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Allen, William Ron, chairman, Jamestown Band of S’Klallam Indians,

Sequim, WA.......

Anderson, Marge, chairperson, Mille Lacs Band of Ojibwe Indians,

Onamia, MN...

Campbell, Hon. Ben Nighthorse, U.S. Senator from Colorado.

Cochran, Hon. Thad, U.S. Senator from Mississippi.

DeLaCruz, Joe, president, Quinault Business Committee, Tahola, WA

DeMoss, Harold, tribal council member, Cherokee Nation of Oklahoma,

Tahlequah, OK..

Ecstrom, Karen, assistant commissioner of administration, Mille Lacs

Band of Ojibwe Indians ..

Kadake, Henrich, president, Organized Village of Kake, Kake, AK

Lavell, William, Director, Office of Self-Governance, BIA, Department of

the Interior, Washington, DC, on behalf of Ada Deer, Assistant Secre-

tary for Indian Affairs....

Lincoln, Michel, Acting Director, Indian Health Service, Department of

Health and Human Services, Rockville, MD.

Manatowa, Jr., Elmer, principal chief, Sac and Fox of Oklahoma Business

Committee, Stroud, OK..

McCain, Hon. John, U.S. Senator from Arizona, vice chairman, Commit-

tee on Indian Affairs.........

Melbridge, commissioner of human services, Mille Lacs Band of Ojibwe


Murkowski, Hon. Frank H., U.S. Senator from Alaska..
Pablo, Michael, chairman, Confederated Salish and Kootenai Tribes, Flat-

land Reservation, Pablo, MT
Roessel, Faith, director, Navajo Nation, Washington office, Washington,


Thomas, Edward, president, Central Council of Tlingit and Haida Indian

Tribes of Alaska, Juneau, AK.

Wellstone, Hon. Paul, U.S. Senator from Minnesota...

Williams, Gary, executive director, Organized Village of Kake, Kake, AK.










Washington, DC. The committee met, pursuant to notice, at 9:30 a.m. in room 485, Russell Senate Office Building, Hon. John McCain (vice chairman of the committee) presiding.

Present: Senators McCain, Cochran, Campbell, Murkowski, and Wellstone.


Senator McCain. Good morning. I want to welcome you all here this morning.

Chairman Inouye wanted very much to be here this morning, but he is currently managing the Defense Appropriations Bill on the Senate Floor. As many of you know, he is the chairman of the Defense Appropriations Subcommittee and we have been involved in spirited debate for the last 4 or 5 days. I am sure he would much rather be here than there.

Chairman Inouye, of course, was one of the original congressional visionaries for the potential of self-governance to better define the Federal/Indian relationship.

Today's hearing will focus on the implementation of the Self-governance Demonstration Project Act by the Bureau of Indian Affairs and the Indian Health Service. We will discuss some of the obstacles as well as some of the successes of the project since its enactment in 1988.

For the past 2 days, a number of the self-governance tribes have been meeting here in Washington, DC to discuss establishing the project on a permanent basis. To assist with those deliberations, I provide the tribes with a draft bill that would make the program permanent for the Department of the Interior with the full intention of including the Indian Health Service at a later date.

I would be interested in any comments the tribes might have on this draft bill as well as your own ideas on what should be included in permanent legislation.

I believe this project has been a success and deserves to be established as a permanent option for all tribes. To fulfill our solemn treaty obligations and to give real meaning to the policy of Indian self-determination, I believe the Congress and the Executive Branch must work together to see that we do everything in our power to allow the tribes to govern themselves and to dispense their own funds in the best manner in which they see fit.

As Joe DeLaCruz, president of the Quinault Indian Nation stated,

No right is more sacred to a nation, to a people, than the right to freely determine its own social, economic, political, and cultural future without external interference. The fullest expression of this right occurs when a nation freely governs itself.

I would like to point out that there is already a vote scheduled at 10:30 this morning. I have an amendment on the Floor following that. I will try to get someone to take over the hearing during that period. If not, we may have to stand in recess for a relatively brief period of time.

Before we call our witnesses, I would like to ask my friend, Ben Nighthorse Campbell, if he has any opening comments. STATEMENT OF HON. BEN NIGHTHORSE CAMPBELL, U.S.

SENATOR FROM COLORADO Senator CAMPBELL. I would just ask unanimous consent to introduce something in the record, Mr. Chairman. I have a conflict as well, so I can only stay for a few minutes. I would prefer to save that time for people who are here to testify.

Thank you very much.

Senator McCAIN. Without objection, your prepared statement will appear in the record.

[Prepared statement of Senator Campbell appears in appendix.]

Senator McCAIN. I would like to call our first witnesses, Michael Lincoln, Acting Director of the Indian Health Service, and William Lavell, Director of the Office of Self-Governance, Bureau of Indian Affairs.

Welcome, gentlemen. Thank you for joining us here this morning.

As you know-and as I would like to inform all the witnesses your complete statements will be made a part of the record. If you choose to summarize your statement, you are free to do so. If you choose to give your entire statement, you are also free to do so.

Mr. Lincoln, we will begin with you this morning. Welcome. STATEMENT OF MICHAEL LINCOLN, ACTING DIRECTOR, INDIAN

Mr. LINCOLN. Thank you, Mr. Chairman.

It is our privilege to be here in front of the committee today. I will not go through the entire statement. We will submit that for the record, but I would like to summarize some of that statement for those points we think most important.

I am joined today by Reuben Howard, who is the acting director of our Office of Self-Governance, and Douglas Black, who is the associate director of our Office of Tribal Activities. Under his leadership, over the past year he has guided our self-governance activities.

The Indian Health Service was afforded self-governance demonstration authority just over 1 year ago. In that period of time, we believe much accomplishment has occurred. There have also been many stumbling blocks that we need to work through. I would like to summarize a little bit of that accomplishment.

We have signed 14 self-governance agreements with tribal governments that are effective this fiscal year, 1994. These 14 agreements transfer almost $50 million to tribal governments, $7 million of which are what is called tribal shares. These tribal shares are Indian Health Service administrative funding from our headquarters office and from our area offices where these compacts were negotiated. We believe this is a marker in terms of complying with the intent of title III of Public Law 93-638.

The Indian Health Service will provide $4 million of tribal shares from the organization, the remainder to be financed using the anticipated appropriation for the self-governance shortfall funding, which is approximately $3 million. Our appropriation was marked up by the Conference, I understand, a couple of days ago. We believe these funds are in that appropriation.

Imp menting self-governance in the arena of health cannot occur in isolation of some of the more recent events and recent documents that will be coming forward to the Congress. There are many, many bills in front of the Congress now regarding health care reform in some form. We believe that as we look at health care in Indian country, not only those services provided by the Indian Health Service but through title I contracts and through Title III self-governance compacts, that we must take into account and start anticipating the impact of the national health care reform effort on our health delivery systems.

In addition, there has been a report called “The National Performance Review" issued by the vice president. The reinventing government ideas, the downsizing, the expanding the span of control that administrators may be experiencing—at least in the Federal Government-are all factors that will impact on our ability to provide adequate, excellent services to Indian people.

The Indian Health Service will be absorbing a $9.4 million reduction in administrative costs in fiscal year 1994, consistent with the President's proposal and concurrent approval by the Congress. The combination of a $9.4 million reduction and the proper absorption of tribal shares at the area and headquarters, will cause the Indian Health Service to take a serious look at how best those administrative reductions can occur.

To this end, the Indian Health Service has appointed a small working group composed of tribal representatives and key Indian Health Service staff to start overseeing the effort to appropriately absorb these administrative reductions.

We have established an Office of Self-Governance with the Indian Health Service. This is one of those areas where I believe the Indian Health Service could be accused of not moving quick enough. In essence, we have had the authority for a year and we have had appropriations for 1 year. We have assigned some of our best staff in acting capacities to carry out the intent of the Office of Self-Governance.

We believe we had done that well, but it is now time to put a permanent staff on board. Just yesterday, the directorship of the Office of Self-Governance advertisement closed. We will be working

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