to tailor health care services to meet the needs of their
people and communities. Since ISDEAA was enacted, numerous Tribes have
entered compacts and contracts with the Indian Health Service (IHS). In
the Portland Area, 38 of 43 Tribes have signed Title 1 (contracts) or
Title V (compacts) agreements with IHS and administer their own
programs, functions, services and activities.
We request that this Committee support Tribal Nations long-standing
requests that all divisions of the Department of Health and Human
Services (HHS) provide funding to Tribal Nations through ISDEAA
compacts or contracts. In the interim, Portland Area Tribes request
that Tribal Nations be given an option to receive grant funding through
compacts or contracts. Such grants include the Special Diabetes Program
for Indians, IHS Behavioral Health Initiatives, SAMSHA Tribal Opioid
Response funding, etc. Moving this funding to a Tribe's compact or
contract reduces Agency level expense, allows more funding to flow to
direct services, and provides a Tribe with flexibility to maximize
limited resources while reducing the Administrative burden of grant
requirements.
Ensure Direct Service Tribes Nations are Protected from Harm
While many Tribal Nations have moved to ISDEAA compacts or contract
to operate programs, functions, services and activities, the Portland
Area still has five Direct Service facilities that continue to rely on
IHS to provide health care to their people. With a 30 percent vacancy
rate at IHSoperated facilities, it is difficult to comprehend how the
Federal government can meet its Trust and Treaty obligation to provide
health care to American Indians/Alaska Natives. Recent Administrative
actions compound long-standing vacancy rates and are destabilizing the
Indian Health system. Because of the hiring freeze, one Tribe in the
Portland Area has been unable to hire staff to maintain and clean their
IHS facility. This is unconscionable. While the layoffs of IHS
employees were rescinded on February 15 by the new Department of Health
and Human Services Secretary, other Administrative Actions (past or
future ones) related to the Federal workforce reductions must exempt
IHS.
Fully Fund the Indian Health Service
The IHS has always been significantly underfunded. This resource
gap leads to poor health and significant health disparities among
American Indian/Alaska Native people. The FY 2024 level of need for the
Indian Health Service was identified as $51.4 billion while the enacted
funding for FY 2024 was only $6.9 billion. For IHS annual
appropriations, the rising costs of Contract Support Costs and 105(l)
lease costs have continued to diminish program increases to IHS. We
still do not what the impact will be on IHS and Tribally-operated
facilities for FY 2025. For FY 2026, we request that the Committee
support full funding for the IHS at $63.0 billion.
Provide Mandatory Funding for IHS
Portland Area Tribes are experiencing annual program decreases due
to the rising cost of 105(l) leases and Contract Support Costs (CSCs).
While we appreciate securing an indefinite appropriation for 105(l)
leases and CSC, we request movement of 105(l) leases and CSC to
mandatory appropriations accounts to ensure that these appropriations
are funded year after year without impacting programmatic increases to
IHS-operated facilities and Tribally-operated facilities.
Expand Advance Appropriations to All IHS Accounts
We appreciate this Committee's support for Advance Appropriations.
We also request that Advance Appropriations for the IHS continue and be
expended to every account in the IHS budget. There must also be
increases to adjust for medical inflation, population growth and
program increases.
Create 10 percent HHS Tribal Set Asides
Lastly, we request that this Committee support 10 percent set
asides across all Department of Health and Human Service (HHS)
divisions and agencies. Changes to funding opportunities by the current
Administration will impact grant opportunities that have been more
broadly available to other populations, not Tribal specific. We also
request that HHS and its operating divisions and agencies transfer
Tribal set-asides and grant funding to IHS through interagency
agreements for distribution to Tribes through ISDEAA compacts and
contracts.
Protect American Indians/Alaska Native People from Medicaid Program
Changes
American Indians/Alaska Natives access to Medicaid is rooted in the
Indian Health Care Improvement Act (IHCIA) (P.L. 94-437, U.S.C. 1601)
which acknowledges the importance of raising the health status of
American Indians/Alaska Natives as a national goal, and documents the
impact unmet health needs have on the health and well-being of American
Indians/Alaska Natives in the United States. This legislation
authorizes Indian Health Care Providers (IHCPs) to bill Medicare,
Medicaid and private insurance, and amends section 1905(b) of the
Social Security Act providing 100 percent Federal Medical Assistance
Payment (FMAP) to American Indians/Alaska Native people for services
received through IHS and Tribally-operated programs.
Portland Area Tribes request protection of 100 percent FMAP for
services to American Indian/Alaska Native people received through IHS
and Tribally-operated programs. Retaining 100 percent FMAP honors the
Trust responsibility and Treaty obligations with the Federal
government, and the intent and purpose of ICHIA.
Exempt AI/AN from State Reductions in Services, Per Capita Caps and
Block Grants
The provision of health care service to eligible American Indian/
Alaska Native people is a Federal Trust responsibility which is met
through IHS, Medicaid/Medicare, and other HHS programs and supports.
Reducing Medicaid funding will reduce available Medicaid services to
American Indians/Alaska Natives and reduce Medicaid reimbursements to
IHS and Triballyoperated facilities. It will also disproportionately
burden State coffers; and is contrary to the legislative intent of the
IHCIA.
An exemption is needed to protect Americans/Alaska Natives from any
changes to Medicaid. Two 2017 bills, although not enacted, provide
examples of exemptions for IHS eligible individuals from the definition
of enrollees used to calculate per capita caps. The first bill is the
American Health Care Act (AHCA), and the second is the Better Care
Reconciliation Act (BRCA). Therefore, we request that this Committee
support an exemption for American Indians/Alaska Natives from
reductions in Medicaid services, state block grants, and state-based
per capita spending caps.
Exempt AI/AN from Work Requirements
Medicaid work requirements dishonor the Federal Trust
responsibility, weakens the IHCIA, and threatens to reduce the capacity
of Indian Health Care Providers to provide health care services to
American Indian/Alaska Native people because revenue from the Medicaid
program to Indian Health Care Providers is used to bridge the current
funding gaps at the IHS. During the first Trump Administration, several
Section 1115 Demonstration Waivers provided an exemption from work
requirements for American Indians/Alaska Natives, including Arizona,
Indiana, South Carolina, and Utah. These exemptions align with the
Federal Trust and Treaty obligations and recognize the chronic
underfunding of the Indian health system.
Thank you for this opportunity to provide written testimony on
Portland Area Tribes priorities for the 119th Congress.
______
Julie A. Malone
Dear Chairwoman Lisa Murkowski,
Thank you for the opportunity to comment on the priorities of
Native communities for the 119th Congress to consider.
My name is Julie Malone, and I am a member of the Osage Nation in
Pawhuska, Oklahoma. I also own a headright share in the Osage Mineral
Estate which is 1.5 million acres of underground minerals belonging to
the Osage Tribe of Indians. My grandfather was an original allottee in
1906, and I inherited my interest when my mother passed away in 2017.
Since 2014 our oil & gas producers have stopped drilling in the
Osage Minerals Estate due to the long period of time it took to begin
drilling. Our BIA Superintendent, Adam Trumbly, was trying to
streamline the process for approving drilling permits and leases. The
producers were starting to return. Many Osages who rely on their
royalty checks each month were excited about increased business.
On February 13, 2025 the Federal mandate that all Federal employees
who were probationary removed. Our Osage Agency BIA Superintendent,
Adam Trumbly was fired after one year and three months.
The U. S. Department of the Interior is our Trustee, and as such is
supposed to be acting in our best interest. That is not the case in
this circumstance. Is there a way to exempt Native communities from
these suddenly-mandated changes? This is harmful to many Osage
Shareholders, or Headright Owners and the future of our oil & gas
production.
Thank you for your time and consideration.
Sincerely,
Julie A. Malone, Osage Nation Member and Shareholder in the
Osage Mineral Estate
______
Defense Credit Union Council (DCUC)
February 11, 2025
Subject: The Need for Increased Access to Credit Unions and
Financial Services in Native Communities
Dear Chairwoman Murkowski and Ranking Member Schatz,
On behalf of the Defense Credit Union Council (DCUC) and our member
credit unions, I appreciate the opportunity to submit this letter for
the record regarding the Committee's oversight hearing on ``Native
Communities' Priorities for the 119th Congress.'' DCUC represents
credit unions stateside and overseas serving military and veteran
communities as well as their families, encompassing over 40 million
members and having over $525 billion in assets.
One of the most pressing issues facing Native American communities
today is the lack of access to affordable financial services. Many
Native American reservations and communities exist in banking deserts,
where access to traditional financial institutions is either limited or
nonexistent. This absence of mainstream financial services leaves
Native Americans vulnerable to predatory lenders, check-cashing
services, and other exploitative financial practices that trap families
in cycles of debt and economic instability.
Credit unions provide a powerful solution to these challenges by
offering safe, responsible, and community-driven financial services.
Unlike for-profit banks, credit unions are not-for-profit, member-owned
financial cooperatives that reinvest in their communities. This
structure allows credit unions to provide lower interest rates on
loans, higher returns on savings, and financial education programs that
help individuals and families build financial security.
For Native communities, the benefits of establishing and expanding
credit union services are clear:
Ending Financial Exclusion: Credit unions can provide low-
cost checking and savings accounts, small business loans, home
mortgages, and emergency credit options-critical services that
are often unavailable in these areas.
Fighting Predatory Practices: Without access to credit
unions, many Native Americans must turn to payday lenders and
other high-cost financial services that charge exorbitant fees
and interest rates, deepening financial hardship.
Encouraging Community Investment: Credit unions reinvest in
their communities, supporting small business growth,
homeownership, and economic development.
Promoting Financial Education: Many credit unions offer
financial literacy programs that help individuals make informed
decisions, build credit, and achieve financial stability.
However, despite the clear need and benefits, regulatory barriers
and financial constraints often make it difficult to establish and
expand credit union services in Native American communities. DCUC urges
Congress to consider policies that will:
1. Encourage and Support the Establishment of Credit Unions on
Reservations--Provide incentives and regulatory flexibility for
credit unions seeking to serve Native communities.
2. Expand Access to Capital for Native-Owned Credit Unions--
Increase funding and grant opportunities to help credit unions
establish branches and digital banking services in underserved
areas.
3. Strengthen Consumer Protections Against Predatory Lenders--
Ensure that Native Americans are not disproportionately
targeted by high-cost lending practices.
4. Enhance Financial Readiness Programs--Support initiatives
that promote financial education and literacy tailored to the
unique needs of Native American communities.
As an organization dedicated to serving military and defense-
affiliated communities, DCUC understands the unique financial
challenges faced by underserved populations, including Native American
service members and veterans. By expanding access to credit unions, we
can provide Native communities with the tools and resources necessary
to build financial independence, strengthen local economies, and break
cycles of financial hardship.
We appreciate the Committee's attention to this critical issue and
stand ready to support efforts to increase financial access and
economic opportunity for Native communities. Thank you for your
leadership, and we look forward to working together to ensure financial
security for all Native Americans.
Should you or your team have any questions or desire additional
information, please do not hesitate to contact me.
Sincerely,
Jason Stverak, Chief Advocacy Officer
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