[Congressional Record Volume 147, Number 57 (Tuesday, May 1, 2001)]
[Extensions of Remarks]
[Page E691]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   INDIAN HEALTH CARE IMPROVEMENT ACT

                                 ______
                                 

                           HON. GEORGE MILLER

                             of california

                    in the house of representatives

                          Tuesday, May 1, 2001

  Mr. GEORGE MILLER of California. Mr. Speaker, today we are 
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.
  This bill 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.
  The basic framework of the IHCIA is retained, including its 
provisions that target diseases for which Indian Country shows an 
astonishingly high rate--such as diabetes, tuberculosis, infant 
mortality, and substance abuse. The major revisions come in the 
following areas: Greater role for tribes in health care delivery, 
including local priority-setting. Authorization for a national 
certified Community Health Aide Program to supply medical care in 
under-served, remote areas. Innovative options for funding of Indian 
health facilities. Strengthening health programs that serve Indian 
people in urban areas. Consolidation of substance abuse, mental health 
and social service programs into a holistic system for behavioral 
health services.
  While there have certainly been improvements in the health status of 
Indian and Alaska Native people in the past two decades, Native people 
still suffer death rates from some diseases at rates many times higher 
than the national population. The Indian health care network 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 vital to the well-being of their members.
  The IHCIA was first enacted in 1976 to present a more organized and 
comprehensive 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 to target 
the high incidence of certain diseases that have plagued this segment 
of the American population.
  I plan to work with my Republican colleagues to ensure that this bill 
is a high priority for the House Committee on Resources, which should 
expedite consideration of this measure. It is my hope that Congress 
will have wisdom and courage to enact this important legislation this 
year.

                          ____________________