[Senate Hearing 119-32]
[From the U.S. Government Publishing Office]


                                                         S. Hrg. 119-32
   
                EXAMINING NATIVE COMMUNITIES' PRIORITIES 
                         FOR THE 119th CONGRESS

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

                                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

                              ----------                              


                      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
---------------------------------------------------------------------------
    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.
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
    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.
---------------------------------------------------------------------------
    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.
---------------------------------------------------------------------------
    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.
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
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.
---------------------------------------------------------------------------
    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\
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
    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\
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
    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.
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
    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.
---------------------------------------------------------------------------
    \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
---------------------------------------------------------------------------
    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\
---------------------------------------------------------------------------
    \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. [. 
. .]''
---------------------------------------------------------------------------
    \11\ 42 U.S.C.  1395qq and  1396j
---------------------------------------------------------------------------
    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.
---------------------------------------------------------------------------
    \12\ H.R. REP. No. 94-1026, pt. III, at 21 (1976), as reprinted in 
1976 U.S.C.C.A.N. 2782, 2796.
---------------------------------------------------------------------------
    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\
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
    \15\ National Governors Association, Resolution HHS-18, ``Indian 
Health Services,'' March 1, 2006.
---------------------------------------------------------------------------
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.
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    \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\
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    \13\ Native American Graves Protection and Repatriation Act (25 
U.S.C. 3001 et seq.).

   National Historic Preservation Act (NHPA) \14\
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    \14\ National Historic Preservation Act (16 U.S.C. 470 et seq.).

   Native American Languages Act (NALA) \15\
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    \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\
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    \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.
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    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.
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    \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/.
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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.
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    \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/.
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    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.
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    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.
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    \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/.
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    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.
---------------------------------------------------------------------------
    \1\ Relocation, National Council for Urban Indian Health, 2018. 
2018_0519_Relocation.pdf
---------------------------------------------------------------------------
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.
---------------------------------------------------------------------------
    \2\ 25 U.S.C.  1601(1)
---------------------------------------------------------------------------
    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)
---------------------------------------------------------------------------
    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.
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
    \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)
---------------------------------------------------------------------------
    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\
---------------------------------------------------------------------------
    \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).
---------------------------------------------------------------------------
    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

                                  [all]