[Senate Report 106-306]
[From the U.S. Government Publishing Office]



                                                       Calendar No. 585
106th Congress                                                   Report
                                 SENATE
 2d Session                                                     106-306

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



 
TO AUTHORIZE THE INTEGRATION AND CONSOLIDATION OF ALCOHOL AND SUBSTANCE 
ABUSE PROGRAMS AND SERVICES PROVIDED BY INDIAN TRIBAL GOVERNMENTS, AND 
                           FOR OTHER PURPOSES

                                _______
                                

                  June 6, 2000.--Ordered to be printed

                                _______
                                

   Mr. Campbell, from the Committee on Indian Affairs, submitted the 
                               following

                              R E P O R T

                         [To accompany S. 1507]

    The Committee on Indian Affairs, to which was referred the 
bill (S. 1507) to authorize the integration and consolidation 
of alcohol and substance abuse programs and services provided 
by Indian tribal governments, and for other purposes, having 
considered the same, reports favorably thereon with an 
amendment in the nature of a substitute and recommends that the 
bill as amended do pass.

                                purpose

    The purpose of this legislation is twofold: to enable 
Indian tribes to consolidate and integrate alcohol and other 
substance abuse programs into one program for purposes of 
management and accounting, thus making it simpler and more 
efficient to operate than a number of smaller programs with 
different auditing and reporting standards; and to recognize 
that tribal governments, as the local entities directly 
responsible for the well-being of their populations, can best 
determine the most effective and appropriate goals and methods 
for establishing and implementing these programs in their 
communities.

                               background

    Native communities continue to be plagued by alcohol and 
substance abuse at staggering rates and this abuse is wreaking 
havoc on Native families across the country. The incidence of 
alcohol and substance abuse among American Indian and Alaskan 
Native adults is far greater than that of the general 
population. Alcoholism occurs among American Indian and Alaskan 
Natives at a rate that is 579% greater than the general 
population. Deaths that are caused by alcoholism occur at a 
rate that is 440% higher than that of the general population.
    Unfortunately, alcohol also continues to be an important 
risk factor associated with the top three killers of American 
Indian and Alaskan Native youth--accidents, suicide, and 
homicide. Based on 1993 data, the rate of mortality due to 
alcoholism among American Indian and Alaskan Native youth ages 
15 to 24 was 5.2 per 100,000 which is 17 times the rate for 
whites of the same age. Native Americans have higher rates of 
alcohol and drug use than any other racial or ethnic group. 
Despite previous treatment and preventive efforts, alcoholism 
and substance abuse continue to be prevalent among Native 
youth: 82% of Native adolescents admit to having used alcohol, 
compared with 66% of non-Native youth. In a 1994 school-based 
study, 39% of Native highschool seniors reported having 
``gotten drunk'' and 39% of Native children acknowledged using 
marijuana.
    Alcohol and substance abuse also contribute to other health 
and social problems including sexually transmitted diseases, 
child and spousal abuse, poor school achievement and dropout, 
drunk-driving related deaths, mental health problems, general 
feelings of hopelessness and, too commonly, suicide.
    In order to deal with the devastating affects of alcoholism 
and substance abuse in all communities, Congress has authorized 
and appropriated program monies in nearly every federal agency 
within the federal structure. many of these programs are 
available to tribes, but even where tribes secure access to 
program funding from several different sources, the amounts are 
generally so low and the auditing and reporting requirements so 
onerous that it is simply not cost effective for a tribe to 
attempt to operate a program which combines all the funds 
available because of the myriad reporting requirements 
attendant to each source of funds. An informal survey made by 
committee staff in May of 1999 identified approximately twenty 
programs in at least seven federal departments which tribes may 
access for the prevention and treatment of alcohol and other 
substance abuse.
    This bill addresses that problem by allowing for the 
submission of a plan to consolidate the funding and develop a 
single plan to meet auditing and other reporting requirements.
    The provisions of S. 1507 are based on the principles and 
proven success of Public Law 102-477, which authorizes the 
integration and consolidation of job training and employment 
related activities into one program. The ``477'' program has 
been widely recognized as one of the most successful economic 
development programs benefitting tribes enacted to date. Based 
on the success of the original ``477'' model, the members of 
the Committee have considered and approved its application in 
the area of substance abuse and treatment.
    The original ``477'' program was designed to provide tribes 
with a mechanism to take full advantage of the wide variety of 
employment training programs, while minimizing administrative 
time and costs, and reducing federal paperwork. By all 
accounts, the ``477'' program has been successful in achieving 
its objective.
    Tribes and tribal consortia who operate ``477'' programs 
report increased success and satisfaction with the programs 
administered pursuant to Pub.L. 102-477, in that they have 
increased the service population and reduced several 
administrative functions involved with the operation of federal 
programs. Equally important, under ``477'' tribes have the 
authority to tailor a program to fit the specific needs of 
their community, which increases effectiveness and 
satisfaction.
    S. 1507 expands the concept of unifying federal funding 
into the areas of mental health, alcohol and substance abuse 
programs are ideal for program integration because it is common 
for funds distributed by federal programs to Indian tribes to 
be awarded in small amounts. It is not uncommon for a tribe to 
receive a number of different federal grants and program 
dollars, each involving different audit, reporting and 
management requirements.
    S. 1507 authorizes tribes to combine small funding streams 
into one account, and use one audit and report to inform the 
federal government of activities carried out in the alcohol, 
substance abuse and mental health areas.

                      summary of major provisions

 Initiation of program

    This legislation largely tracks the organization of Pub.L. 
102-477, and the operation of several of the main provisions of 
this bill is intended to be the same.
    The bill gives the Secretary of Health and Human Services 
the responsibility of carrying out the coordination of programs 
at the federal level. The Secretary of Health and Human 
Services is the ideal official to hold this responsibility 
because the Secretary has responsibility for the administration 
of Indian programs and also has a great deal of experience in 
the implementation of the Indian self-determination policy.
    It will be the Secretary's responsibility to develop and 
implement the interdepartmental Memorandum of Agreement at the 
Cabinet level. This Memorandum of Agreement will provide the 
framework for the implementation and operation of the 
consolidation program. The Committee does not anticipate that 
there will be any problem drafting and adopting this Memorandum 
of Agreement, as there is an existing model readily available.
    Initially, the Committee expects that the departments of 
Health and Human Services, Interior and Education will develop 
the Memorandum of Agreement. Eventually, every department which 
funds alcohol and substance abuse and mental health programs 
will be expected to be signatories to the Memorandum and to 
participate in a meaningful way.
    The Committee expects that, similarly to Pub.L. 102-477, 
the Memorandum of Agreement for this bill could address the 
following issues:
    1. Advising tribal governments regarding their eligibility 
to integrate programs and how they may develop and implement a 
tribal plan for the consolidation of funds.
    2. Procedures for the review and approval of plans, 
including time lines for the review and approval.
    3. The agreement which will be used by tribes and 
department or agencies to govern their relationships under the 
program. It is anticipated that the agreement that is currently 
being used will provide guidance to the Secretaries who enter 
into the Memorandum of Agreement.
    4. An expedited process for the review of waiver 
applications from tribes who participate in this program. 
Additionally, it is anticipated that appeals from a denial will 
also be accelerated.
    5. An agreement and procedure for the timely payment of 
funds to tribes who are participants in the program.
    The Committee expects that the opportunity to access this 
program will be extended to all tribes, tribal organizations 
and tribal consortia who express a desire to participate.

Review and approval of tribal plans

    Central to the success of this program is a tribal plan to 
operate and consolidate programs. It is the belief of the 
Committee that tribes can best determine where resources will 
be used and what type of services are most appropriate to serve 
their members. Accordingly, the federal agencies that 
administer program funds which are authorized to be 
consolidated under this legislation are expected to give 
deference to tribal allocations of resources and program 
design.
    The Secretary is expected to allow tribes a great deal of 
flexibility in designing the plan which will be submitted 
pursuant to this legislation. Creativity in the use of multi-
year plans, mix of services and innovative approaches to 
treatment should not be stifled. The primary objective of this 
legislation is the reduction of the incidence of alcohol and 
substance abuse suffered by American Indians and Alaskan 
Natives. It is clear that traditional treatment approaches to 
treating these problems have not been effective. Clearly, 
tribal involvement in developing new and culturally appropriate 
services is needed. It is expected that the Secretary will keep 
this in mind when reviewing tribal plans.
    The Secretary should focus on the following when reviewing 
a tribally submitted plan:
    1. Does the tribal plan effectively address the purposes of 
the tribal program, how those purposes meet tribal goals to 
address the existing problems, and what the projected effect 
the program is expected to have on individuals served?
    2. Does the plan lay out an overall strategy for dealing 
with alcohol and substance abuse and mental health problems 
within the tribe's service area?
    3. Does the plan integrate other available resources?
    Where tribes have integrated or have an intent to 
consolidate competitive grant programs, it is expected that 
federal agencies will provide as much flexibility as possible 
to tribes who are attempting to match grant requirements to 
tribal needs. The character of a grant program is relevant but, 
unless there is a statutory mandate, serious consideration 
should be given to allowing a tribe whose plan does not match 
with those of a grant to consolidate funds.

Waiver authority

    As part of the plan submission and review process, the bill 
provides that the tribal government and federal reviews 
identify any rules, regulations, policies, procedures or 
underlying statutory provisions which need to be waived in 
order to successfully implement the tribal plan.
    One of the purposes of this bill is to simplify federal 
requirements pertaining to the operation of federal programs. 
The Committee expects that unless a federal requirement is 
central to the very nature of the program involved, it should 
be considered an appropriate requirement to be waived under the 
authority provided.

Amendments to the bill, as introduced

    The bill as introduced, has been amended by designating the 
lead agency for coordination and implementation and as the 
Indian Health Service rather than the Bureau of Indian Affairs, 
as originally designated. All witnesses who appeared at a 
hearing held on S. 1507 in October of 1999, recommended that 
the Indian Health Service be designated the appropriate agency 
in which the coordination of this program should be maintained.
    A definition of ``substance abuse'' has also been added. 
This definition was added in response to concerns that the 
program monies consolidated pursuant to this authorization 
could not be used to treat inhalant abuse, which is a growing 
problem among American Indian and Alaskan Native youth. It is 
the intent of the Committee that funds used under this 
authorization may be used to treat inhalant abuse where a tribe 
determines that to be necessary. The definition is by no means 
exclusive, and any omissions should not be deemed as evidence 
that a particular type of substance abuse is not included.
    Additionally, section 5 of this legislation has been 
amended to address the different types of programs which may be 
included in a tribe's plan for consolidation. The bill, as 
introduced, originally authorized the consolidation of formula 
funded programs.
    The Committee was made aware that formula funding is rarely 
used to fund alcohol and substance abuse programs, and that the 
majority of funds used for these programs are competitive or 
other grant programs. Accordingly, the Committee has changed 
this authorization to include grant programs and other types of 
funding that may be distributed to tribes for the treatment of 
alcohol, substance abuse or mental health treatment.
    Testimony from the Indian Health Service and the Bureau of 
Indian Affairs indicated that both agencies also had a concern 
with the provisions of section 5 regarding the availability of 
grant funding. The concern focused on whether the original 
language of the bill allowed tribes to access grants without 
competing. The agencies pledged to present a report to the 
Committee in January or February of 2000, which would address 
this issue and discuss viable alternatives to the original 
language. However, the Committee has not received a report from 
either agency.In drafting amendments to section 5, considerable 
thought was given to the provision which allows grant funds to be 
consolidated. The Committee recognizes that without the inclusion of 
grant monies this program authority would not be effective. Yet there 
was a great deal of concern about this legislation having a chilling 
effect on the ability of tribes to compete for grant money. The 
Committee did not want the effect on this law to be a predisposition on 
the part of the administration to deny grant applications submitted by 
tribes because it was unwilling to have grant programs consolidated. At 
the same time, the Committee wanted to protect the grant process. 
Accordingly, a tribe must still apply for and win a competitive grant 
before it can include it in a consolidation plan.
    This section accommodates the granting agency by allowing a 
consolidation where the tribe's plan to include grant funds is 
essentially the same as the requirements of the grant program. 
This allows some flexibility for the tribe, but still requires 
that tribes significantly conform to the requirements of the 
grant program. The other option is to allow the agency the 
discretion to authorize a consolidation where the plan does not 
conform to grant program's reporting requirements.
    Finally, an amendment was made to the bill which clarifies 
that programs that provide for treatment of mental health 
problems are also available for consolidation. Quite often, 
alcohol and substance abuse problems are symptoms of or are 
triggered by other mental health problems. Without treating the 
mental health problem at the same time as the alcohol or 
substance abuse problem, the effect of treatment is limited. 
Accordingly, the Committee amended the bill to allow the 
inclusion of mental health programs.

                          legislative history

    On August 5, 1999, S. 1507 was introduced by Senator 
Campbell, and was referred to the Committee on Indian Affairs. 
Senator Murkowski was added a cosponsor on April 11, 2000. The 
Committee held a hearing on S. 1507 on October 13, 1999. On 
March 29, 2000, the Committee voted unanimously to order the 
substitute amendment to the bill to be reported favorably to 
the full Senate.

                      section by section analysis

Section 1. Short title

    The Act may be cited as the Native American Alcohol and 
Substance Abuse Program Consolidation Act of 1999.

Sec. 2. Statement of purpose

    There are two purposes of this Act. One is to enable Indian 
tribes to consolidate and integrate alcohol and other substance 
abuse programs and the other is to recognize that Indian tribes 
can best determine the goals and methods for establishing and 
implementing alcohol and substance abuse programs for their 
communities.

Sec. 3. Definitions

    This section contains definitions for ``Federal Agency,'' 
``Indian Tribe'', ``Indian'', ``Secretary'', and ``Substance 
Abuse''.

Sec. 4. Integration of services authorized

    The Secretary of the Department of Health and Humans 
Services in cooperation with the other appropriate Secretaries 
shall, upon the receipt of an acceptable plan from an Indian 
tribe, authorize the tribe to consolidate its federally-funded 
alcohol and substance abuse programs into a single, 
coordinated, comprehensive program.

Sec. 5. Programs affected

    The programs affected shall include alcohol, substance 
abuse and mental health programs. This section addresses the 
different types of funding mechanisms and how they may be 
consolidated. First, formula-funded program are authorized to 
be consolidated. Also, programs funded through grant-making are 
also authorized for consolidation, which may be accomplished in 
either of two ways: (1) the Secretary determines that the 
reporting requirements are essentially the same as those of the 
grant, or (2) the Secretary determines that the tribes may 
consolidate the grant using other reporting requirements. 
Finally, programs that are funded through any other funding 
scheme are also authorized for consolidation.

Sec. 6. Plan requirements

    The requirements for a plan are to: (1) identify the 
programs to be integrated; (2) be consistent with the purposes 
of this Act; (3) describe a comprehensive strategy which 
identifies the full range of existing and potential programs; 
(4) describes how the services are to be integrated and 
delivered and the results expected; (5) identify a single 
budget; (6) identify the agency or agencies in the tribe to be 
involved in the delivery of the services; (7) identify any 
statutory provisions, regulations, policies or procedures that 
the tribe believes need to be waived; and (8) be approved by 
the governing body of the tribe.

Sec. 7. Plan review

    The Secretary of Health and Human Services shall consult 
with the Secretary of each Federal agency providing funds to be 
used to implement the plan, and with the tribe submitting the 
plan. The parties shall identify any waivers necessary to 
enable the tribal government to implement its plan. The 
Secretary of the affected agency shall have the authority to 
provide the waiver.

Sec. 8. Plan approval

    The Secretary of Health and Human Services shall have 90 
days after the receipt of a tribe's plan to approve or 
disapprove the plan. If the plan is disapproved, the tribal 
government shall be informed, in writing, of the reasons for 
the disapproval and shall be given an opportunity to amend its 
plan.

Sec. 9. Federal responsibilities

    (a) Responsibilities of the Department of Health and Human 
Services.--Within 180 days following the date of enactment of 
this Act, the appropriate Secretaries shall enter into an 
interdepartmental memorandum of agreement providing for the 
implementation of the plans authorized under this Act. The lead 
agency under this Act shall be the Indian Health Service within 
the Department of Health and Human Services. The 
responsibilities of the lead agency shall include--
          (1) the use of a single report format to be used by a 
        tribe to report on the activities undertaken by the 
        plan;
          (2) the use of a single report format to be used by a 
        tribe to report on all plan expenditures;
          (3) the development of a single system of federal 
        oversight for the plan;
          (4) the provision of technical assistance to a tribe 
        appropriate to the plan; and
          (5) the convening by an appropriate official of the 
        lead agency (whose appointment is subject to the 
        confirmation of the Senate) and a representative of the 
        Indian tribe of a meeting not less than 2 times during 
        each fiscal year.
    (b) Report Requirements.--The single report format shall be 
developed by the Secretary. It shall contain such information 
as will allow a determination that the tribe has complied with 
the requirements incorporated in its approved plan.

Sec. 10. No reduction in amounts

    In no case shall the amount of Federal funds available to a 
participating tribe involved in any project be reduced as a 
result of the enactment of this Act.

Sec. 11. Interagency fund transfers authorized

    The appropriate Secretaries are authorized to take such 
action as necessary to provide for interagency transfer of 
funds otherwise available to a tribe.

Sec. 12. Administration of funds and overage

    (a) Administration of Funds.--(1) In General.--Program 
funds shall be administered to allow for a determination that 
funds from specific programs are spent on allowable activities;
    (2) Separate Records Not Required.--The tribe is not 
required to maintain separate records tracing any services or 
activities conducted under its approved plan to the individual 
programs under which funds were authorized.
    (b) Overage.--All administrative costs may be commingled 
and participating Indian tribes shall be entitled to the full 
amount of such costs.

Sec. 13. Fiscal accountability

    Nothing in this Act shall be construed to interfere with 
the ability of the Secretary to fulfill the responsibilities 
for the safeguarding of Federal funds.

Sec. 14. Report on statutory and other barriers to integration

    (a) Preliminary Report.--Not later than two years after the 
date of enactment of this Act, the Secretary shall submit a 
report to the Committee on Indian Affairs of the Senate and the 
Committee on Resources of the House of Representatives on the 
implementation of this program.
    (b) Final Report.--Not later than five years after the date 
of the enactment of this Act, the Secretary shall submit a 
report to the Committee on Indian Affairs of the Senate and the 
Committee on Resources of the House of Representatives on the 
results of the implementation of the program, which identifies 
statutory barriers to the ability of tribes to integrate more 
effectively their alcohol, substance abuse and mental health 
services.

Sec. 15. Assignment of Federal personnel to State Indian alcohol and 
        drug treatment programs

    Any State with an alcohol and substance abuse program 
targeted to Indian tribes shall be eligible to receive, at no 
cost to the State, such Federal personnel assignments deemed 
appropriate to help insure the success of such program.

                   cost and budgetary considerations

               congressional budget office cost estimate

                                     U.S. Congress,
                               Congressional Budget Office,
                                      Washington, DC, June 1, 2000.
Hon. Ben Nighthorse Campbell,
Chairman, Committee on Indian Affairs,
U.S. Senate, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 1507, the Native 
American Alcohol and Substance Abuse Program Consolidation Act 
of 2000.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Eric Rollins.
            Sincerely,
                                          Barry B. Anderson
                                    (For Dan L. Crippen, Director).
    Enclosure.

S. 1507--Native American Alcohol and Substance Abuse Program 
        Consolidation Act of 2000

    CBO estimates that implementing S. 1507 would cost about 
$600,000 in 2001 and less than $500,000 annually after that, 
assuming appropriation of the necessary funds. The bill would 
permit Indian tribes to consolidate alcohol and substance abuse 
programs that are currently funded through a number of federal 
agencies.
    Under S. 1507, tribes would submit plans to the Department 
of Health and Human Services (HHS) for approval. HHS would 
approve or reject plans after consulting with the federal 
agencies that would be affected. During this approval process, 
these agencies would be able to waive statutory and other 
requirements to enable tribes to implement their plans. CBO 
estimates that the costs of approving plans, monitoring their 
implementation, and providing technical assistance would cost 
about $600,000 in 2001 and $350,000 annually in later years. 
The bill would also require HHS to submit reports on the bill's 
implementation within two and five years of enactment. CBO 
estimates that these reports would each cost less than 
$100,000. The additional costs of S. 1507 would be borne by the 
Indian Health Service, the lead agency for the bill's 
implementation.
    S. 1507 would not affect direct spending or receipts; 
therefore, pay-as-you-go procedures would not apply. This bill 
contains no private-sector or intergovernmental mandates as 
defined in the Unfunded Mandates Reform Act. By allowing tribes 
to consolidate programs for alcohol and substance abuse, the 
bill would provide tribes with greater programmatic 
flexibility.
    The CBO staff contact for this estimate is Eric Rollins. 
This estimate was approved by Peter H. Fontaine, Deputy 
Assistant Director for Budget Analysis.

                        executive communications

                        Department of the Interior,
                                   Office of the Secretary,
                                  Washington, DC, October 13, 1999.
Hon. Ben Nighthorse Campbell,
Chairman, Committee on Indian Affairs,
U.S. Senate, Washington, DC.
    Dear Mr. Chairman: This responds to your request for the 
views of the Department of the Interior on S. 1507, the Native 
American Alcohol and Substance Abuse Program Consolidation Act 
of 1999.
    The Department supports S. 1507 for the reasons set forth 
more specifically below.
    Understanding the scope and underlying causes of the 
alcohol and substance abuse problem, as found in varying 
degrees within Indian Country, is a difficult task. Yet, proven 
indicators of alcohol and substance abuse, both behavioral and 
economic, can be readily observed in many American Indian 
communities. Examples of co-occurrence indicators come from 
tribal and federal law enforcement records. Law enforcement 
records document increasing levels of child abuse, gang 
activity, youth violence, domestic violence, DWI violations, 
and drug-related arrests among youth and adult tribal members. 
Too often Indian tribal members, whether they happen to be 
perpetrators or non-perpetrators, live in harsh economic 
conditions--conditions that have shown over time to compound 
the numbers of alcohol/substance abuse related violence 
observed in tribal communities. The economic adversity facing a 
majority of the nation's tribal members was noted in the BIA's 
1997 Labor Force Report: almost 50 percent of the adult labor 
force was unemployed, and, of those employed, 30 percent were 
still living below the poverty guidelines established by Health 
and Human Services.
    The Indian Health Service (IHS) has published studies 
suggesting an association between alcohol and drug abuse and 
the American Indian and Alaska Native suicide rates, which are 
nearly twice the rates for all races in the United States. 
Also, according to IHS, 17 times as many Indians and Alaska 
Natives die from alcoholism than the U.S. white race rate from 
ages 15 to 24. The Department of Justice Bureau of Justice 
Statistics has published data showing that Indian and Alaska 
Native offenders who were under the influence of alcohol and/or 
drugs committed 55 percent of the violent crimes against other 
American Indians or Alaska Natives.
    One of my priorities for Indian Country was to help direct 
Bureau of Indian Affairs (BIA) resources to assist Tribes 
better in reducing alcohol and drug abuse in their communities. 
Toward that goal, the BIA has initiated interagency agreements 
and established other interagency liaisons. One promising 
interagency agreement with the Administration for Native 
Americans at HHS involves 48 small Tribes in a pilot study to 
employ a normed screening survey to assess the extent of 
alcohol problems among all adult members, household by 
household. After analyzing the assessment information, the 
Tribes will be designing abuse prevention programs.
    As we embark on a new millennium, alcohol and substance 
abuse in Indian Country shows no sign of reversing itself on 
its own. The BIA is prepared to continue to use its available 
resources. The BIA will continue to exercise its role as stated 
in S. 1507 to improve the quality of life of tribal members by 
working with individual Tribes to reduce incidents of alcohol 
and substance abuse taking place in their respective 
communities.
    Currently, we are meeting with representatives of the 
Corporation for National Service's AmeriCorps program to share 
resources and strategies to involve our nation's Indian and 
Alaska Native youth and elders in alcohol and substance abuse 
community projects.
    We view S. 1507 as both a challenge and as an opportunity. 
S. 1507 provides an opportunity for HHS and BIA to work 
constructively with each Tribe, to share federal resources, and 
to help draft or negotiate a quality plan that identifies the 
Tribes integrated approach to implementing alcohol and 
substance programs and services.
    The Department believes the concept of S. 1507 holds the 
promise to be as successful in reducing tribal administrative 
costs and reporting requirements for S. 1507-eligible alcohol 
and substance abuse prevention programs, as is reflected within 
the Public Law 102-477 program.
    The Department strongly supports the goals and intent of S. 
1507. However, the Administration believes that we need to 
provide the Committee with a report that will be delivered to 
you early in the next session. The report will outline the most 
effective and efficient means to implement the concept outlined 
in the legislation. Further, the Administration believes that 
S. 1507 should be amended to assign the lead agency 
coordination responsibility to the Department of Health and 
Human Services.
    The Office of Management and Budget has advised that there 
is no objection to the presentation of this report from the 
standpoint of the Administration's program.
            Sincerely,
                                               Kevin Gover,
                            Assistant Secretary for Indian Affairs.

                        changes in existing law

    In compliance with subsection 12 of rule XXVI of the 
Standing Rules of the Senate, changes in existing law made by 
the bill are required to be set out in that accompanying 
Committee report. The Committee finds that enactment of S. 1507 
will not result in any changes in existing law.

                                  
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