[The questions and answers referred to follow:] COMMITTEE ON INTERIOR AND INSULAR AFFAIRS, Hon. STANLEY THOMAS, Assistant Secretary for Human Development, Department of Health, Education, and Welfare, Washington, D.C. DEAR MR. SECRETARY: During the Subcommittee hearings on S. 1017, I indicated that the Subcommittee would be submitting further questions to the Department on various aspects of the legislation. I would appreciate your consideration and full response to the following questions for inclusion in the hearing record: TITLE I 1. In section 4(c), defining “tribal organization", what do you feel is the import and effect of the phrase "or elected by the Indian population to be served by such organization"? 2. Section 102 (c) authorizes the Secretary of HEW to require a tribal contractor to secure liability insurance. Do you feel that the provisions adequately protect the rights and interests of the general public and adequately protect the sovereign immunity of the tribes? What would be the cost factor to the tribes in securing such insurance? 3. Section 106 (a) would exempt contracts under section 102 and 103 from the provisions of the Act of August 24, 1935, particularly regarding performance bonds. What effect would such a provision have on tribal contractors and their subcontractors? 4. Do you feel that the provisions of section 106 (g) adequately protect the rights of individuals to be benefited by the particular program or service contracted from arbitrary or discriminatory action by the tribal contractor? What would be the remedy? 5. Assume that the tribal contractor, through mismanagement or otherwise, depletes the contract funds prior to the end of the contract period for some important service. Assume further that the contractor requests a retrocession pursuant to section 106(d). Would the Department accept retrocession under those circumstances? If the Department accepted retrocession, how would they continue to provide this essential service? I would appreciate your response to these questions as soon as possible. LLOYD MEEDS, Chairman, Indian Affairs Subcommittee. Hon. LLOYD Meeds, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, OFFICE OF THE SECRETARY, Chairman, Subcommittee on Indian Affairs, Committee on Interior and Insular Affairs, House of Representatives, Washington, D.O. DEAR MR. CHAIRMAN: In testimony on S. 1017, the "Indian Self-Determination and Education Assistance Act," before your Committee on Monday, May 20, 1974, I stated that the Department of Health, Education, and Welfare would be proposing some technical amendments to the bill in the near future. In accordance with that statement we wish to submit the following technical changes for the Committee's consideration. Grants to Indian Tribal Organizations Section 104 of the bill would provide grant authorities to both the Secretary of Health, Education, and Welfare and the Secretary of Interior. The Commissioner of Indian Affairs in his bill report of May 17, 1974, expressed the belief that the present provisions of this section would be unduly restrictive in his ability to assist tribal governing bodies. Consequently, he proposed to the Com mittee a revision of section 104 which would authorize grant authority only for the Secretary of Interior. In transmitting that proposal, he also indicated that the Department of Health, Education, and Welfare would propose another provision relating to grants. Our proposed revision is as follows: "Section (a) The Secretary of Health, Education, and Welfare may, in accordance with regulations adopted pursuant to section 107 of this Act, make grants to any Indian tribe or tribal organization for (1) the development, construction, operation, provision or maintenance of adequate health facilities or services including the training of personnel for such work, from funds appropriated to the Indian Health Service for Indian health services or Indian health facilities; (2) the planning, training, evaluation or other activities designed to improve the capacity of a tribal organization to enter into a contract or contracts pursuant to section 103 of this Act. (b) Notwithstanding any other provisions of law, any funds made available to a tribal organization pursuant to this section may be used by that organization for matching any other Federal grant which would contribute to the purposes for which the grant under this part was made." We believe that this suggested section adequately provides for grant authority while maintaining a reasonable degree of flexibility in the administration of the overall health services responsibility. We wish to express our concurrence in the Commissioner of Indian Affairs' suggestion that section 109 of the bill (concerning grant appropriation authorization) be deleted. Such authorizing language is unnecessary in view of the proposed revised section above and the open ended appropriation authority contained in the Snyder Act (25 U.S.C. 13). Comments on Department of Interior Suggested Amendments In the Department of Interior, Bureau of Indian Affairs, bill report of May 17, 1974, a number of amendments were suggested. Several of these pertain solely to that Department's functions and responsibilities. We would defer to their decision on those suggestions. Some of the suggested changes, however, would also affect the functions and responsibilities of this Department's Indian Health Program. Generally, we concur with these proposed changes but three of them would be of sufficient importance to this Department to warrant additional comments. These comments are as follows: Multiple Tribal Use of a Health Facility This Department through its Indian Health Service (IHS) provides comprehensive health services to about 450 federally recognized Indian tribes and groups. These services are delivered through a system of 51 hospitals, 83 health centers and numerous health stations. Many of these facilities serve more than one Indian tribal group. In certain instances where several tribal groups share a common health facility, there exists among the groups historically based, well established, and deep rooted rivalries. While the Government operates these shared facilities, health services are available on an equal basis to the members of all the federally recognized tribes. If, however, these shared facilities were to be operated by only one of the rival groups, there would be a probability that the total Indian population currently served by the health facility would not receive services on a fair and equal basis. Apparently, the Department of Interior, Bureau of Indian Affairs, has envisioned the possibility of similar situations occurring in their areas of responsibility if a program or service activity is assumed by one group and that activity currently serves several groups. This recognition leads to a proposed change in the definition of "tribal organization" in section 4 (c) of the bill. That suggested change would require each tribal group served to approve or at least not object to a requested contract or grant when it is made by only one of the groups currently served by the program or project. We wish to express our agreement in principle with the BIA proposed change. If it is adopted by the Committee and the legislation enacted, we wish to assure the Committee we would undertake whatever administrative measures as might be reasonably necessary to provide all affected tribal groups a full opportunity to react to the merits of any requests for a contract or grant when the request is made by a single tribal organization and services to others would be required. We believe this suggested amendment to be particularly important where several tribal groups currently share the use of a number of the Indian health facilities. Transfer of Federal Employees to Tribal Organizations The Department of Interior has proposed certain changes to section 105 of the bill. These proposed changes would substantially eliminate the need for Section 2(5) of H.R. 6853, the "Federal Employee Indian Tribal Organization Transfer Act." This Department generally concurs with the proposed changes providing the Committee accepts them as additional authorities to those already in section 105 of the bill. Our concern is that non-Indian health professionals would not be readily attracted to the possibility of becoming tribal employees. If this were the only option available, it could severely limit the ability of the tribes to operate health programs if health professionals would not accept such a transfer. We would, therefore request that the options available to these professionals be kept open so they could retain their status as Federal employees or transfer to tribal employment status as they might so desire. To close this option would, we believe, seriously jeopardize this Department's ability to recruit and retain health professionals who are already in short supply in the remote areas where most Indians live. The need for this flexibility and the need to provide continued protection of health professionals against malpractice claims, as is now provided for in the bill, and our reasons for suggesting that the Department of Interior's proposed amendments to section 105 be considered as additional authorizations to those already contained in the proposed legislation. Emergency Authority to Rescind Contracts and Agreements The Department of Interior has suggested that section 109 of the proposed legislation be revised to enable the appropriate Secretary to, upon notice to a tribal organization, immediately rescind a contract or grant where there is an imminent threat to the health and safety of the Indian people. This Department strongly endorses this suggested amendment. The bill (S.1017) in its present form does not relieve the Secretary of DHEW of his assigned responsibility to "conserve the health of American Indians." It provides authority to permit Indian and Alaska Native tribal organizations to assume greater autonomy in the management of their health care delivery system. The Secretary should, therefore, have the necessary authority to resume the management of the health delivery system if there ever should develop a situation where there is an imminent threat to the health or safety of the Indian people. This would be considered the maximum authority necessary if the Secretary is to fulfill his responsibilities as assigned by Congress. The Office of Management and Budget has advised that the presentation of these comments is in accord with the program of the resident. Sincerely yours, STANLEY B. THOMAS, Assistant Secretary for Human Development. Mr. MEEDS. Now in a different regard, HEW is presently, through grants, conducting or having conducted a number of programs directed to Indian tribes and Indian organizations, is it not? Mr. THOMAS. Yes, we are, Mr. Chairman. Mr. MEEDS. Would you like to just for the record tell us about some of those programs and what is being carried out? Mr. THOMAS. Mr. Chairman, I would be delighted to ask my colleague, Mr. Robert Howard, to expand on this, but the basic intent of our grant program out of the Office of Native American Programs for Indian tribes is ultimately to respond to what those tribes consider priority areas of concern in order to provide them with resources to fill service gaps in any of the human resource areas or economic development areas. Perhaps equally important, Mr. Chairman, it is to provide the tribes. with resources which are designed to strengthen their own ability to manage and plan and organize and deliver services. Mr. MEEDS. What has been the experience of the Department of HEW generally in direct grants to Indian tribes with regard to programs that might otherwise have been carried out by HEW directly? Mr. THOMAS. Mr. Chairman, of course, the Native American Program was transferred from the Office of Economic Opportunity only this past August of 1973 but I would say that our general experience is that in many ways, having the Indian people themselves very much involved in determining how those programs should operate has been extraordinarily beneficial for the Indian people. There are those instances where they have requested technical assistance from us in one form or another and we are willing and able to provide that upon their request but I would say ultimately the fact that the Indian tribe itself has taken the leadership role, that I think has been very beneficial. Mr. MEEDS. Is it not true that what were formerly Indian Community Action programs are now being administered through ONAP? Mr. THOMAS. That is right. The Office of Native American Programs in the Department provides resources directly to the tribal government or to the tribal organization. Prior to the transfer of the programs from OEO, those resources flowed through the ICAP, the Indian Community Action Agency on that particular reservation." Mr. MEEDS. In terms of some of the apprehensions indicated by the Commissioner and his colleagues, have you found generally that those programs through ONAP have been well carried out. Are they executed within the guidelines which are set forth, is there adequate personnel, and, just generally, do they function fairly well? Mr. THOMAS. Yes, Mr. Chairman. We believe they do function fairly well. Obviously on an annual basis we review the grants. We have a staff that is regularly interacting with the grantees and as a general proposition, Mr. Chairman, we would very much say that the programs are effective. Mr. MEEDS. Do you think it is necessary to retain, at least through guidelines, some general objectives for which the Secretary of HEW should be responsible. Mr. THOMAS. Well, Mr. Chairman, over the past several months we have been communicating with tribal government leaders and other Indian groups and organizations with respect to the Native Americans program with the idea in mind ultimately that we would have to promulgate regulations and guidelines for the administration's recently introduced statutory request for an extension of the program. And so we anticipate that should our legislation be enacted, that guidelines and regulations would be promulgated after consultation with Indian people. Mr. MEEDS. Is not the study on Indian education due in September of this year? Mr. THOMAS. That study is due September 30 to October 1. That is not related to the issue that we are discussing. That is under the Office of Education. Mr. MEEDS. Very well, thank you sir. Mr. THOMAS. Thank you, sir. [The full statement of Mr. Thomas follows:] STATEMENT OF STANLEY B. THOMAS, JR., ASSISTANT SECRETARY FOR HUMAN DEVELOPMENT, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Mr. Chairman, Members of the Subcommittee, it is a pleasure to appear before you today to testify on S. 1017, which seeks to assure to Indian people the right of self-determination and to obtain reforms in the education of Indian children. 1. GENERAL POLICY As you know, the Administration is deeply committed to Indian self-determination. The President stated in his message to Congress, on July 8, 1970, transmitting his "recommendation for Indian policy": "For years we have talked about encouraging Indians to exercise greater selfdetermination, but our progress has never been commensurate with our promises. Part of the reason for this situation has been the threat of termination. But another reason is the fact that when a decision is made as to whether a Federal program will be turned over to Indian administration, it is the Federal authorities and not the Indian people who finally make that decision. "This situation should be reversed. In my judgment, it should be up to the Indian tribe to determine whether it is willing to assume administrative responsibility for a service program which is presently administered by a Federal agency." The Department of Health, Education, and Welfare is vitally interested in the enactment of legislation which would promote and encourage further self-determination for the Indian people to attain the ultimate goal of "Indian solutions to Indian problems." As we advance toward self-determination, however, we must also be sensitive to the need for maintaining Federal support and concern for the Indian people. As we strengthen the Indian's sense of autonomy, we must be sure not to threaten his sense of community and tribal life. That means making it clear to Indians that they can become independent without losing their unique relationship with the Federal Government and that self-determination and the assumption of control of HEW programs and services by Indian tribes represents a reinforcement rather than a termination of this unique relationship. 2. ADMINISTRATIVE ACTIONS Before I discuss the bill under consideration, I would like to quickly highlight a few of the things being done by our Department under existing mandates to advance Indian self-determination. A. Office of Native American Programs The Department established the Office of Native American Programs under the Office of the Assistant Secretary for Human Development last August. This Office was transferred from the Office of Economic Opportunity, and with this transfer efforts of the Department in Indian affairs increased significantly. In addition to responsibility for program administration, the Office of Native American Programs assumed the dual role of principal advisor to the Secretary on Indian affairs and advocate for the Indian population on Departmental policy. The Office of Native American Programs has made appreciable progress in laying a foundation for promoting Indian self-determination based on representative Indian consultation. The Office arranged a series of nine meetings, five on Indian reservations and four in areas with appreciable Indian population, to invite Indian input on the functions and policies of the Office. The product of these meetings, at which over 850 representatives of Indian tribes and organizations participated, were a set of issues raised by the Indian people as well as a number of recommendations on resolving the issues. B. Office of Education Over the years, Office of Education assistance benefiting Indian children and adults has been substantial. In fiscal year 1974 it is estimated that $140 million in the Office of Education obligated funds will benefit Indians. This represents an increase of 17 million dollars over the amount provided in fiscal year 1973. Much of the increase has resulted from implementation of Title IV of the Education Amendments of 1972, known as the Indian Education Act. Through the implementation of the Act, increased consultation between local education agencies and Indian communities has occurred. Indian people are now involved in making decisions that affect the education of their children. In fiscal year 1974 the Department will have provided $40,000,000 under Title IV alone for programs to improve educational opportunities for Indian people. |