tv House Hearing on Tribal Communities CSPAN July 8, 2020 11:07am-1:38pm EDT
is approved. i want to say thank you to everyone and a couple of announcements to make. i ask unanimous consent staff be permitted to make technical changes to the measure just approved without objection so ordered. please ensure that the materials before you are returned. >> the committee holding a hearing entitled addressing urgent needs of tribal communities and due to the covid-19 public health emergency today's hearing is being held remotely, members and witnesses will be participating via videoconferencing and as part a hearing microphones will be set on mute for purposes of eliminating inadvertent background noise. members and witnesses need to unmute their microphone when you wish to speak, documents for the record can be sent to rebecca at the email address
provided and into the record to the conclusion of the hearing. i recognize myself for 5 minutes for opening statements. let me find my opening statement here. i believe this hearing is long overdue. suffering terrible inequalities. unreliable access to the energy grid, little or no broadband connectivity, and reliable funds for the federal government and other systematic problems that created unnecessary hardship and turmoil and covid-19 is exacerbating these long existing problems. one third of tribal members are at high risk of serious covid-19 complications due to underlying health factors and navajo nation has seen higher infection rates than those in china at the peak of the pandemic. despite this stark reality the
impact of covid-19 on tribal communities, we've seen the struggles of tribal communities and access to personal protective equipment and testing to protect against covid-19. is this pandemic redesign and covid-19 cases continue to rise in many areas of the country access to ppe and testing and access to proper sanitation will be critical to cutting the curve for tribal communities with our tribal communities deserve better. that is why we are here to listen to representatives of tribal governments to assure congress meets its obligation to tribal governments and communities. i would like to believe we made incremental improvements for tribes over the years it is clear not enough has been accomplished. in the area of healthcare, tribal communities experience greater health disparities compared to other groups which increase their risk of hospitalization due to covid-19 and associated complications. we need to tackle the fact the indian health service remains
chronically underfunded. it is impossible for ihs to meet the healthcare needs of members in a pandemic or not without sufficient and stable resources which contributed to outdated infrastructure and medical equipment and while congress provided increased resources in recent coronavirus packages the administration failed to get this money to tribal communities swiftly putting tribal members further at a disadvantage in receiving testing, ppe and healthcare access it needs to respond to covid-19. moving forward act includes 5 million for ihs and travel recipients, construction and renovation of hospitals and outpatient care facilities. i look forward to hearing what the federal government can do to make sure all tribal communities have access to internet service. the pandemic is driven home how internet connectivity is essential for everyone. telehealth services are slightly special in remote areas, distance learning is the
only option in e-commerce, growing important. if all the benefits, two thirds of people living in rural tribal lands have no internet connectivity which i think is a disgrace, moving forward act brings more connectivity to tribal households by providing $80 billion for broadband deployment projects, electricity, border access that continue to be a major issue and tribal households less likely to have access to indoor plumbing at a safe water supply. the moving forward act addresses these issues by investing $47 billion in drinking water including indian reservation drinking water program, to improve tribal community access for reliable energy sources. i just want to say we would like to bring more renewable or other energy production to tribes, to encourage moving in that direction. i want to give half of the time left to representative louise
and o'halloran, we start with representative ruiz, you have 30 seconds and the other 32 tom. >> thank you for holding this important historic hearing, and for years now, along with a friend on the other side, i'm pleased we are having this critical hearing and appreciate your leadership on tribal issues that i have been working on since before i came to congress. nations long suffered from massive underfunding and scarcity of resources in the covid-19 pandemic amplifies the lack of funding. during this congress, report commissioned by myself and the chairman exposed challenges including access to broadband inequities and failure to tribal consultation process within the superfund program.
the drastic health disparities in indian country, i'm looking for to discussing these issues during the hearing and further markups in coming months. i yield back. >> only a few seconds left, you want to say something, i am sorry. tom? maybe he is not on. >> he is. historically federal policy is unacceptably left for native american communities, the president knows that i have been working together to address, people have been left behind in developing policies needed to rectify this. i recognize all the chairman of the committee, recognizing the bills we put forward the needs of tribal lands to do much more. >> i recognize mister walden for five minutes but if you want to give an extra 30 seconds to mark wayne because we gave an extra 30 32 tom it is up to you.
greg? >> 2 and a half minutes to me, to representative -- >> i recognize mark wayne mullet. >> i am not ready to speak to you. let me just -- i left my notes at home. >> thank you, the full committee, for listening to my concerns and happiness in court hearing as was addressed earlier, this is the first time in my time, definitely on the committee, that we had a full committee hearing on native american issues. native americans deserve quality reliable healthcare service as promised by the federal government, the only federal obligation for
healthcare we have out there. the cherokee i grew up going to at hastings which is down the road from me was where i received my healthcare and i understand how important, direct services and facilities are to tribal members. i was fortunate enough to cochair the ihs task force which led to several key areas in which we can improve healthcare and improve care to over 2.2 million native americans. ihs is not only terribly underfunded but is only federally held healthcare agency who doesn't receive mandatory or advanced appropriations. we have to fix that. ihs must also be motorized. its it system needs to be brought into the 21st-century. there is so much going on in indian country that applies to this committee and we need to
take a deeper dive. i want to thank you for holding this hearing. i urge my committee to continue to process with additional hearings in health and oversight, with investigations of committees and i yield the remainder of my time as the gentleman from montana -- >> i think the gentleman from oklahoma for yielding. i appreciate his leadership on indian health service task force. i have long asked the we hear from indian country and i'm glad we are having this hearing today. native americans make up 7% of montana's population in 2% of the us population. i was proud to pass legislation restoring federal recognition to the little shell tribal the chippewa creek in montana last year, that was long overdue. federally recognized tribes enjoy a nation to nation relationship with the us government. this recognition allowed tribes to access critical resources for economic development,
healthcare and education and regulate affairs on tribal land. these resources often come with federal procedures, we need to better understand these challenges to increase opportunities for these communities. during the covid-19 pandemic americans rely on broadband connection for daily activities. broadband is essential for business education and telemedicine. many tribal lands in the united states are among those areas in our country that lack adequate broadband access which each tribe has unique challenges for deployment from rough terrain to complicated and expensive federal permitting regimes. last month i joined with republican everest introduce legislation that will help streamline some of those reviews making it easier for companies to deploy broadband infrastructure and close the digital divide. the fcc offered tribes early access to the 2.5 gigahertz
band in order to ensure that tribes could obtained spectrum licenses. these are great first steps but we must do more to close the digital divide. also, key to tribal nations is energy. access to it as well as ability to develop, produce and sell it, many tribal nations are rich in resources they use for energy development and production. in my home state of antenna -- montana we face challenges exporting. one of our witnesses today, the southern youth indian tribe, the southern youth are engaged in oil and gas production on and off the reservation. these energy resources are economic drivers and fund investments and other businesses for the tribes. not all tribal lands have these types of resources and services developed and are ready available still many have issues with access to
electricity and say freaking water. we want to address how these challenges, i look forward to this important discussion today. with that i yield back. >> you are on mute. >> i just want to remind everyone that pursuant to committee rules all members written opening statements will be made part of the record and now we go to our witnesses for today's hearing and i want to recognize mister o'halloran, the president of the navajo nation.
is tom there? can you guys hear me? >> i can hear you, mister chairman, not sure what happened. >> i don't see mister o'halloran's picture. are you there? maybe you needs to unmute but i don't see your picture either. there he is. >> thank you. the leader of the navajo nation. committed public servant of the navajo people. he served in all offices of the navajo nation, fully understands the scope of the challenges facing the navajo nation and indian country. the realities of life on the navajo nation is harsh and in
many places as you indicated earlier there is lack of water, electricity and basic needs of life. the federal government goes up to the treaty and trust obligations that it has been >> we are going to hear from the honorable christine page who is chairman of the southern use indian tribes and linda sharp who is president of the indian nation and was testifying today as president of the national congress of american indians. mark wayne mullen to introduce doctor charles grimm. >> thank you. i am honored to introduce fellow cherokees, and accomplished healthcare professional and as i said, fellow cherokee doctor, doctor
graham has decades of experience with ihs including director of ihs under president george w. bush, he spent years leading health services for the cherokee nation and also a retired assistant surgeon general and rear admiral in the commission core of us public health services, native doctor dedicated his life to serving indian country and i am proud to have him here representing the great state of oklahoma. thank you for being here today. >> our last witnesses laura thomas, a partner in quarrels and grady. we are now recognized for five minutes for your statement. thank you. >> thank you.
chairman malone, ranking member walden and members of the committee on energy and commerce. thank you, tom o'halloran, i am the president of the navajo nation, i greet you today. i appreciate this opportunity to testify before the full committee to address urgent need facing the navajo nation in the same issues, 573 tribes throughout the country. the navajo nation is going through tough times right now as the chairman mentioned and i
appreciate the prayers and support for the congressional delegation, and congress, thank you so much. today i am going to be talking about water, electricity and broadband infrastructure. this committee oversees other jurisdictions throughout the united states. water, electricity and broadband will be our focus, i would like to start with covid-19 update on the navajo nation. as of yesterday at 5:00 pm, there are a total of 7941 confirmed covid-19 positive cases. we are also tracking recovery
numbers, so 5650 have recovered. we have lost 379 of our relatives in the navajo nation. please hold them in prayer. we have tested over 60,000 individuals since this crisis entered our borders and we have been testing very aggressively and this shows 29.4% of total population have been tested for almost two months, navajo nation saw the highest per capita infection rate in the us. per capita we are testing more of our citizens than any state or country, many countries throughout the world as a result of the chronic underfunding of indian programs which was mentioned earlier tribes were not equipped with prompt and adequate resources
to respond to covid-19. for example, funding did not fully reach the navajo nation until three months after congress, i appreciate the committee for convening this hearing today to shed light on these matters and for hearing our most urgent needs. in terms of water there is no greater need on the navajo nation then clean drinking water. 40% of the navajo nation households do not have running water, and sanitation facilities are an extension of primary healthcare delivery. legislation, hr 756 introduced by congressman o'halloran and congressman young is a great step toward providing safe drinking water to our navajo people.
the house should pass a water rights act which the senate unanimously passed as 886, the navajo nation would receive $220 million in federal and state funding for desperately needed drinking water infrastructure. further delay the passage of senate 886 will deny clean drinking water to the navajo people. the navajo nation has waited decades for this day to come and life-saving legislation is one vote away from becoming the reality. i respect -- the house passed bill 86 as passed by the senate immediately. in terms of electricity, 10,000 homes lack electricity, red tape is as much to blame as funding, takes anywhere from 1 to 2 years to get the next approval for infrastructure
products, we encourage you to reduce federal law and regulations that impede and delay infrastructure projects. in terms of broadband 60% of residents population lack broadband access. this is unacceptable when considering the opportunity our citizens and residents are denied in our current economy. broadband limitations for navajo residents is due to the current broadband infrastructure. there are 1000 communication towers on the navajo nation that provide capability for broadband and broadcast carriers. by comparison the state of new jersey which is almost 137 of the navajo nation boasts success of 100,000 communication towers. in conclusion, chairman and members of the committee, the navajo nation seeks to strengthen the sacred trust relationship between our governments working together in partnership with you, we can close the digital divide,
expand access to water, health and other needs, inviting written testimony, i discussed the impacts of climate change, the generating station and other concerns such as air quality and uranium mine remediation. i hope you can review those comments. thank you for the opportunity to testify and i am prepared to answer any questions the members of the committee may have. >> thank you for outlining those urgent needs which is the main focus of the hearing today. next we have chairman sage, you are recognized for five minutes. chairwoman, we can hear you.
>> good morning, ranking member walden and members of the committee. i am christine stage, chairman of the indian tribe, thank you for inviting me to testify. it was an honor to speak to you about the effect of the coronavirus on the southern indian tribe and the needs of indian country. it exemplifies the success of self-determination for the tribal nation. that policy is 50 years old today. the tribe exercised it self-determination with the coronavirus pandemic early this year. we acted quickly, tribal members, in particular tribal elders and others who are at risk. because of our diligence, a relative statement, rapidly increasing cases of the virus.
the pandemic has highlighted weaknesses in the relationship between the tribes and the federal government and that is what i want to emphasize today. recent legislation was supposed to benefit tribes during this crisis but has failed to consider the unique circumstance of tribal government. for instance the ppp did not fully take tribes into consideration, relying on entities to raise revenue for government operation, the businesses may be operating under a single aim, a loan to the ai in. and this places tribal businesses that a unfair disadvantage. there is no reason to allow each location, to apply for a loan.
we need legislation allowing tribal businesses operating under a single e i am to be eligible. the cares act allocated $8 billion, congress directed the fund be dispersed within 30 days to address emergency needs of indian country but the full disbursement is made by two months. confidential data provided by treasury by tribe. the guidance on the use those funds comes from treasury and it is apparent that i -- it does not understand tribal government operates. it is unclear to tribes, tribes are not permitted to pay employees who are unable to work due to the coronavirus, states may use those funds to pay the same employees
unemployment compensation as they terminate their employment. additionally guidance is restrictive and makes it difficult to put funds to good use without risk of an audit. moving forward prior to issuing guidance, treasury needs to genuinely consult with tribal government. the third area of focus is around the energy industry which has been ignored during this economic crisis. it is vital to the economy and much of indian country, we must use this opportunity to revitalize energy programs and prepare for the future. the energy policy act of 2005 authorize the department of energy to establish the tribal energy loan guarantee program which is seriously underfunded. the development or extension of power generation and transmission projects that
employ commercial -- carbon neutral and renewable energy technology. the current travel program only provides 90% guaranteed loans while the innovative energy programs provide 100%, the percentage guarantee be increased to 100% for innovative technology program projects to make energy development on tribal lands equitable with developer don on tribal lands. feasibility study grant would improve speed in developing this project. the weaknesses in communication and high-speed internet technology in indian country. many tribes are in revolt for broadband infrastructure, our students are unable to participate in distance-learning, for the healthcare provider virtually.
the federal government embarked on this era of self-determination. congress is able to look at this. today we look at the advance of the past few months identify the weaknesses. learn from them and direct them. >> you are on mute. >> sorry, i keep forgetting to turn it off automatically. i wanted to thank the chairwoman who just spoke and i
want to go to president sharp, president of the adult tribe but is testifying today on behalf of the events di. you are recognized for five minutes. >> good morning. on behalf of the american indians, thank you for this hearing. the president of the national congress of american indians. tribal nations strive to ensure well-being in the central government services, these services are funded by the treasury responsibility of the united states. this obligation has been chronically ended for a long time, underfunded as documented in the us commission on federal rights report that was recently
released to congress last year. this details and concludes not one federal agency is living up to its responsibility and every sector affecting our lives and communities there is a widespread underfunding. these disparities have led to our vulnerability and disproportionate impact of covid-19 through our communities in terms of infection rates and rate of death. to address this pandemic we urgently need an increase, we heard there is a belief on additional funding, creates a real problem. treasury has a timeline of july 17th to report back use of the funds and we are concerned this report creates a distortion on the need within indian country because it is three months when appropriated by congress.
and the remaining balance, the litigation, we are at the point, they are disproportionately impacted, they incorporated three months ago. i want to make clear, we need additional dollars. in addition to the pandemic, there are structural barriers within treasury. i want to focus my testimony on a few points. i want to speak to healthcare. we must secure stable funding. we experience the greatest health disparities in the united states and we are harmed by delays in federal appropriations. they are funded by the direct responsibility. since 1998 only once has the
interior environment and related agency appropriations bills been enacted before the new fiscal year. in 2019 the government shutdown the reduction of health services endangering tribal health, to address this instability coverage -- congress must pass legislation authorizing advanced appropriations for ihs that would protect essential tribal government services from appropriation delays. additionally stable funding is needed in the diabetes program for indians with high rates that increased the lee family of covid-19 to the population. the special diabetes program reduce the disease and save medicare $52 million per year. despite this success it has been flat funded at $150 million since 2004 entry
authorizations have impaired each, the same is critical to the program, congress must support long-term stable funding. i would like to shift to climate change and clean water. climate change threatens the economy of tribal peoples, due to these impact, they are key partners in the national and global response to climate change. to support this partnership congress should pass legislation that includes consultation with decision-makers, management opportunities and financing climate activity and to ensure there is government parity and climate action by federally funded responses to the climate crisis. in addition to climate change, they experience environmental disparities involving lack of access to clean and safe drinking water. the clean drinking water state revolving funds are important mechanisms for addressing these issues, it increases revolving
funds with severe water access needs to tribal communities. we also encourage congress to increase tribal energy access and development, they encounter many barriers in developing energy resources including financing challenges, providing funding for energy infrastructure and tribal land. hr 2 increased funding, we appreciate this increase and also request illumination of matching requirements which are access to barrier for many tribal nations especially this pandemic which has resulted in loss of tribal revenue. and the restrictions are needed for energy financing to enable tribal access, the department of energy tribal energy loan guarantee program was authorized in the energy policy act of 2005 in 2017. in part this is due to
eligibility requirements that require complex commercial financing. for removal of nonstatutory restrictions would allow applicants to access the credit necessary to develop the method. to address immediate connectivity needs, all tribal nations and the sec, 2.5, which closes on august 3rd, 2020. the spectrum license, broadband and mobile coverage. emergency access for immediate broadband deployment while the long-term broadband infrastructure, tribal nations are responding to the pandemic and would have to diver resources for the august deadline and requested extension of the intel january of 2021, due to the pandemic,
sec has not responded. they have created in this spectrum which is a violation of the productivity challenges by providing coverage. to address these issues we ask congress to extend the deadline to ensure the sec make all tribal nations and lands eligible to this opportunity. in conclusion i thank you for the opportunity to testify and ask you to bring any questions. >> thank you and thanks for all that nci does on a regular basis to inform members of congress what needs to be done in the priorities for indian country. i want to turn to doctor grimm. you are recognized for five minutes. >> good morning ranking member waldman and members of the committee.
truly appreciate you holding this important hearing with needs of tribal communities. i want to thank representative mullen for that kind introduction. my name is doctor charles raymond, secretary of health for the chickasaw nation. the mission of the chickasaw nation is to advance the overall quality of life of the chickasaw people. in 1994 we entered into a self-governance compact with the healthcare system. we currently serve 90,000 patients the hospital and three outpatient facilities with a staff of 1700. this committee, healthcare for american indians and alaska natives often comes from a system that is separate from that of mainstream america. the ihs is a federal agency with primary responsibility for filling the trust application was acting under the brought authorization of the snyder act congress appropriates funds to ihs, they are inadequate to
fulfill the vast needs and cost of care during the covid-19 pandemic, added financial burden, already overwhelmed and underfunded healthcare system. prior to that the indian health system had an average 25% in hospital system, four times older than the national hospital system. limited attention to address a surge of covid-19 cases, further strain limited purchasing dollars and while cdcs noted that handwashing for many measures, approximately 6% of american indian and alaska native households lack access to running water. the indian health system paid significant funding disparities compared to other federal health care programs but now covid-19 impacted the finances of many healthcare programs. it showed a decrease of 46%
decreased approximately $25 million. indian country appreciates all that has been done in the current funding packages for covid-19, ensuring funds be made available for indian country. it is imperative the obligation be met in the face of this pandemic. there was a state of emergency on march 17th, 2020. in a span of two weeks a majority of them person visits were converted to virtual business. a patient screening process was introduced at all of our facilities, call center was introduced, covid-19 clinic was developed for persons with symptoms and testing was set
throughout the chickasaw nation, we have tested 25,000 american indian and alaska native patients and non-native community members and employees. we also integrated with local, state, national entities, ihs, fema and emergency operations. because of swift action, all nonessential businesses and offices in the chickasaw nation, we have a low preference rate with 400 positive cases today. i would ask the committee for indian country to address the needs. it is recommended by tribal council budget formulation because lack of timely enacted budget would leave us all and prepared for another wave of covid-19 infections. we have to billion dollars to fully fund the main projects in the grandfathered healthcare facility construction priority.
the ihs and joint-venture construction program is one of the most successful and cost-effective means providing newest facilities. the ihs director announced selection of 5 projects for new or expanded healthcare facilities through that program in the chickasaw nation was one of those selected. the economy is taking a sharp downturn so we respectfully ask congress to consider funding construction of these critical here -- healthcare facilities. we ask you to consider package of senegal 3937, special diabetes program for indian reauthorization act, 2019, slight changes to the new delivery funds like was that will ensure tribes and tribal organizations receive rewards for self determination and self-governance, contract and time passed, we ask for $1 billion for water and sanitation development across ihs, tribal facilities needed to ensure access for water and
waste systems, the chickasaw nation has $70 million and we also ask $3 billion for health information technology to address the surveillance reporting and transition through the telehealth delivery system to allow ihs and tries to convert for new electronic health record. for tribal medical residency programs to meet the challenges of the physician shortages. we after it grants to fully fund broadband access to instruction projects and fix broadband wireless solutions. members of the committee, appreciate the opportunity to testify in these important matters today. the chickasaw nation is committed to ensuring highest quality of healthcare for our citizens, in indian country, thank you.
>> thank you for the suggestion. the last witness is miss thomas, recognized for five minutes. >> thank you, can you hear me? sorry about that. members of the committee, i am a partner based in tucson, arizona where i specialize in working with tribes on tribal energy, natural resource and economic development. thank you for the opportunity to provide my views on indian renewable energy and including urgent energy tribal energy needs in this important hearing. i'm encouraged the house and committee recognize importance of renewable energy, energy efficiency and workforce development for indian tribes in the role tribes can play and should play in the nation's clean energy future. we heard from chairwoman stage and president sharp, access to
funding for affordable and reliable electricity is critical for community, economic, business, infrastructure development in indian country. the broken nexus between energy, water, food and economic development has been laid bare in the midst of this crisis. legislative and funding priority for tribal energy development should seek to accomplish several goals including but not limited to mitigating economic harm by reducing energy costs for tribal communities, jumpstarting economic development through increased capital and investment in tribal utility and energy development efforts, creating jobs, supporting tribal energy, self-sufficiency, self-determination and reliability and recognizing tribal sovereign authority over energy develop and on indian land.
to accomplish these goals i would like to highlight a handful of immediate and impactful opportunities for tribes that congress can support it should incentivize. tribes partner with corporations for renewable energy procurement as this will support commercial scale development on tribal lands bringing much-needed revenue and jobs and can be leveraged to attract businesses and jobs to locate on tribal land. mass deployment of community solar distributed energy, storage, energy efficiency and micro grids will lead to energy cost savings, job creation, energy or liability and resiliency and utility formation gives tribes the ability to control their energy cost, energy resources, create jobs and keep revenue, there
are many barriers to tribal energy development, some of these barriers are structural but to be overcome. others legal and can be overturned and some are physical and financial. time and money can be resolved. one is state regulatory action that hinder tribal energy development, it is development on state electricity policy and regulatory regimes through state jurisdiction over and regulation of utility companies that serve tribal land. tribes want to develop and use their own energy resources they comply with state policies and regulations, with state energy policy. another major barrier, lack of distribution infrastructure. grid modernization is expensive but necessary to improve grid performance to integrate renewable and distributed energy and storage and improve grid resiliency and reliability for tribal community.
access to the bulk transmission system and wholesale markets through the middle grid in the capital necessary to build it is also necessary for tribes to access wholesale markets for electricity purchases or sell power into the market. a third critical barrier is lack of private capital investment. it is important but not enough. there has been little to no private-sector investment, tribal renewable energy projects that directly serve tribal communities and tribes, have lagged behind other governments and attracting outside capital through public private partnerships. and and under those two statutes. this would confirm tribal
regulatory authority and jurisdiction over retail and distribution utility serving tribal lands and the benefit of making tribes nonjurisdictional entities. a second potential no-cost solution was raised previously by chairwoman and president sharp to amend the tribal and guarantee program, with the types of projects that are eligible, where tribal entities that are eligible. with green bond guarantees and reduce barriers to apply and qualifying for guarantees and loans. covid-19 has exposed energy and environmental injustices in indian country, had devastating public health and economic impacts. there is hope for renewable energy and energy efficiency deployment to lead the way out. there are considerable opportunities tribes can pursue his economic recovery efforts,
short and long-term, requires major barriers are addressed by federal policy, law and funding. i look forward to your questions. >> thank you for that information on the electricity grid and renewables, very important for what our committee is looking into. that concludes my opening. we go to member questions, each member will have five minutes to ask questions of our witnesses, recognizing myself. there are so many things i want to add but i will focus on the digital divide, for the most part because it is so stark on tribal land. given what is happening with covid-19 the lack of reliable high-speed internet means left out of healthcare services, education, employment
opportunities, civic engagement and it is unacceptable. let me start, i am concerned the lack of connectivity will put disadvantage further behind. in the moving forward act, $5 billion through the fcc's program for schools and libraries to provide wi-fi hotspots and other connected devices to families that don't have internet access and have a specific currency of funding for tribal schools and libraries so as that became law would schools and families in navajo nation benefit if you would? >> thank you for the question, chairman and members of the committee. the navajo students, the navajo people would benefit on high-speed internet access locally but our goal on the navajo nation is to reach more into rural areas into the house.
with this covid-19 right now, chairman and members of the committee, we are encouraging our navajo people to shelter in place. we have stay-at-home orders. if people are staying home, they don't have internet connectivity, they have to go to libraries or chapter houses to get internet access which may, you know, get them exposed to the virus. there is so much uncertainty, we know there is no vaccine, no cure for covid-19. our focus on the navajo nation is try to get high-speed internet into the homes where students could connect to their schools and turn in their homework, also telehealth and we are in an enclosure right now, a lot of our employees are
working from home and all based on how much money or resources could be allocated to get high-speed internet closer to the home and lastly i appreciate what was mentioned by ms. thomas. we've been talking about funding, projects, what we should really be focusing our attention on to get these projects done quickly is to reevaluate federal laws, policies and regulations, those no-cost changes that can occur so projects get done completely, quickly and complete and with the cares act funding the deadline is december 30 first. we didn't get the first a location of the cares act fund, tries -- tribes throughout the country didn't get there until three months ago and three weeks ago we finally got that
40% of the cares act funding so i am asking members of the committee to lead the charge in putting into legislation an extension of the cares act funding for tribes. in december of 2021, many of you know, lawmakers, projects don't move as quickly in indian country and that would give us some time to get these projects underway. .. >> do you think that broadband deployment is contemplated? with that help and what kind of
robin investment would help if not? i know i went with 30 seconds left, though quickly as you can. >> well, , just, the tribe with support that. it's clear that funding is sorely needed for broadband deployment for our communities who need it most. we are glad this issue is receiving attention and a legislative efforts, for example, senator bennet from colorado recently introduced the bridge act which would include $1 billion for tribals for broadband deployment. thank you. >> thank you, chairwoman. so now -- am i going to go to fred? ranking member -- okay. i recognize the gentleman from michigan for five minutes. >> thank you, mr. chairman, and appreciate the hearing. i got really a couple of questions. what to congratulate you first
on your primary win last night, so i'm glad you're resting comfortably after your landslide victory. just would like to say as we look at the $8 billion that was in the cares act, treasury had 30 days to disperse the money but because of the delays in getting the money to drive involving litigation with the alaskan native corporation, we have real issues trying to find, to follow the guidance regulations that were provided by the treasury. treasury is requesting all the recipients of cares to submit what they're spent the money on so far. i know that it's somewhat unique year in terms of what's happening, but can you expand on how you all are going to comply with that and what we might want to do to try and help? may be president sharp first and again i'm watching the clock and a want to make sure --
>> there was a deadline of aprit to the tribal nations. that was not met. i would like to just provide context to why this is such an urgent need. tribal nations are limited in taxing authority. instead of being able to generate revenues like any of the government, we are forced to generate profits in commercial enterprises. because of the pandemic our economies have been suffering. so we desperately need the additional dollars in the relief fund to not only is a delay in the responsibility of necessary resources come of that relief, we cannot spend money to back fill lost revenue from our economies, from our commercial enterprises. treasury has explicitly said we cannot use these funds for business losses. in other words, in loss of any sort of revenue through taxation
or through business. that is crippling us. not only are we vulnerable because madonna and economic relief comic any opportunity to access resources to the national stockpile and other things are limited. like chairman frazier, we have no choice to stand at the border to try to protect her tribal nation we are vulnerable. we don't have resource or access to ppe and where suffering. we need to have increases and we desperately need to make sure that treasury appropriates and distributes these dollars the way congress intended. >> thank you. chairwoman sage come did mention and think for samiti new testament in advance, you mentioned the oil and gas industry has been in your words ignored during the crisis. what a fact has the oil market crash had on your tribe in your ability to a invest in the workforce? you mentioned in the southwest colorado, all of your employees mostly nontribal members are
receiving full pay. how important is that fossil energy, especially natural gas to your economy and what will you see see a playing in the ys ahead? >> thank you for the question. the price collapse of oil and gas has cost us real problems. the virus only made them worse. many of our producers are shouting in and were actively seeking relief that our producers don't just give up and leave and abandon active wells. the collapse has been challenging and the virus has have five those challenges. many of our producers are shouting in and were actively seeking relief for producers to continue production through this pandemic sustaining the local economy and preventing orphaned wellbores on the reservation. the tribe has not furloughed or laid off in the tribal employees which i supported the local economy at the expense of risk
to the tribal economy. thank you for that question. >> so since you do have energy in your backyard how do you strike the right balance between the environment and able to conserve scarce resources like water? >> chairwoman sage? >> what was that they can? >> since you have energy production right there in southwest colorado, how is it you're able to strike the right balance? we know the colorado water issues that are there between protecting the environment and scarce resources like water? >> well, with the water in the economy, really we have a lot of our water, our water is
irrigation water for our farmers and ranchers. and this is really put a it because we have our dilapidated irrigation system, and that was brought forward earlier. as of during this pandemic it's taken a lot of the economy also away from our farmers and ranchers. >> i know my time is expired. i yield back, mr. chairman. >> i'm sorry. next we have the rush is recognized for five minutes. -- bobby rush. >> i want to thank you mr. chairman for holding today's important hearing. i also want to thank the witnesses for sharing their
insights. the coronavirus pandemic continues to shed much light on the disparities that exist and persist within our nation's most vulnerable communities. these discoveries include the long-standing needs of our tribal communities, tribal nations. among others who have limited access to physical infrastructure, reliable electricity, and training needed to support these critical resources. ms. thomas, you were a senior member of energy policy office. how are communities less served by this office, and what
improvements should we make to the administration of the -- [inaudible] >> thank you very much, congressman. yes, i formerly served as both a deputy director and acting director of the office of indian energy policy and programs in the department of energy in the second term of the obama administration. one of the biggest challenges that that office had come we stood it up from scratch basically. one of the biggest challenges office had was an lack of administrative infrastructure, and we, , our primary focus that was to put together programs that were directly help tribal governments and tribal enterprises, including tribal leadership and tribal staff building capacity to help them understand and develop their energy resources. we had and all-of-the-above energy policy, and so our focus
was to use that only the offices resources, which were very limited at the time, $2 million i think was the budget that we had, by building had just been appropriated. congress has been kind to the office in substantially increase its appropriation. now i think the house interior -- sorry, house energy appropriation just increase that to 22 million. those resources are greatly needed. those resources tend to be split between technical assistance for tribes and other capacity building efforts and deployment grants for tribes here there is a bit of a challenge now though as tribes get more sophisticated and try and do more projects with the department being able to keep up with them and the res necessary for the department to keep up with them. so the more funding that congress can provide to that office to help with technical assistance, to help with
capacity building, 575 tribes +200+ alaska native corporations and countless other tribal energy enterprises which are all covered by the office is a lot, a lot of constituency. so i do think that there's a lot of benefit to continuing to find that office at a robust amount so they can continue to do some of that soft touch work like technical assistance and capacity building that necessary to keep moving energy development forward on tribal lands. >> i want to thank you. mr. chairman, i see my time is almost expired so i yield back the amount of my time. >> thank you. thank you, mr. rush. next we are going to go to the gentleman from illinois, mr. shimkus, recognized for five minutes.
i can't hear you, john. are you on mute? can the rest -- >> i'm sorry. i thought you were a meeting this on your it also. >> let me thank you all, chairman, a great shooting. it's too much. we should've won on health. we should have one on telecommunications and we should have one on energy because there's all this is so much in our jurisdictions i'm going to pull it down to three quick questions. one is just an observation, chairman. we have this in the coming up which -- ndaa bilking up which the authorizers are trying to steal our jurisdictions or if i protecting from the testimony today is that broadband internet access is critical, and if we
allow them to any fear with the ability of the satellite broadband, this will not provide our tribal and the ability to get connected, either to their healthcare or their energy or whether educational issues. i would hope that we would develop a bipartisan strategy for the floor to offer an amendment to strip -- in the house bill, two amendments were passed a good friend mike turner that will hurt this ability. as you know ligado was passed by the sec unanimously, which should happen very much. i put that on the tip. i think nobody understands of broadband connectivity. i'd like to go back to ms. thomas, because also even regulatory burden on energy
resources something we talked about numerous times, and i'm surprised that nations don't have their ability to control their own destiny in energy development. so of course in role america we have real electric co-ops that a not-for-profit entities. are you asking for something like that in that ability to create some energy independence for indian nations? >> so thank you, congressman. so in about 16 states, were electric co-ops are not regulated by the state utility commission. and the rest of the states they are. in arizona for example, our arizona corporation commission does regulate the rural electric co-ops from a ratemaking standpoint, terrorist,, reliability, subject to the states renewable energy standard.
but in 16 states the states to exercise jurisdiction. so the co-ops like public power companies set their own rates. of course they are member owned in member driven so the idea that the members would help control what the co-op does. there was some friction admittedly between tribes who are trying to do especially distribute energy rooftop solar and co-ops who have limits on the amount of renewable energy they can put into the system. it's a complicated story, back story, because the big gmd's label and that like tri-state and basin. but there is a challenge, there's one tribe, for example, that does have a utility regulatory scheme that it imposes on its co-op. and so it tribes and co-ops that are not bigoted by the state do want to do more renewable
energy, do want to interconnect community solar or rooftop solar, going through state regulatory scheme can be problematic if -- >> that simple. let me just get to president nez real quick, because reliable low-cost energy, i from southern illinois and its coal basin. president nez, , what happens if and when you're coal-fired power plant goes off line? what happens the economy? what happens to employees? what happens to all the folks in that line of work? that's president nez. >> sorry, i was on mute. thank you for the question, and members of the committee and chairman. we already are going through closure of a generating station, two actually. want on our lands, navajo
generating station. the closure of that facility affected the coal mining operation, and that have to close because that's where the call was going to the coal-fired power plant. 30-$50 million of revenue coming in to the navajo nation is now gone, and so we have to supplement that. and in order for us to bring in new monies we are looking at extending broadband and to have other businesses flourish here on our navajo nation to bring in that 30-$15 30-$15 billion los. thank you. >> thank you. thank you, mr. chairman. i yield back. >> thank you, john. next we have this issue, recognized for five minutes. thank you, mr. chairman. congratulations on your win last night. and i want to thank all the witnesses. you have given superb testimony,
and what i'm so -- in all of the basics of life, whether it's clean water, electricity, connectivity relative to broadband, healthcare. there really is a national shame that surrounds what is taking place. and i think really to neglect for native americans. so it has to be the political will to get these things done. these are not issues that we don't know how to address. it's a matter of political will. so thank you all your testimony and to me there's an enormous sadness that surrounds all of this. let me start by asking dr. grim and jonathan is an christine
sage. have your treisman able to get adequate ppe, diagnostic testing supplies and other resources like ventilators and drugs to treat covid-19 cases in your communities? one of the challenges getting adequate supplies and it seems to me that there's confusion regarding how indian health programs can access the strategic national stockpile. so have tribes enabled access the strategic national stockpile? anyone of you can address that. >> thank you. this is jonathan is. thank you, in terms of your question. the navajo nation did get some supplies from the strategic national stockpile but it took some time before the resource
came to the nation. and when it also came to the nation we also noticed that some of the items, supplies, were outdated. but we did have to use what we were given because of the shortage throughout the country of course, that first spike, there were just so many governments out there and municipalities wanting to get ppe. so tribes were left bidding on this fine resource out there, and sometimes tribes most of the time, maybe all of the time, tribes were on the back burner. states like new york and other states were getting the most of these supplies, but we are hopeful that the other industries out there will be supplying more ppe and maybe it's time for tribes to be developing their own stockpile for the nation's as well. >> that's a good idea.
ms. sharp, what clarification do you think is necessary to allow tribes to be able to access the stockpile? >> i think there needs to be clarity in direct access. it was very clear to us in the pandemic that those outside of the united states, world health organization, the imf, the world bank all understand the vulnerability to indigenous populations. there's a a collar for global action to address the desperate need among indigenous communities because anybody evey recognizes their vulnerability and so to the extent this economic recovery plan, a global strategy for building autonomy i think that's an appetite to work for our economy. also saw the world health organization private sector partnership with the u.n. foundation -- so to the extent
this pandemic exceeds resources, we know there's a global strategy to prop up national economies. [inaudible] so that's what we need. we need our resources. >> i appreciate your answer. just very quickly, in the california area of the indian health service, the last ihs hospital close its doors over five decades ago. so my constituents and tribes in my area rely on the california tribal health program which we receives very limited annual funding from ihs. so the dr. grim, how are areas like mine with no ihs hospitals and the reliance on tribal health programs treated differently in funding allocation? >> one of the things i was going to say was that ihs as a whole
doesn't have that much in the way of come in terms of cash intensive care unit. there's a number of areas across ihs that have zero hospitals, and those that do have it have relatively small number of icu beds. our hospital has six beds, six icu beds. they happen to all be full today, , and so we are at capacy on icu. early on we tried to get resources such as testing materials, testing machines, other things like that and a lot of times, and ventilators, too. somebody would say yes, and they return around and pull it back because it would need to go to a higher priority. what those places have to do, they have to rely on the -- they are absolutely at the mercy of that distance him at all to a hospital that has that sort of
capacity. >> thank you, mr. chairman, and i yield back. >> thank you. next we go to mike bridges. you are recognized for five minutes. >> good morning. did i successfully unmute? >> you did. >> i cannot see the clock,, chairman, so i will trust your kind nature to let me know about time. you generally do. let me just say this is a great hearing, the landscape is broad. i agree with mr. shimkus, there is -- i hope this isn't just a check the box hearing. i do hope we can come back in the various subcommittees with a jurisdiction is a little more focused and drill down on some of these issues. because the communities that are served, these issues are clearly so critical, and it is hard to drill it all done with one single broad panel.
and, mr. chairman, just a point your talk at the beginning of this, , when was the last time e had a hearing on any health service? i do recall a subcommittee of health hearing, but it was so long ago that nathan deal was the chairman and i think that was 2005-2006 so we were deal. so i'm glad you organized it today. dr. grim, i want to thank you first off for your service and thank you for providing such clear and coherent testimony. one of the things in preparation for this reviewing, there was a report out by the office of inspector general on the indian health service and the title was more monitoring leader to ensure quality care. one of their suggestions in
there is, that the center for medicare and medicaid assists with more frequent surveys. so can i just ask you, and i apologize for not knowing this, but in a non-ihs hospital, i know it's a voluntary but hospitals have an agreement with the joint commission of the accreditation of hospitals to be surveyed at least every three years. is there a similar joint commission survey that happens in ihs hospitals? >> yes, sir. and three years is the normal standard in our surveys. i have often thought with seen as being a sister agency of the indian health service under two probert of health and human services, if it did work together closer when there are problems like that, it would be a great service.
some of the hospitals have had some issues that are being rectified. some of them have already been rectified. but, yes, i think more frequent surveys would help. and any other thing, part of the ihs region put together survey teams is a biblical out and survey their own facilities on a much more regular basis than every three years. >> i was on the board of a hospital, unity hospital. i'm a physician as well. it was not a good day when the center for medicare and medicaid services came to serve a hospital. generally there was some sort of problem that had occurred. that was actually not looked upon as a good thing. i suspect there was a problem that needed to be corrected. but you do go through the standard for your accreditation with the joint commission. let me ask you this.
i searched for probably 20 years on our hospital credentialing board and i remember having to query the national practitioner data bank for anyone who applied for hospital privileges. does indian health services also have the ability to query the national practitioner data bank? >> first, let me say i cringed a little bit when i i said cms should come in more often because -- i like everything years but yes, sir, ihs has criteria as we all -- on credentialing and privileging their staff. one of the requirements is -- [inaudible] >> it's also a two-way street so there is reporters back to the national practitioner data bank that the problem is identified with the physicians practice, is that correct? >> yes, sir, that's true but the process within the agency that
you follow up to get that done and it's been a few years since i've been there, but basically it rises up through the region of the facility to the region, ihs headquarters where things are reviewed. if there's been a potential violation or -- then a decision is made whether it was the standard care was met or the standard of care was not met. so the agency has a process to do that, and tribes do the same as well. >> so the quality assurance is very similar to non-ihs hospital. do i understand that correctly? >> yes, sir, you do. >> and then let -- let me ask you this. there's been some success in the v.a. system with the v.a. system acted have you described your icy with six beds so now if you have a patient who requires
ventilator assistance, do you have the ability or do contract with another facility to transfer the patient? how is the care for that patient handled when your incapacity? >> most of the facilities out there, including ours, have, i will call them preferred provider networks. it are not always called that, but you establish relationships with entities that use frequently and trust that your contracts within. so most locations have a primary hospital with two or three day refer to when they cannot provide that care locally or they are at capacity. there are some places within the indian health service however where it is two hours or more to the nearest hospital, and so there are those challenges as well. but yes, , most people and has that. i mentioned earlier, referred to care dollars. those -- if you have to refer to
meetings out, a lot of tribes will run out of that before the year is out. >> you are a minute and half over, so speedy well, i told you i could see the clock. so i'm depending upon your time. >> i have some additional questions but energy issues and also with those for the record. thanks everyone for being here this morning. >> thank you, mike. next is the gentlewoman from colorado, ms. degette. >> thank you, mr. chairman. want to thank all the witnesses for attending today. i want to get a special welcome to the honorable christine sage from the southern ute indian tribe done a my home state of colorado. i worked a lot with the southern ute and are glad to see you today. hope you are staying cool because we are having a really bad heatwave appear in denver. i would like to talk about some of health issues that are unique to tribal lands, and the first
thing i want to talk about is i want to talk about the covid-19. mr. naz, you thankfully give us an update about what's going on in navajo land with covid hipaa i think, jenna, and a culture of the diabetes caucus in congress, and i think one of the reasons why tribal issues and covid are so extreme is because non-hispanic adults, in particular native americans are 2.5 times are likely to die from diabetes. add another diabetes is a big impact on your community and i'm wondering if you can talk about how you think that it's impacted the terrible coronavirus that we
pat sat on navajo lands and other tribal areas? >> chairman, members of the committee and representative to get, thank you for that question, ma'am. we have heard the vulnerable population and the elders. the data that i cited earlier in the testimony is that of those 300 plus deaths here on the navajo nation, 379 deaths, 56% of those who have passed from covid-19 are over 60 years old. and those are our elderly. our elderly are in the vulnerable population because their opinion system is not strong, but many of them as you are seeing -- have diabetes,
cardiovascular disease and cancers. and one out of five native americans you have diabetes. and we hear on navajo are starting to focus more on our health and well-being, meaning that we should be bringing some of those individuals out of that vulnerable population category so that they have strong immune systems. we talked earlier about being in the food desert. we need to get more food, healthier foods to our native american citizens so that their bodies can fight off any virus. so thank you for the question. >> look, that's 20% with type two diabetes, right, among native americans. standing. a sharp, you talked about, this leads me to my question about the special diabetes program which was enacted 1997.
[inaudible] -- and it has been reauthorized but what happens is it's reauthorized for short periods of time and that it and of itself -- could you talk about this -- you said we have to authorize it for a long period of time. can you talk about why that is so important? >> yes. as we need a stable funding source to make sure we develop not only short-term or meeting strategies but they are already underlying challenges we need a long-term strategy. to effectively work with our community to develop community by in an various strategies we need to have stable funding thank you for the question. >> originally when we first passed it in 1997, we had a long-term authorization, and everybody agrees that it needs to be authorized long-term.
it just doesn't seem to happen. i'm going to give a shout out to my colleague representative o'halloran was the lead sponsor on the five-year reauthorization and it calls for $200 million and that's really what we need to have. so i'm hoping, and half of the money goes for type type i dia. the other half for type two among tribes. we need to reauthorized both of those components. we need to meld them together to for five years so mr. chairman, i hope you can, i know you're committed to be that so just need to make it happen. with that i will yield back. >> thank you, diane. next we'll go to mr. latta is recognized for five minutes. >> thank you, mr. chairman for holding three important hearing today to really appreciate all the witnesses for their testimony today and for all that you are doing.
president nez, if i messed up with you. inmate president trump issued an executive order directing federal agencies to review the regulations and modified -- rescind the memo to help in the economic recovery from covid-19. on behalf of the navajo nation he submitted a white paper in response to that executive order following some of the regulatory reforms to speed up infrastructure deployment on the navajo land. you wrote that currently federal laws, policies, regulations stifle the completion of projects that address the critical and basic needs of your people some of these projects are more than three years old because of the obstruction. republicans until the package for legislation that would achieve many of the suggestions you made into white paper such as streamlining reviews of the
national environmental policy act and applications for co-application and previously disturbed lands from undergoing lengthy federal reviews. [inaudible] what are some of the regulatory obstacles you face in the navajo nation to deploy broadband infrastructure? >> great question and thank you for reading that white paper. you know, we're in an emergency operation here on the navajo nation, all across the country with this pandemic. and so the cares act funding was intended to aid and give relief to u.s. citizens. and as we've been mentioning, we got those dollars late into this
year, three months ago, 40% of the cares act that's going to tribes went to the tribes. just three weeks ago the remaining 40% came to the tribes. we have a deadline to get these projects done by december 31 and a little bit on that. what we need, i'm hoping all the committee members recognize that tribal lands are characterized as any federal lands throughout the country. so you have to jump those, come through those federal regulations, those policies, and this white paper that we submitted with help temporarily based on these dollars get these projects developed in a timely manner. that's why we're asking for an extended period one to two years, two years at the most extension to get these cares act finds it because and tribal communities it's hard to get projects complete. one of those examples is right of ways, and also environmental
clearances for permits. you also is a site leasing regulations that hinder development. and so it we can set aside certain policies and regulations to help build a wall between mexico and u.s., i'm sure we can do the same here in tribal communities throughout the country. i appreciate that question, and i know this committee could be the champion to make those changes, not just temporary but permanently for tribes throughout the country. >> thank you very much. chairwoman sage, , if i could ak a last-minute, southern ute indian tribe has been significant process, progress in connecting its citizens despite the challenging geography. how are you able to overcome somebody bears ears that you face and how are you able to bring connectivity to your reservation?
>> thank you for the question. the southern ute indian tribe is unique in many ways, including its success in energy department on the reservation. as well as its robust environmental program. the tribal sovereignty over its lands enables greater economic development by making the most of what we have been given by our creator. we have been able to provide for our people in a in a meaningfu. our most vulnerable, valuable resource is our people, but there is still much to be done if we are to reach our full potential. the current pandemic has been somebody's hardships very apparent. historically, tribal lands, particularly those in rural communities come have been the most underserved when it comes to communication infrastructure. we are the largest employer in southwest colorado and the second-largest in the four corners area.
we have invested millions of the tribes own funds in technology but with employees and tribal members working from home, relying on -- relying on telehealth, those investments are strained and -- prove inadequate. given the demand of the modern era. most communities across the country -- speed of the internet and cell phone coverage. for the vast -- worried about -- whether -- we would support any congressional measure that help enable indian country to have robust and -- that would include measures to help ease the burden of -- development. [inaudible] provided to the tribe have fewer restrictions -- we could improve
the quality and range of communication services. as it currently stands we will struggle to -- [inaudible] necessary audit by the treasury. thank you very much. >> thank you very much, mr. chairman. my time expired and i yield back. i think against the witnesses for being with us today. >> thank you, bob. next we have ms. schakowsky. jan? i think you have to unmute. >> their i am. >> good. >> thank you, mr. chairman. the united states has failed to meet its responsibilities to provide comprehensive high-quality healthcare to all federally recognized, recognized tribal tribes and their members.
but nowhere is that barrier more appeared in my opinion than in reproductive health care. since 1976 the hyde amendment has denied federally funded abortion care to low income vulnerable women who get the health insurance through medicaid. but over the past 44 years the hyde amendment has expanded and expanded coming today restrictions on abortion coverage also impact anyone receiving healthcare to the indian health service. because ihs facilities are often the loan source of reproductive health care for native american women, the hyde amendment effectively denies women their constitutional protected right to a safe and legal medical
procedure. a study published by the native american women's health education resource center found that only 25 abortions were performed through the ihs system. between 1976 when the hyde amendment was passed in 2002. tragically, we've also seen nationwide that as abortion access goes down, maternal mortality and morbidity goes up. the center for disease control and prevention, cdc, reports that today american indians and alaskan native women are twice to three times more likely to die rom pregnancy related causes
than white women. -- to die from. president trump, uncommitted to passing concrete -- president sharp, i am committed to pass -- with barbara lee to end the hyde amendment once and for all. but what else do you think we need to do to improve -- [inaudible] >> i really appreciate that question, thank you. and thank you for recognizing the disproportionate and high rate of maternal mortality rates. you're right, we do suffer at a rate of 2.3 times higher, and it's even worse in rural communities where that rate is 4.5 times higher for our population. and i can say from personal experience, i have one child and
ended up in intensive in the ie unit. my child was at risk of dying, and he was born at four pounds and only had one child for that reason. so because we do suffer these impacts, it is a very important that we pay special attention to women's reproductive health and appropriations for ihs, so thank you so much for the question and raising attention to this very important issue. >> thank you, and i look forward going to head to work with you, specifically targeting that community. let me just say this is really a historic caring. we have over the history of our country so badly treated native americans. and we're still seeing residuals of all of that. we had to do so much more. but the good news is that we are -- [inaudible] in the congress to help women
battle -- and charisse david are in the congress now. and you know the saying, if you're not at the table, you are probably on the menu. and so we're happy to have them and now to have this historic caring. i think we were talking before this that this may be the first real comprehensive hearing that we've had about tribal communities. so i hope it's the first of many and let's work together on women's reproductive health. with that i yield back. thank you so much. >> thank you, jan. and now we get to ms. rodgers for five minutes. >> good morning. good morning, mr. chairman and thank you everyone on the panel for joining us today on this important topic. i have had on her of
representing several tribes in eastern washington including the caldwell, and the spokane. like many other tribal communities in the country they had been hit hard especially during this public health crisis, the coronavirus, and the issues that event brought to the forefront. the digital divide is especially highlighted in rural communities, in the tribal communities and it underscores the importance of us taking action to address and close the digital divide. i am proud that the eastern washington tried are working collaboratively with other stakeholders. we have a broadband action team that is focused on identifying and addressing barriers to deployment, including from unique models to lay fiber in part with the private sector to provide the service. healthcare is also really important and we must address some of the disparities that are
in healthcare the caldwell confederate tried has shared with me that they had seen an abrupt decline in third-party billing during the pandemic that is threatening disability to financing the construction of a new clinic. this is one of five projects selected by eating health services for a joint venture facility construction program. a very competitive nationwide program and five projects would have multiple levels of review. however, as dr. grim discussed in the viability of some of these projects have been negatively impacted by covid-19. so dr. grim, i want to start with asking you that if congress makes additional appropriations available over ihs facility construction, should it also allowed tribes to use those funds for approved joint venture
projects? >> thank you for that question. i don't say this lightly, because that's not the way this program normally works but i think everyone would agree we're in unprecedented times. all of those projects -- extensive review as you pointed out, competitive process that meant that they were fully ready to do all these things. and now the economy has taken a huge downturn. lights have been impacted as you've heard throughout the searing at a think allowing the agency that flexibility are asking them to spend some portion of those on these projects is entirely appropriate under the circumstances. >> thank you. i appreciate that, dr. grim, and i would like to ask unanimous consent to enter into the record the statement from the confederated tribes of the caldwell reservation and it is on the joint venture project.
>> without objection, so ordered. >> thank you. i also want to focus on medicaid which is an essential program and medicaid expansions played a critical role for tribal health. however, we know problem still exists within the indian health system in states that have expanded. in washington state and the states it has expanded. as of the about how we can support the tribes in both expansion and non-expansion states, we've have full understanding of the needs the tribes are facing and the role here in congress that we can be planning to uphold our obligation. 202-748-8000 did you kill some issues we're seeing in the medicaid expansion space as relates to indian health? >> as you pointed out, congresswoman, those states that have a doing better than those states that don't, and some studies are coming out now that show it has improved the health care of the population but it's
not the be-all and end-all. whenever you expanded that probably you start running into more problems. and so there's a group under cms, tribal technical advisory group, debates and talks and discusses all of these issues with cms. my written testimony, a number of things that would both help the efficiency of the agency and of tribes, but also the funding. i'll give one example of one of the issues. it's called the -- it has to be done within the four walls of a facility. that meets at a time like this with covid when tribes are putting testing centers outdoors, might be using alternate care facilities, those things i'm not able to be billed adequately. the telemedicine that went into
effect -- across the nation, the billings and the rules around the building of that has lagged. another issue read it in healthcare -- providing services that are authorized by the office since -- state-by-state program, you don't get the necessary bill for all those services. if it was authorized to indian health -- that medicaid would allow those services to be billed across indian country. those are a few brief examples. i will stop there. >> that is what i was hoping you would highlight and i appreciate that. i yield back, mr. chairman. >> thank you. next is mr. butterfield, recognize for five minutes.
>> let me see who is next year if those two are not you. okay, so next one, we will go to kathy castor the gentleman from florida is recognized. >> terrific. hi, everybody. thank store terrific witnesses, but thank you, chairman pallone, for calling this very important hearing and congratulations on your big win last night. i think it's very clear, we didn't even need to have a hearing to understand that our indigenous people and our tribal nations have not been respected under the law. but i'd like to shift to talking about the potential to clean energy and climate solutions. many of you know that last week the democrats on the select committee on the climate crisis which i chair release the majority staff report which laid
out a climate crisis action plan. that included numerous recommendations to support tribal nations. the plan calls on congress to work with tribal leaders to expand clean energy solutions, cut pollution, to advance environmental justice, to improve public health, among other recommendations. we know that tribal nations can contribute to the deployment of climate solutions and clean energy using the natural resources and the long-standing tenets of environmental stewardship. as president sharp can't attest to the national congress of american indians has outlined the indian countries priority for addressing the climate crisis in a resolution that emphasizes the importance of economic development as tribal sovereignty, as part of the transition to clean energy economy. the offices within the
department of interior and department of energy have provided technical assistance to tribes on clean energy, but the level of support for these initiatives is often inconsistent. broader infrastructure backlogs at the bureau of indian affairs also need attention and funding. so in addition to major statutes like the federal power act, regulatory policies act, rural electrification act, they are all silent on jurisdiction of tribes. the our utilities. we have discussed some of that today. in a 2015 resolution, ncai called on congress to clarify the indian tribes could have regulatory jurisdiction over utilities on reservations but i would like to delve into that a little bit deeper and hear from our leaders today. so president sharp, it's good to see you again. thank you for testifying and
advising the climate crisis select committee. thank you for your kind words on our action plan last week. we recommend expand and increasing funding or the office of indian energy policy department, department of energy. how would this investment assist tribal -- to advance clean energy infrastructure and other -- ? >> thank you so much for your leadership and thank you for directly engaging tribal nations on this point maker i would really like to focus my remarks around with sovereignty of tribal nations and advancing economies, and as we pointed out in our meeting, and i cite an example. when there is a cap-and-trade system early in my presidency, the international rate was $5-$8 a metric ton. here in this country and it wat
even close to that level. but domestic companies could accesses international markets because the u.s. was not a signatory to the kyoto protocol. however, i tribal nation could access those. looking at global solution and the global economy, ways that tribes -- we can attract foreign investment that otherwise would never see the united states, so there are many opportunities in partnership that we can deal with with additional funding and support. those are the exciting things were looking at in building a new economy. ..
40 million americans how to work and i know that's a big problem on our reservation. >> the most effective policy and government can back, those who are directly responsible accountable to generate revenue. they will be invested in recovery and restoration, that will put millions of people back to work with the economy, natural resources and restoration so we will boldly take action to generate revenue that can be reinvested in creating jobs across many sectors. >> thank you very much. i yelled back. >> thank you, kathy. next, mr. guthrie for five
minutes. >> thank you. i appreciate the opportunity and witnesses for being here today. i want to start with last congress, representatives : entries bipartisan task force for the committee to identify numerous issues examined by the subcommittee oversight investigations including issues with hiring, treatment of patients and general recite, an agency is in dire need of oversight. during the covid-19 pandemic, we are seeing even more issues within services congress and committee must examine in more detail but i appreciate the hearing today but i hope it will and on the discussions today and they will have hearings on oversight again this year. for my first question, the indian health care improvement act authorized billing for medical services from dental care to long-term care to
behavioral healthcare. these are qualified indian provider services but because medicaid is administered by state and the federal government, tribes can't have these essential services if they are covered in the state medicaid plans despite being authorized under federal law. why must congress do to address this issue and how long will fixing it for native people? how will it impact reimbursement in ihs, tribal and urban indian facilities? think you. >> thank you for that question. the indian health care improvement act allows indian healthcare providers to provide a number of services and we are going to do that whether they
have a third party of any sort or not. with comes to rely heavily on third-party resources for our operational budget. what we need is an authorization from congress to allow indian healthcare providers to receive to get reimbursement for all medical services and health care improvement act. another qualified indian provider services. whenever we deliver them to medicaid or alaskan natives. we only receive reimbursement by state and made those services eligible. medicaid varies state to state and eligibility and services. also, you all know states don't have to pay any match like they do for the rest of the population for american indian patients indian facilities. what we are asking you to do would not have an impact on the state budget either.
so thank you. >> in your testimony, you mention the impacts the coronavirus has had on this indian tribe, specifically you mentioned the pandemic has underscored lack of access to high-speed internet in indian country, in my district its remote learning and working has highlighted the challenge of broadband. how is your tribe bridging the gap in the short-term? what are some solutions you're looking at to help address this issue in the long term? >> thank you for the question. dealing with the cap here with the internet service, we do have our own entity that i oversee with the department and they monitor all of the internet, wi-fi that's available for us
and we are success and wealth with this but we do need broadband. my concern with broadband is if our students are going to go to college, they're going to have to take classes online. there's no way they will be able to do this because they don't have internet they go through the state. we are always, it's always very push this. nothing is really dominant and in saying they are going from we are doing well with what we have. >> thank you very much. i have five seconds left.
>> this is a tremendous hearing. access to broadband infrastructure are clearly major concerns for travel communities but even broadband, people are being left behind because they can't afford broadband or they lack literacy skills. on the house sponsor which would help address these challenges never introduced the bill with my colleagues, representative clark, i'm pleased they've endorsed it last week. would your immunity benefit from resources be made available with
individuals with devices that provide literary skills including tasks like jobs onli online, with that be helpful? >> it would be incredibly helpful. we thank you for your leadership and recognizing meeting that needs with resources. we recommend munication among the federal agencies because there are agencies but there's no one lead agency providing this. those two things would be helpful with the leadership. >> thank you. that's good information. spectrum is also important for productivity needs of the tribal communities. the tribal priority window for 2.5 closes august 3.
the house acted in hr to extend this period by 180 days the fcc could act on its own to do as they want to do so, applying for fcc can be complicated, especially for tribal governments representing a vast territory, can you describe the typical decision-making process for the navajo nation when applying for licenses, including how long each step takes? >> thank you for the question representative. chairman and members of the committee, thank you for that question. navajo nation is 27000 square miles. we are in three states, medicaid expansion, a deal with three states. in terms of broadband and
internet access for telecommunication, we have to be able to work with the states as well with this initiative, i appreciate you championing this will travel communities to allow tribes to fit in 2.5, navajo nation 2.5 to be able to be used in the world most parts of the navajo nation. that's in the eastern part of the navajo nation and one sample in the western part, we have a hospital or doesn't have internet capability connecting to, i forgot what it's called,
the connectivity there that we utilized for funding during the american recovery investment act, fiber line to go to the hospital right now in the community, that doesn't get that fast speed internet. during covid-19, this pandemic, it's going to be hard for telemedicine and this spectrum would help get some relief high-speed internet and connectivity to these places don't have either. >> what else you believe the communication should be doing with help on this issue? >> cc if they would look at some of the white paper, about how we can have federal agencies working together to either set
aside federal regulations and policies so that we can get high speed internet and also sell service for those who don't have, especially now. have to go to these hotspots them internet availability. here we are in a stay-at-home order and we are seeing students traveling to these hotspots and community members going to these hotspots where as if we open it up, they could be able to connect from the home, which would lessen the spread of coronavirus. >> thank you. i will submit a question for the record about the effect on the navajo. >> thank you, jerry. >> thank you.
chairman's age, it's remarkable southern has accomplished creating and operating new services on and off the tribes. your tribe seems to have a diverse portfolio and investment in real estate housing and gaming, oil and gas production appeared to be particularly important. check your tribe's experience with national environmental policy act on any other federal regulatory failures of you have advanced energy development on your travel and?
>> it hinders reservation development, not just energy development, every time a major federal action pending regarding the agencies using problem analysis and your tribe has the kind of sophisticated government such as indian tribes, it should be allowed to develop and administer its own, tribal environmental privacy act instead of the federal. they often place inconsistent requirements to the various federal agencies on markets in the u.s. as its core service. consistent will greatly benefit. thank you. >> would you support modernizing the needs to bring clarity
matters? >> definitely. >> are you concerned by some of the environmental proposals, particularly those more extreme out there that would ban fracking phase out fossil fuels completely? >> that is a good question. [laughter] >> to be determined? >> yes, definitely. it wouldn't have to take a lot of revealed collaboration to make sure this is going to benefit. >> of course if you also feels outright, you have the same situation, many people in my district are looking for ways to replace revenue 30 to $50 million lost by the nation as a result closing down the power of the coal mine was hiring and
employing members of his nation. the same thing shut down oil and gas production in your area? >> yes. it's always there. definitely. thank you. >> you have any comments you might make, how do we replace 30 to $50 million was lost as a result of shutting down the power plant and mining jobs that we replace that? how does it impact your ability to try to get electricity to the roughly 10000 homes in the navajo nation that currently lack electricity? >> thank you for that question. let me go to representatives question about climate change.
yes, we are seeing closures and power plants, one on the navajo nation, another outside our nation. there's potential of others closing down in the future in fact jobs and revenue economy being impacted negatively but there's a move to transition away from fossil fuel energy. projects being planned right now, : and wind and it goes back to these federal regulations to be able to set some of the galatians aside from start some of these projects quickly. i appreciate talking about that.
thank you. >> reforming it would help the nobles as well. one of the things i've been championing as we have research on fossil fuels and clean energy fuels, not trying to reduce that but if we have parity, we can maybe figure out a way to make that.more efficient and less costly being said, as of thank you for your. >> next, then. >> i appreciate that. it's an honor to be with you, thank you for being available today, special greetings to the president, and the navajo time to represent, third congressional representative the navajo nation conversations with
tribal leaders have the coronavirus pandemic exacerbate challenges and inequities that long before covid-19. the inequities include lack of access to broadband, insufficient housing support, barriers to ensuring incentives and failure to guarantee access to the ballot box, the federal government is not living up to responsibilities, housing, water, healthcare and broadband projects are underfunded and wait for federal communities decades and presidential ministrations acceptable we work together in a bipartisan way to fulfill patient from communities. is there, will you please state yes or no whether the indian health services has been underfunded before covid-19.
>> yes, sir. has spoken about three billion-dollar ihs comcast contact this company delivered for use ihs to the fertility. some people receive lower quality supplies or facilities were lower? >> it is. >> i appreciate that. in your testimony, you know the digital divide impact businesses ability to thrive, students ability to learn workers ability to see your doctor about all of this has been made worse by the covid-19. according to the ftc, 60% of
mexicans living on the land lack access to broadband. his capital. as for now, do we the congress and federal government need to make more investment and broadband access to ensure tribal communities are not left behind? >> lulu. i appreciate that. usually, commissioner joined in new mexico to have a conversation with tribal and political communities about the program which is an important program to expand broadband to educational abilities, libraries. long-term needs stay-at-home order is lifted, yes or no, you agree congress should support conductivity tribal institutions tribal libraries, by making them eligible for program? >> yes.
your testimony, the u.s. was addressing environmental processing on land as you know, these consequences severe respiratory illnesses, yes or no, has covid-19 crisis exacerbated the health impact of our nation's legacy of reigning mining on the navajo people. >> absolutely. >> should congress passed the radiation compensation amendment to extend and expand compensation to those impacted by mining during the cold war? >> yes, sir. >> i appreciate that.
that's one area i hope my colleagues, democrats and revoke and currently not cosponsored but providing support to mine workers and communities like new mexico for the first tested on soil and communities, can all come together and pass legislation? it's important aspects in whatever package is to covid-19 because of the exposure to so many families respiratory illnesses i have, what does lack of access to running water mean for tribal amenities including families, at least covid-19 and other health issues? >> american indian land, their homes as he 6% have unacceptable water compared to the white population. covid-19 is one of the biggest
things cdc says to do is wash your hands but they don't have the ability to do that. look at mortality and morbidity statistics and you look at reduced by safe water and sewer for the you go to a tribal hospital or clinic, it's remarkable. it's necessary to people's health and during covid-19. >> i appreciate your concern. i yield back. testimony is 10.83% times more likely in homes without indoor plumbing spread of covid-19. thank you for this important hearing. >> thank you. going to move your recognized i think thank you for testifying today as well. trials often provide the only
treatment option for the condition. however, costs associated trials, they did not of the latest technology, neurological and scientific advancements as a treatment option. medicaid serves many demographics including problem communities that are under represented in current medical trial enrollment. lack of participation in clinical trials on the medicaid tabulation means they are being excluded from lifesaving trials and not reflecting the outcome of the clinical research. my good friend, hr, the clinical treatment act which would address this issue by providing routine care costs associated
for participations. this increase access to clinical trial participation for medicaid enrollees, health insurers medical research more accurately, and the population of the country and if so, why is that important? especially with better treatment options and a vaccine for covid-19. that's a question for doctor. >> thank you. you're right, there's been under representation and a lot of clinical trials in all minority populations and medicaid patients. one of the reasons it's so important is that a new drug or treatment is not tested on a specific population group, whatever the medication or treatment comes out, doctor and
health services, there wasn't a significant or indian population or particular trial, how do we know this drug is going to work the same on our population? that goes across the sector so it's extremely important although i've not read your full bill, i support your concept and appreciate your question. >> thank you. i appreciate the answer. according to nih, common risk factor arterial disease, circulatory deficiency, the blockages of the blood vessels that supply to the lower extremities. it's a disproportionate rate in
certain regions of the u.s. native americans are more likely to undergo related amputation in caucasians. patients who are to undergo amputation and exchange independence and personality for amex, there mostly preventable, screened and diagnosed early. i've witnessed a procedure that is incredible for what we are doing today. tribal communities are disproportionately affected, steps can be taken to ensure these communities, even in the midst of a pandemic, have better access that would prevent progressions to things like amputation? >> thank you.
amputation specifically, i'll talk about in the natives communities, is higher and it's terrible when the disease reaches that, when there's no other way. because of the community's ability to get a specialist on the sort of work to recruit people to your communities, it's difficult hurdles to overcome. just off the top of my head, and i'm willing to research this firmly but the agency would need more referred care dollars, the dollars we used to refer higher level specialist or care that would help our population. the other thing mentioned earlier is the approval of the bill that would extend longer term special diabetes program for indians and raising a dollar
amount on that. the program has done immense amount to reduce prevalence and diabetes in that country. that's one of the primary factors higher level of this disease in this population. >> i know we could save money amputations, it's very expensive but it's a quality of life issue. >> i'm not sure if i have more time, i can't see the clock but i have one more question if i had time. >> yes, you do. >> very good. i appreciate it. your testimony talks about accessing the paycheck protection program, ppp funding, specifically mentioned the disparities between tribal businesses and large corporate chains. can you tell us more about this?
we will move to muster butterfield. >> thank you very much. i'm very appreciative of technology. i first started this 50 miles on the internet and now i'm in my home. thank god for technology. thank you, mr. chairman for this historic hearing. i share the views of all of you that we must pay more attention to the needs of indian country and i will certainly are. thank you to the witnesses for your testimony today. i've heard most of it and it's been very powerful. , let me start with you if i may, in your testimony, you talk about the lack of competition among providers -- [silence]
[silence] [silence] do my part. thank you to the witnesses for your testimony today. effort most of it and it's been very powerful. president, let me start with you in your testimony, you talk about the lack of competition among providers and currently -- [silence] >> during the summer months, reach out to your elected officials with c-span's congressional directory. it contains all contact information you need to stay in
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