[Congressional Record Volume 147, Number 57 (Tuesday, May 1, 2001)]
[Extensions of Remarks]
[Pages E688-E689]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   INTRODUCTION OF INDIAN HEALTH CARE IMPROVEMENT ACT REAUTHORIZATION

                                 ______
                                 

                         HON. NICK J. RAHALL II

                            of west virginia

                    in the house of representatives

                          Tuesday, May 1, 2001

  Mr. RAHALL. Mr. Speaker, today I join 43 Members in introducing 
legislation to reauthorize and amend the Indian Health Care Improvement 
Act (IHCIA)--the keystone federal law that directs the delivery of 
health services to American Indian and Alaska Native people.
  The Indian health care network--comprised of reservation- and 
traditional homeland-based hospitals, clinics, school health centers 
and health stations in very remote areas, and urban Indian health 
programs in major cities--is the primary source of medical care for 
over 1.3 million American Indians and Alaska Natives. The Indian Health 
Service administers this comprehensive health care network largely in 
partnership with Indian tribes themselves who have assumed an 
increasingly greater role in operating health programs so vital to the 
well-being of their members.
  The IHCIA was first enacted in 1976 to present a more organized and 
comprehensive

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approach to the delivery of medical care to Indian people, most of whom 
live in isolated, sparsely-populated and under-served areas of our 
country. Subsequent reauthorization, has amended the Act to reflect 
advancements in health care delivery, respond to the desire of tribes 
for greater responsibility of programs, and target the high incidence 
of certain diseases that have plagued this segment of the American 
population.
  The bill we introduce today is based largely upon recommendations 
made by the Indian health community--including tribal leaders, tribal 
health directors, health care experts, Native patients themselves, and 
the Indian Health Service. Its primary objective is to improve access 
to quality medical care for this population.
  In this bill we maintain the basic framework of the IHCIA, including 
its provisions that target diseases for which Indian Country shows an 
astonishingly high rate--such as diabetes, tuberculosis, infant 
mortality, and substance abuse. We have included a greater role for 
Indian tribes in setting local priorities for health care delivery and 
provide for innovative options for funding of Indian health facilities. 
This legislation authorizes a nationally certified Community Health 
Aide program to supply medical care in under-served, remote areas and 
strengthens health programs that serve Indian people in urban areas. In 
addition, this bill will provide for the consolidation of substance 
abuse, mental health and social service programs into a holistic system 
for behavioral health services.
  We have certainly made improvements in the health status of Indian 
and Alaska Native people since IHCIA was first authorized including; 
infant mortality which has decreased by nearly 55 percent. Native 
people, however, still suffer death rates from some diseases at rates 
many times higher than the national population such as; diabetes at 249 
percent higher, tuberculosis at 533 percent higher, and substance abuse 
at 627 percent higher.
  I will push for immediate action on this important legislation in the 
Resources Committee where I serve as the Ranking Democratic Member and 
look forward to working with my colleagues and Indian Country as we 
proceed.

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