[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]


                       EXAMINING THE PRESIDENT'S FY 2025 
                              BUDGET REQUEST FOR THE
                       BUREAU OF INDIAN AFFAIRS, INDIAN.
                        HEALTH SERVICE, AND OFFICE OF 
                               INSULAR AFFAIRS

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

                           OVERSIGHT HEARING

                               BEFORE THE

               SUBCOMMITTEE ON INDIAN AND INSULAR AFFAIRS

                                 OF THE

                     COMMITTEE ON NATURAL RESOURCES
                     U.S. HOUSE OF REPRESENTATIVES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             SECOND SESSION

                               __________

                         Wednesday, May 8, 2024

                               __________

                           Serial No. 118-118

                               __________

       Printed for the use of the Committee on Natural Resources
       
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                                __________

                   U.S. GOVERNMENT PUBLISHING OFFICE                    
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-----------------------------------------------------------------------------------           
                    COMMITTEE ON NATURAL RESOURCES

                     BRUCE WESTERMAN, AR, Chairman
                    DOUG LAMBORN, CO, Vice Chairman
                  RAUL M. GRIJALVA, AZ, Ranking Member

Doug Lamborn, CO			Grace F. Napolitano, CA
Robert J. Wittman, VA			Gregorio Kilili Camacho Sablan, 	
Tom McClintock, CA			    CNMI
Paul Gosar, AZ				Jared Huffman, CA
Garret Graves, LA			Ruben Gallego, AZ
Aumua Amata C. Radewagen, AS		Joe Neguse, CO
Doug LaMalfa, CA			Mike Levin, CA
Daniel Webster, FL			Katie Porter, CA
Jenniffer Gonzalez-Colon, PR		Teresa Leger Fernandez, NM
Russ Fulcher, ID			Melanie A. Stansbury, NM
Pete Stauber, MN			Mary Sattler Peltola, AK
John R. Curtis, UT			Alexandria Ocasio-Cortez, NY
Tom Tiffany, WI				Kevin Mullin, CA
Jerry Carl, AL				Val T. Hoyle, OR
Matt Rosendale, MT			Sydney Kamlager-Dove, CA
Lauren Boebert, CO			Seth Magaziner, RI
Cliff Bentz, OR				Nydia M. Velazquez, NY
Jen Kiggans, VA				Ed Case, HI
Jim Moylan, GU				Debbie Dingell, MI
Wesley P. Hunt, TX			Susie Lee, NV
Mike Collins, GA
Anna Paulina Luna, FL
John Duarte, CA
Harriet M. Hageman, WY


                    Vivian Moeglein, Staff Director
                      Tom Connally, Chief Counsel
                 Lora Snyder, Democratic Staff Director
                   http://naturalresources.house.gov
                                 
                                 ------                                

               SUBCOMMITTEE ON INDIAN AND INSULAR AFFAIRS

                     HARRIET M. HAGEMAN, WY, Chair

                JENNIFFER GONZALEZ-COLON, PR, Vice Chair

               TERESA LEGER FERNANDEZ, NM, Ranking Member

Aumua Amata C. Radewagen, AS         Gregorio Kilili Camacho Sablan, 
Doug LaMalfa, CA                         CNMI
Jenniffer Gonzalez-Colon, PR         Ruben Gallego, AZ
Jerry Carl, AL                       Nydia M. Velazquez, NY
Jim Moylan, GU                       Ed Case, HI
Bruce Westerman, AR, ex officio      Raul M. Grijalva, AZ, ex officio

                              ----------
                              
                               CONTENTS

                              ----------                              
                                                                   Page

Hearing held on Wednesday, May 8, 2024...........................     1

Statement of Members:

    Radewagen, Hon. Aumua Amata Coleman, a Delegate in Congress 
      from the Territory of American Samoa.......................     1

    Leger Fernandez, Hon. Teresa, a Representative in Congress 
      from the State of New Mexico...............................     3

Statement of Witnesses:

    Newland, Hon. Bryan, Assistant Secretary, Indian Affairs, 
      U.S. Department of the Interior, Washington, DC............     5
        Prepared statement of....................................     7
        Questions submitted for the record.......................    12

    Cantor, Hon. Carmen, Assistant Secretary for Insular and 
      International Affairs, Office of Insular Affairs, U.S. 
      Department of the Interior, Washington, DC.................    14
        Prepared statement of....................................    16
        Questions submitted for the record.......................    17

    Tso, Hon. Roselyn, Director, Indian Health Service, U.S. 
      Department of Health and Human Services, Rockville, 
      Maryland...................................................    18
        Prepared statement of....................................    19
        Questions submitted for the record.......................    25



 
     OVERSIGHT HEARING ON EXAMINING THE PRESIDENT'S FY 2025 BUDGET
                    REQUEST FOR THE BUREAU OF INDIAN
     AFFAIRS, INDIAN HEALTH SERVICE, AND OFFICE OF INSULAR AFFAIRS

                              ----------                              


                         Wednesday, May 8, 2024

                     U.S. House of Representatives

               Subcommittee on Indian and Insular Affairs

                     Committee on Natural Resources

                             Washington, DC

                              ----------                              

    The Subcommittee met, pursuant to notice, at 2:16 p.m., in 
Room 1324, Longworth House Office Building, Hon. Aumua Amata 
Coleman Radewagen [Member of the Subcommittee] presiding.
    Present: Representatives Radewagen, Carl, Moylan; Leger 
Fernandez, Sablan, and Case.
    Also present: Representative Stansbury.

    Mrs. Radewagen. The Subcommittee on Indian and Insular 
Affairs will come to order.
    Without objection, the Chair is authorized to declare a 
recess of the Subcommittee at any time.
    The Subcommittee is meeting today to hear testimony on the 
President's Fiscal Year 2025 budget request for the Bureau of 
Indian Affairs, Indian Health Service, and Office of Insular 
Affairs.
    Under Committee Rule 4(f), any oral opening statements at 
hearings are limited to the Chairman and the Ranking Minority 
Member. I therefore ask unanimous consent that all other 
Members' opening statements be made part of the hearing record 
if they are submitted in accordance with Committee Rule 3(o).
    Without objection, so ordered.
    I ask unanimous consent that the gentlewoman from New 
Mexico, Ms. Stansbury, be allowed to sit and participate in 
today's hearing.
    Without objection, so ordered.
    I will now recognize myself for an opening statement.

STATEMENT OF THE HON. AUMUA AMATA COLEMAN RADEWAGEN, A DELEGATE 
        IN CONGRESS FROM THE TERRITORY OF AMERICAN SAMOA

    Mrs. Radewagen. The Subcommittee is meeting today to 
examine the President's Fiscal Year 2025 budget request for the 
Bureau of Indian Affairs, or BIA; the Indian Health Service, or 
IHS; and the Office of Insular Affairs, OIA.
    Under the Constitution, Congress has the responsibility to 
tax and spend wisely, making decisions on how best to 
prioritize the finite Federal resources. It is also Congress' 
job to provide oversight of how Federal funds are spent by 
agencies, and their prioritization of programs and policies.
    The BIA is responsible for honoring the United States' 
treaty and trust responsibilities towards American Indians and 
Alaska Natives. The President's Fiscal Year 2025 budget 
requests $2.9 billion in discretionary funding for the BIA. 
Additionally, the budget proposes that tribal leases and 
contract support costs be reclassified as mandatory spending 
beginning in 2026, bypassing the appropriations process from 
that point on.
    The BIA administers 56 million surface acres and 59 million 
acres of subsurface mineral estates held in trust by the United 
States for the benefit of individual American Indians or 
tribes. The President's budget continues to focus on 
conservation and climate change programs that can limit tribal 
access to natural resource development on tribal lands. History 
has shown that we can balance conservation and resource 
development. Tribes have the knowledge and the experience to 
make it work, and BIA should be supportive of all efforts of 
self-determination.
    Turning to health care, the IHS is the primary agency 
charged with providing medical services to Native people, such 
as primary care, emergency services, and substance abuse care. 
The President's budget requests $8.2 billion and proposes 
moving all budgetary authority for the agency to mandatory 
spending starting in Fiscal Year 2026.
    I think many would agree that there needs to be continued 
oversight and accountability of IHS. There continues to be 
concerns with the agency's ability to provide adequate care and 
the efficiency of the Purchased and Referred Care program.
    Concerns also remain regarding the Indian health facilities 
construction list, as it has yet to be completed, and costs for 
these projects have ballooned. The average IHS hospital is 39 
years old, which is three times the age of an average U.S. 
hospital. The President's budget does not include any 
innovative proposals to address this ongoing issue.
    Additionally, questions remain regarding the hiring and 
retention of IHS medical and support personnel, how to best 
care for individuals suffering from substance abuse and mental 
health disorders.
    Lastly, the OIA is charged with carrying out the 
responsibilities for the U.S. insular areas of American Samoa, 
Guam, the Northern Mariana Islands, and the U.S. Virgin 
Islands, as well as administering the implementation of the 
Compact of Free Association, or COFA.
    OIA's budget shows an overall $9.62 million decrease in 
discretionary funding. However, this decrease is attributable 
to the expiration of the previous COFA agreements. If we look 
at the non-COFA-related spending, the OIA budget request is 
actually increasing discretionary funding by $2.44 million. I 
hope the testimony from our OIA witness today will clearly 
explain why the OIA has requested this increase, and how they 
calculated these costs.
    I would like to stress that Congress will continue to 
oversee OIA's implementation of COFA. We will not stand idly 
by, and we will ensure that all provisions are carried out in 
the manner that Congress intended.
    I would also like to remind the OIA of its responsibility 
to facilitate and coordinate the work of the interagency group 
on Freely Associated States. I urge the Department to be 
transparent and communicate timely with Congress on the status 
of COFA implementation.
    Energy security and reliability are of crucial concern for 
the insular areas. I want to ensure that the Department 
advances insular economic opportunity and self-determination to 
increase energy reliability and affordability.
    In general, the Federal Government has increased spending 
over the last decade, leading to a higher deficit and an 
increased worry for our nation's fiscal future. It is important 
that this Committee continues to provide oversight of the BIA, 
IHS, and OIA to ensure they are fulfilling their missions 
effectively in a fiscally responsible manner and for the 
benefit of those they serve.
    I want to thank the witnesses for being with us today.
    The Chair now recognizes the Ranking Minority Member for 
any statement.

STATEMENT OF THE HON. TERESA LEGER FERNANDEZ, A REPRESENTATIVE 
            IN CONGRESS FROM THE STATE OF NEW MEXICO

    Ms. Leger Fernandez. Thank you so very much, Madam Chair, 
for your opening statement, and thank you so very much to the 
witnesses for being here with us today on the budget request 
for the Bureau of Indian Affairs, Office of Insular Affairs, 
and the Indian Health Service.
    This Subcommittee has held 16 hearings this Congress 
discussing a wide range of issues and legislation that impacts 
Indian Country.
    We held a hearing on public safety in tribal communities 
and heard the consequences suffered by Native Americans from 
the lack of tribal law enforcement officers. In many cases, 
there are only a few tribal officers to patrol hundreds of 
miles to keep the community safe. And too often we hear that 
tribes must use their own funds to make up the funding 
shortfalls from Congress.
    In response, our Committee passed the Parity for Tribal Law 
Enforcement Act. This is a very important bill. But to actually 
make a difference and to have the parity work, we need to 
actually provide the funding so that we can get to parity. We 
need to make sure we appropriate the money to pay the salaries, 
to hire officers, and to purchase the needed patrol vehicles 
and other equipment.
    When we hear about priorities, I believe it is a priority, 
in fact, one of the most urgent priorities, given our trust 
responsibility to Indian tribes to fund the solutions to the 
problems we have heard about in this Committee room. For 
example, we recently heard about Purchased and Referred Care 
services at the Indian Health Service, and how the IHS needs to 
improve. But let's look at the funding numbers. The Indian 
Health Service's per capita expenditure per person was only 
$4,078 in Fiscal Year 2019, compared to the U.S. national 
health expenditure of $9,726 per person. That means that tribal 
citizens are seeing less than half the investment for their 
health.
    And I want to remind everybody, and myself, that we have 
taken on a trust responsibility and obligation to provide that 
health care. It was part of the promise we made in exchange for 
everything that the United States has received from the first 
Americans. It is unacceptable.
    [Chart.]
    Ms. Leger Fernandez. This chart tells it all. It shows the 
fact that for urban Indians it is even worse, $672.
    So, these highlight a common theme across all the hearings 
we have had in this Committee room this year and a half, 
stories from tribal leaders illustrating that Congress needs to 
be doing more to uphold our trust responsibility.
    Even when we heard about the benefits tribes see from 638 
contracts and compacts to the 477 workforce program at the BIA, 
it was coupled with agencies only having one or two staff to 
handle hundreds of applications. Deputy Secretary, you shared 
the increase in the requested self-determination contracts that 
you are seeing, but you have not increased the number of people 
to process that.
    And while we continually hear the benefits communities are 
seeing from the Bipartisan Infrastructure Law and the Inflation 
Reduction Act, I want to recognize that the bulk of the work 
mandated by these laws was sent to the Department of the 
Interior, including the BIA.
    I know that you are all working, processing more. I know 
that you are all working because we need to do more and do the 
kind of oversight and fixing the problems that aren't about 
funding, but are about responsiveness, communication, and 
transparency that you must do. But we will also need to couple 
that with the resources you need. The Indian Health Service and 
Bureau of Indian Affairs will see under your budget a 16 
percent and 18 percent increase in your budgets. This is a 
welcome increase, but we know it is not enough. Congress must 
do more when it comes to resources for Indian Country.
    Turning to the budget for our fellow U.S. citizens in the 
insular areas, the insular areas might be seen as small, 
isolated, and dependent on one or two main sources of income. 
But in our travels there we understand and we recognize the 
important role they play for America's national security and 
our identity in the blue continent. The insular areas are also 
on the front lines of the impacts of our changing climate, 
facing catastrophic hurricanes and typhoons almost annually.
    In many of the islands, Federal programs are the major 
source of government revenues. According to the Office of 
Insular Affairs statistics, Federal funds are 20 percent of the 
U.S. Virgin Islands government income, 33 percent in Guam, 34 
percent in the Mariana Islands, and 65 percent in American 
Samoa. Yet, despite these facts, the budget for the Office of 
Insular Affairs has remained constant for the past decade. It 
is my hope that, starting with today's hearing, we can, on a 
bipartisan basis, explore ways to ensure that adequate 
resources are provided to OIA to enable them to address the 
unique, important challenges that are faced by some of the most 
vulnerable members of our American family.
    Once again, thank you to the witnesses for being here 
today. Thank you for the work that you do for tribes and the 
insular areas.
    And I want to again go back to the theme of recognizing 
that you and your staff are processing more and more requests 
without a substantial increase in funding. And I would like to 
remind myself and my colleagues of the importance of funding 
these programs. Unlike any other Federal agencies, we have a 
trust responsibility to Native Americans because they don't 
have any other sources of funding. So, we will take that into 
account, and I look forward to hearing from you.
    With that, Madam Chair, I yield back.

    Mrs. Radewagen. Thank you. I will now introduce our 
witnesses for our panel.
    The Honorable Bryan Newland, Assistant Secretary for Indian 
Affairs, Department of the Interior, Washington, DC; the 
Honorable Carmen Cantor, Assistant Secretary for Insular and 
International Affairs, Office of Insular Affairs, Department of 
the Interior, Washington, DC; and the Honorable Roselyn Tso, 
Director, Indian Health Service, Department of Health and Human 
Services, Rockville, Maryland.
    Let me remind the witnesses that under Committee Rules, 
they must limit their oral statements to 5 minutes, but their 
entire statement will appear in the hearing record.
    To begin your testimony, please press the ``talk'' button 
on the microphone. We use timing lights. When you begin, the 
light will turn green. When you have 1 minute left, the light 
will turn yellow. And at the end of 5 minutes, the light will 
turn red, and I will ask you to please complete your statement. 
I will also allow all witnesses on the panel to testify before 
Member questioning.
    The Chair now recognizes the Honorable Bryan Newland for 5 
minutes.

   STATEMENT OF THE HON. BRYAN NEWLAND, ASSISTANT SECRETARY, 
INDIAN AFFAIRS, U.S. DEPARTMENT OF THE INTERIOR, WASHINGTON, DC

    Mr. Newland. Thank you, and good afternoon, Madam Chair and 
members of the Subcommittee. My name is Bryan Newland, and I 
have the privilege and honor of serving as the Assistant 
Secretary for Indian Affairs at the Department of the Interior.
    And I want to thank you, Madam Chair and members of the 
Subcommittee, for allowing me to present the Department's views 
on President Biden's budget request for Fiscal Year 2025 for 
Indian Affairs. That budget request totals $4.6 billion, which 
is an increase of $651 million over the Fiscal Year 2024 
enacted level of funding. This funding would go toward the 
Bureau of Indian Affairs, the Bureau of Indian Education, the 
Bureau of Trust Funds Administration, as well as programs 
within the immediate office of the Assistant Secretary, and 
this funding is an important step forward to meeting our trust 
obligations to Indian Country, and we believe that it supports 
the President's Executive Order to reform Federal funding and 
promote the next era of self-determination.
    Madam Chair, I have submitted a written statement for the 
record. I want to use my limited time here today to focus on 
three important areas of the President's budget: mandatory 
funding for legally required payments, funding for public 
safety programs, as well as management improvements.
    First, we have proposed reclassifying tribal contract 
support costs and 105(l) tribal lease payments as mandatory 
funding beginning in Fiscal Year 2026. We are required by law 
to provide these payments to tribes upon their request, and in 
recent years those costs have grown significantly. In Fiscal 
Year 2025, the Department will need an additional $232 million 
just to cover these costs without cutting funding for existing 
programs, programs like public safety, transportation, and 
education. Reclassifying these funds as mandatory aligns our 
appropriations with our legal obligations, and it protects 
funding for other programs that are essential for Indian 
Country.
    I also want to speak directly to funding necessary to meet 
our trust obligations to protect people across Indian Country. 
In Fiscal Year 2022 and 2023, we were able to work with 
Congress to secure an additional $131.2 million for public 
safety and justice programs within the BIA. I want to thank the 
Subcommittee and Congress for working with the Administration 
on those increases to our public safety and justice funding.
    But even with those increases, our most recent report to 
Congress under the Tribal Law and Order Act shows that the 
United States funds public safety and justice programs at only 
13 percent of the total need of Indian Country. In addition, 
appropriations law directed 52 percent of that increased 
funding in Fiscal Year 2022 and 2023 to just 16 tribes. That 
left only $11.5 million in additional funding to distribute 
across 182 tribes throughout the country.
    The President's Fiscal Year 2025 request would increase 
public safety and justice funding by 17 percent over the Fiscal 
Year 2024 enacted amount. That would include a $33.5 million 
program increase in criminal investigations and police 
services, which is specifically targeted to increase the number 
of officers and investigators on the ground across Indian 
Country. That would fund an additional 222 Federal and tribal 
police officers in tribal communities, and would also add an 
additional 120 Federal and tribal corrections staff at 
detention facilities.
    The 2025 budget request would get us from 13 percent of the 
overall need for public safety and justice in Indian Country up 
to 19 percent. Without this requested increase, the Department 
would have to reduce other public safety and justice programs 
to meet court-ordered obligations to the Navajo Nation. It 
would delay maintenance, as well as operating requirements at 
tribal courts.
    And lastly, I want to highlight the work our Indian Affairs 
leadership team is doing to improve our operations. We are 
prioritizing recruitment and retention of staff in critical 
areas such as law enforcement, awarding officials which move 
the money from the Bureau of Indian Affairs out to tribal 
governments, as well as our realty staff.
    Within our law enforcement programs we have worked to 
ensure that BIA officer salaries are in line with their 
counterparts at other DOI bureaus to improve our retention and 
recruitment rates and be competitive with other agencies.
    We are focused on infrastructure investment by exploring 
opportunities to address the growing number of 105(l) leases 
and data improvements related to facilities.
    We are also improving timelines for land into trust and 
other realty activities, and we are working to approach these 
issues from multiple angles, including resourcing and staffing 
levels, to improve our processes.
    Madam Chair, I want to thank you once again for the 
opportunity to testify, and I look forward to answering any 
questions members of the Subcommittee may have. Thank you.

    [The prepared statement of Mr. Newland follows:]
   Prepared Statement of Bryan Newland, Assistant Secretary--Indian 
                  Affairs, Department of the Interior

    Good afternoon, Chair Hageman and members of the Subcommittee. 
Thank you for the opportunity to provide a statement on the President's 
Budget Request for Fiscal Year 2025 (FY 2025) for Indian Affairs. The 
FY 2025 budget request for Indian Affairs programs totals $4.6 billion, 
which is an increase of $651 million over the FY 2024 Enacted level of 
funding.
    As the Assistant Secretary for Indian Affairs, I oversee the 
numerous programs within the Bureau of Indian Affairs (BIA), the Bureau 
of Indian Education (BIE), and the Bureau of Trust Funds Administration 
(BTFA) along with other programs within the immediate Office of the 
Assistant Secretary for Indian Affairs (IA or Indian Affairs). All of 
these programs play important roles in carrying out Federal trust, 
treaty, and other responsibilities to 574 federally recognized Indian 
Tribes. Programs serve more than two million American Indians and 
Alaska Natives in Tribal and Native communities. The BIA provides 
direct services and funding for compacts and contracts for Tribes to 
provide Federal programs for a wide range of activities necessary for 
strong Tribal communities, including natural resource and land 
management, public safety, and social service programs, among many 
others in Indian Country. BIE manages and serves a school system of 183 
schools, funds 29 Tribal Colleges and Universities (TCUs) and two 
Technical Colleges, delivering educational services and resources to 
approximately 40,000 K-12 students, as well as thousands of pre-school 
children and post-secondary college students. The BIE also operates two 
post-secondary schools. The BTFA is responsible for the financial 
management of approximately $8.8 billion of Indian trust funds held in 
about 4,200 Tribal accounts (approximately $7.2 billion) and about 
411,000 Individual Indian Money (IIM) Accounts (approximately $1.5 
billion). Indian Affairs programs are built on strong and productive 
government-to-government relations with Tribes.
    The FY 2025 budget request continues to invest in programs that are 
a foundation of Indian Country's strength. The request for the 
individual organizations is as follows: IA/BIA--$2.9 billion, an 
increase of $485.1 million above FY 2024 Enacted; BIE--$1.5 billion, an 
increase of $154.6 million above FY 2024 Enacted; and BTFA--$111.3 
million, an increase of $11.3 million above FY 2024 Enacted.
    The funding requested is an important step forward to meet our 
obligation to Tribes. To support fully meeting our obligation to 
Tribes, the President signed Executive Order 14112 (EO), Reforming 
Federal Funding and Support for Tribal Nations to Better Embrace Our 
Trust Responsibilities and Promote the Next Era of Tribal Self-
Determination. The EO directs Federal agencies to increase their 
deference to Tribal decision-making, streamline application processes 
for Tribes to obtain funding, and remove some restrictions and cost-
sharing requirements, consistent with applicable law or to recommend 
changes to existing law. The EO also directs the establishment of a 
one-stop Tribal funding clearinghouse and requires agencies to measure 
and report annually on Tribe-related funding need shortfalls. We have 
already established an initial clearinghouse and will continue to 
expand its contents and make it more user friendly to utilize for 
Tribes. I look forward to reporting to you on our further progress to 
meet the requirements of the EO.
    Before I dive into the details of the budget, I want to stress the 
importance of mandatory funding proposals for Indian Affairs and 
underline my focus on management improvements. Regarding mandatory 
funding, Contract Support Costs, payments for 105(l) Tribal leases and 
Water Rights Settlements costs are growing, legally required payments. 
These three programs should have mandatory funding to align with the 
mandatory legal requirements associated with each. If the funding 
associated with these programs is not transitioned to mandatory 
funding, it could force cuts to other critical operations such as law 
enforcement and school operations.
    Regarding continual management improvements, I want to let you know 
that our Indian Affairs leadership team is focused on operational 
improvements. One key area of focus is on improving recruitment and 
retention of staff in critical areas such as law enforcement, awarding 
officials and realty staff. Another area is infrastructure investment, 
this includes exploring opportunities to address the growing number of 
105(l) leases to process and data improvements related to facility 
improvement and repair and construction. We have also focused on 
improving timelines for land into trust status and other realty 
activities. In each of these areas, we are looking at these issues from 
multiple angles, including appropriate resources and staffing levels, 
process improvement and better use of technology. Now I will turn to 
highlights for the FY 2025 budget.
Strengthen Tribal Communities

    Tiwahe means family in the Lakota language and symbolizes the 
interconnected-ness of all living things and one's personal 
responsibility to protect family, community, and the environment. To 
empower federally recognized Tribes to realize this potential, IA 
launched the Tiwahe Initiative in FY 2015. The Tiwahe Initiative is an 
extensive and bold approach to furthering Indian self-determination. 
The Tiwahe Initiative fosters systemic change in the delivery of 
services to children and families through the integration of Tribal 
practices, customs, values, and traditions. Each participating site's 
Tiwahe Initiative plan offers Tribes the flexibility to design 
programming and services to address the gaps and needs of their 
individual communities. To date, the Tiwahe Initiative has focused on 
improving collaboration and coordination across core programs like 
social services, Indian Child Welfare Act (ICWA), recidivism, housing, 
and job placement and training. The 2025 Budget requests an increase of 
$28.6 million to expand the Tiwahe program by extending that 
coordination to include Healing to Wellness Courts and economic 
development needs as well as supporting the participation of new Tribes 
while sustaining the existing 10 Tiwahe Tribes.
Federal Boarding School Initiative

    The BIA is uniquely positioned to assist in the effort to recover 
the histories of Federal Indian boarding schools. In 2023, as part of 
the Secretary's Federal Boarding School Initiative (BSI), Secretary 
Haaland and I completed a 12-stop Road to Healing tour, during which we 
traveled to locations across the country giving Indigenous boarding 
school survivors the opportunity to share their stories and connect 
with trauma-informed support. The 2025 budget includes $7.0 million to 
continue the Secretary's BSI and its comprehensive review of Federal 
boarding school policies. This funding will continue to implement 
recommendations laid out in the May 2022 Federal Boarding School 
Initiative Investigative Report Volume 1, including continued 
historical research and documentation, and work to identify and protect 
the remains of those identified. The funding will also support an oral 
history project to document and make accessible the experience of the 
generations of Indigenous children who attended the Federal boarding 
school system. Through the BSI, the Department is seeking to work with 
Tribal Nations to begin the long healing process through transparency 
and accountability.
Protect Indian Country

    The BIA Office of Justice Services (OJS)-administered public safety 
and justice programs fund law enforcement, corrections, and court 
services to support safe Tribal communities and schools serving Indian 
Country youth. These programs safeguard life and property, enforce 
laws, maintain justice and order, and ensure detained American Indian 
and Alaska Native offenders are held in safe, secure, and humane 
environments. These programs also directly support the Administration's 
commitments to Indian Country, by increasing safety on Tribal lands and 
tackling the crisis of violence against Native women, children, and the 
elderly.
    The 2025 budget includes $651.2 million for Public Safety and 
Justice (PS&J) operations, an increase of $95.7 million above the 2024 
Enacted level. Operational funding supports the expanding Tribal needs 
in policing, detention, and Tribal courts. The budget includes a $33.5 
million program increase in Criminal Investigations and Police 
Services, specifically targeted to increase the number of officers and 
investigators on the ground in Indian Country. A program increase of 
$2.0 million is also requested to enhance functions within the OJS 
Professional Standards Directorate, including recruitment and retention 
initiatives, development and evaluation of law enforcement policies, 
program reviews, and training.
    The 2025 budget also includes $16.5 million to address the crisis 
of Missing and Murdered Indigenous People. The Missing and Murdered 
Unit engages in cross-departmental and interagency collaboration to 
identify gaps in information sharing and data collection to more 
effectively investigate these cases. As part of the proposed expansion 
to the Tiwahe Initiative, the budget includes a program increase of 
$1.9 million for the Office of Tribal Justice Support to provide 
technical assistance to Tribes looking to develop and operate Healing 
to Wellness courts. These courts serve as alternatives to incarceration 
and provide a culturally appropriate forum to support those within the 
criminal justice system by assisting in addressing underlying 
behavioral health and substance abuse issues.
    The recently released 2021 Tribal Law and Order Act report 
identified a total funding need of $3.5 billion for law enforcement, 
detention/corrections, and Tribal Court needs. (see: https://
www.bia.gov/sites/default/files/media_document/
2021_tloa_report_final_508_compliant.pdf). The total requested increase 
for law enforcement is an important step forward.
Economic Opportunities

    The 2025 budget funds the Community and Economic Development 
activity at $43.0 million, a $12.5 million increase above the 2024 
Enacted level, to advance economic opportunities in Indian Country. Job 
Placement and Training is funded at $13.9 million to assist Tribal 
members in obtaining job skills and finding and retaining jobs. 
Economic Development projects are funded at $24.5 million and include a 
request for an additional $11.5 million investment in Native language 
revitalization, which is crucial to preserve endangered languages, 
promote self-determination, and strengthen Tribal communities. A $1.2 
million program increase in Community Development Oversight is 
requested to support the implementation of Native language activities, 
the administration of the Native American Business Incubators program, 
and oversight of other grant programs.
Manage Trust Resources and Lands

    Tribal sovereignty and economic development cannot be achieved 
without addressing land needs. The FY 2025 budget continues to invest 
in Indian Land Consolidation with a request of $11 million to address 
fractionation and incorporate lessons learned from previous programs. 
This program has been especially important since the Land Buy-Back 
Program for Tribal Nations (LBBP), established as part of the Cobell 
Settlement, ended in November 2022. If the land consolidation program 
is not funded at a sufficient funding level, all the gains from 
reducing fractionation from LBBP funding could be lost by 2038, and we 
project that Indian Country will be back to the same level of 
fractionated interests as of 2012, preventing Tribes from effectively 
using large land areas. (see: U.S. Department of the Interior, ``Ten 
Years of Restoring Land and Building Trust 2012-2022, Land Buy-Buy Back 
Program for Tribal Nations,'' pg. 1 (December 2023)) The Land 
Consolidation program continues to be complimented by the $2 million 
provided for land acquisitions within Trust Real Estate Services 
through the Operation of Indian Programs account in FY 2024 enacted.
Trust Natural Resource Management

    The budget includes $359.3 million, a $37.0 million increase over 
the 2024 Enacted amount, for critical trust natural resources 
activities and investing in climate resilience and environmental 
justice. Of that amount, $48.8 million is provided for the Tribal 
Climate Resilience program. This program includes the Climate 
Relocation Grant program, which is funded at $13.5 million, $4.0 
million more than the 2024 Enacted amount, to provide relocation, 
managed retreat, and protect-in-place support for critically vulnerable 
communities. Also included in the request is $26.8 million for the 
Tribal Climate Adaptation Grant program, which helps Tribes better 
assess and address their growing adaptation needs. The Tribal Climate 
Resilience program also includes $7.8 million for Tribal youth corps 
programs. The Tribal youth corps program is an important jobs 
initiative to tackle climate change on the ground, ensure a living 
wage, and provide skills and a pathway to employment. These funds will 
also support Tribes in developing science, obtaining tools, training, 
planning, and implementing actions to build resilience into resource 
management, infrastructure, and community development activities. The 
budget supports the America the Beautiful initiative by honoring Tribal 
sovereignty and supporting the Trust Natural Resources priorities of 
Tribal Nations.
    Included in the budget request are two new elements of the Tribal 
Climate Adaptation program. First, it includes a $500,000 increase to 
fund the BIA's role in the National Seed Strategy. This funding will 
advance critical scientific requirements by supporting botanists and 
ethnologists who will seek out Indigenous knowledge to incorporate into 
restoration practices. The funding will also support co-developed 
climate adaptation and resilience best management practices for seed 
production and use in restoration. Second, in support of the White 
House national strategy to prioritize nature-based solutions (NBS) that 
benefit people and nature, advance equity, are evidence informed, 
integrate continuous improvement, and advance collaboration/co-
stewardship opportunities, the BIA is requesting $250,000 to establish 
a Resource NBS expert to implement the NBS roadmap and strategies. The 
BIA will develop and maintain a tool for Tribes and decision makers 
that allows access to data needed to invest in protecting, sustainably 
managing, and restoring natural ecosystems.
    The budget also includes $41.0 million to support Agriculture and 
Range efforts and $33.6 million for Energy and Minerals activities, 
which includes investment in the deployment of clean energy in Tribal 
communities. IA views renewable energy as one of many tools available 
to American Indians and Alaska Natives to create sustainable economies 
on Indian land; many Indian reservations are well positioned to access 
or provide a stable source of competitively priced, low-carbon clean 
energy. These efforts also support the Justice40 Initiative, ensuring 
that at least 40 percent of the overall benefits from certain Federal 
investments are delivered to disadvantaged communities.

Construction

    The 2025 budget includes $154.8 million for BIA Construction 
activities. The funding supports replacement and deferred maintenance 
projects to address needs at PS&J facilities. It also includes the 
irrigation rehabilitation program, which addresses critical deferred 
maintenance and construction needs at BIA-owned and operated irrigation 
facilities, including 17 Indian irrigation projects. The Safety of Dams 
program is responsible for 141 high-hazard dams on 42 Indian 
reservations. The Construction program also addresses needs at regional 
and agency offices serving Tribal programs and operations in Indian 
Country.
    Within Construction activities, the budget includes $10.0 million 
to address water-quality issues at BIA-owned water infrastructure, 
including systems of concern identified by EPA. In addition, $1.4 
million is included to support the Administration's governmentwide goal 
to accelerate the use of zero-emission vehicles (ZEVs) to enable a 
clean transportation future. Funds will be used to acquire ZEVs, 
install solar panels and related charging infrastructure, and perform 
planning and integration to support the initiative across Indian 
Affairs.

Contract Support Costs and Tribal Grant Support Costs

    Contract Support Costs funding is critical for Tribal sovereignty, 
enabling Tribes to assume responsibility for operating Federal programs 
by covering the costs to administer the programs. The budget proposes 
to reclassify Tribal Contract Support Costs from discretionary to 
mandatory funding beginning in 2026 while estimating $426.2 million in 
discretionary funding needs in 2025 to fully cover projected 
requirements.
    The BIE 2025 request includes $100.7 million in Tribal Grant 
Support Costs. These funds provide operating and staffing resources to 
Tribes who choose to operate BIE-funded schools. Nearly 70 percent of 
all BIE-funded K-12 schools are operated by Tribes.

Payments for Tribal Leases

    Section 105(l) of the Indian Self Determination and Education 
Assistance Act (ISDEAA) provides that Tribes and Tribal organizations 
carrying out Federal functions under a self-determination contract or 
self-governance compact may enter into a lease agreement with the 
Department for the Tribally owned or rented facility used to carry out 
those functions. This critical Tribal sovereignty payment is allowing 
IA to get Tribes closer to meeting the full cost of program 
implementation and improving their facilities. The 2025 budget proposes 
to reclassify 105(l) lease agreement requirements from discretionary to 
mandatory funding beginning in 2026 while estimating $120.0 million in 
discretionary funding needs in 2025 to fully cover projected 
requirements. The budget also includes an increase of $2.2 million in 
Executive Direction which will help fund additional staff to meet the 
growing level of requests of Tribes. The annual number of Tribal lease 
requests currently exceeds 600. This funding for additional staff is 
critical to meet this demand in a timely manner.
Land and Water Claims Settlements

    Tribal land and water rights settlements ensure that Tribes have 
access to land and water to meet domestic, economic, and cultural 
needs. The 2025 budget proposes $45.9 million for the Settlements 
account. The 2025 funding request covers the continuing implementation 
of the White Earth Reservation Land Settlement Act (Public Law 99-264) 
and Truckee River Operating Agreement (Public Law 101-618). The request 
also includes initial funding of $45.0 million for Federal payments 
authorized in the Hualapai Tribe Water Rights Settlement Act of 2022 
(Public Law 117-419). The Hualapai settlement authorizes discretionary 
appropriations of $317.0 million plus indexing to the Tribe for the 
construction of the Hualapai Water Project and other domestic water 
supply infrastructure on the Hualapai Reservation. Payments to satisfy 
the settlement must be made by April 15, 2029.
    The Administration is interested in working with Congress to find a 
solution to meet Federal commitments regarding current and future 
Indian water rights settlements, including the Hualapai settlement. The 
2025 President's Budget proposes legislation to provide robust 
mandatory funding for Indian Water Rights Settlements, building on the 
Indian Water Rights Settlement Completion Fund (IWRSC), established in 
the Bipartisan Infrastructure Law (Public Law 117-58). The IWRSC went a 
long way in clearing the backlog of settlement obligations and the 
Department has allocated over $2.4 billion of the $2.5 billion 
appropriated. However, more remains to be done. At this time, there are 
four Indian water settlements pending before Congress and a number of 
other water settlements are in negotiation and may be introduced soon. 
The proposal would provide the fund $2.8 billion: $250.0 million 
annually over 10 years for existing and future water rights settlements 
and $34.0 million a year over 10 years for on-going requirements 
implemented by the Bureau of Reclamation associated with the operation, 
maintenance, and repair costs of the Ak Chin Indian Water Rights 
Settlement Project, the Animas-La Plata Project (Colorado Ute 
Settlement), the Navajo Gallup Water Supply Project, and annual 
responsibilities under the Columbia and Snake River Salmon Recovery 
Project (Nez Perce Settlement).
Foster Tribal Student Success

    The 2025 budget for the BIE is $1.5 billion in current 
appropriations, a $154.6 million increase from the 2024 Enacted level. 
The budget includes key investments to strengthen the BIE's autonomy as 
a Federal agency and improve local services for Tribally controlled and 
bureau-operated schools while also advancing equity for historically 
underserved Tribal communities.
    The United States has a trust and treaty responsibility to provide 
eligible Indian students with a quality education. The BIE serves as a 
capacity builder and service provider to support Tribes in delivering 
culturally appropriate education with high academic standards to allow 
students across Indian Country to achieve success. Funding for the BIE 
supports classroom instruction, student transportation, Native language 
development programs, cultural enrichment, gifted and talented 
programs, behavioral health and wellness services, school safety, 
security, and education technology investments. The BIE operates two 
postsecondary institutions, administers grants for 29 Tribally 
controlled colleges and universities, funds two Tribal technical 
colleges, and supports multiple scholarship programs for highly 
qualified Native American students.
    The 2025 budget invests in improved educational opportunities and 
service delivery for Native American students from their earliest years 
through college. Under the BIE, the FY 2025 budget includes $310 
million for Education Construction activities, supporting critical 
school construction, deferred maintenance for schools and TCUs, and new 
employee housing and repair to support teacher recruitment and 
retention in underserved communities. With the 2025 budget request and 
Great American Outdoors Act Funding anticipated through 2025, the BIE 
expects to support the planning, design, and construction work at four 
BIE schools and address inflationary cost increases at schools funded 
in prior years. As the BIE continues to strengthen delivery of services 
to underserved communities as an independent bureau, the 2025 request 
includes a $6.3 million program increase in Education Program 
Management, which includes additional support for critical grant 
specialists, facilities specialists, and education information 
technology specialists. To ensure current and additional resources are 
well targeted, the BIE has developed and recently completed Tribal 
consultation across Indian Country regarding its 2024-2029 strategic 
plan, which will be published this summer. The BIE strategic plan 
creates a roadmap for the future to support Tribes in educating their 
youth and to deliver a world-class and culturally appropriate 
education.
Trust Fund Management

    The 2025 budget includes $111.3 million, an $11.3 million increase 
from 2024 Enacted, to support Tribal and Individual Indian Money 
financial functions managed by the Bureau of Trust Funds Administration 
(BTFA). The BTFA was established within the Office of the Assistant 
Secretary--Indian Affairs in 2020 to house the ongoing financial trust 
management functions of the Office of the Special Trustee for American 
Indians. Trust funds include payments from judgment awards, settlements 
of claims, land-use agreements, royalties on natural resource use, 
other proceeds derived directly from trust resources, and financial 
investment income. Trust financial management functions include 
receipting, investing, disbursing, reconciling, and reporting of trust 
funds on behalf of individual Indians. We appreciate Congress's full 
recognition of BTFA as a bureau in the FY 2024 Enacted Appropriation, 
which will allow the organization to focus on its mission of serving 
Indian Country.
Conclusion

    This FY 2025 budget request maintains strong and meaningful 
relationships with Native communities, strengthens government-to-
government relationships with federally recognized Tribes, promotes 
efficient and effective governance, and supports nation-building and 
self-determination. The request delivers community services, restores 
Tribal homelands, fulfills commitments related to water and other 
resource rights, executes fiduciary trust responsibilities, supports 
the stewardship of energy and other natural resources, creates economic 
opportunity, expands access to early childhood, K-12, and post-
secondary education, and assists in supporting community resilience in 
the face of a changing climate.
    Thank you for the opportunity to appear before you today. I am 
happy to answer any questions the Subcommittee may have.

                                 ______
                                 

Questions Submitted for the Record to the Hon. Bryan Newland, Assistant 
     Secretary for Indian Affairs, U.S. Department of the Interior

The Honorable Bryan Newland did not submit responses to the Committee 
by the appropriate deadline for inclusion in the printed record.

            Questions Submitted by Representative Westerman

    Question 1. As discussed during the hearing, the Committee has 
heard testimony from tribal members that are fearful of the influence 
criminal drug cartels have on tribal lands. Would you commit to work to 
form a multiagency task force focused specifically on the international 
drug cartels actions throughout Indian Country?

    Question 2. In your written testimony, you mentioned the Missing 
and Murdered Unit and how it has engaged in cross-departmental and 
interagency collaboration for data collection and information sharing.

    2a) Are there any barriers to interagency data sharing on this 
topic?

    2b) What legislative changes would the Department make to resolve 
any barriers to interagency data sharing?

    Question 3. The Land Buy Back Program spent $1.69 billion dollars 
to reduce land fractionation on reservation lands. However, as 
mentioned in your written statement, long-term forecasts indicate land 
fractionation levels will return to pre-program levels by 2038 without 
further sustained efforts.

    3a) Has the Department considered what programmatic changes to the 
Land Consolidation Program should be made to make sure funds 
appropriated for land consolidation are used sustainably?

    Question 4. The President's budget proposes $8 million for a Tribal 
Land and Water Conservation Fund.

    4a) Why does the fiscal year 2025 budget proposal move the Land and 
Water Conservation Fund from the BIA's account to the DOI?

    4b) Will this hinder BIA's ability to manage this suggested tribal 
set aside for the Land and Water Conservation Fund?

    4c) Is there concern that purchasing lands for tribes with LWCF 
funds will curtail the future use of these lands in a way that will 
prevent tribes from developing lands in multiple ways?

             Questions Submitted by Representative Hageman

    Question 1. I continue to hear from tribes across the country about 
issues associated with the responsiveness of the Bureau of Indian 
Affairs (BIA), especially in relation to the regional offices. These 
reported problems are not limited to one state or region, but are 
instead an agency wide responsiveness issue that impact a variety of 
tribal services.

    1a) Assistant Secretary Newland, are there processes or systems in 
place to track the questions and inquiries received, as well as BIA's 
responsiveness to the tribes they serve, including, but not limited to, 
metrics on the time it takes to respond to inquires, and whether the 
substance of such responses actually resolve the issues raised by the 
tribes?

                i) Could you share with the Subcommittee any documents, 
                forms, intake materials, etc., that will shed light on 
                how the BIA responds to tribal inquiries and requests?

    1b) If the BIA does not have any particular processes or systems in 
place to track tribal inquiries and agency responses (including time 
and substance), will you commit to reviewing this responsiveness issue 
and putting systems in place to address the complaints being received, 
including an oversight mechanism to gather the metrics on the inquiries 
being received and how quickly the BIA responds to messages?

             Questions Submitted by Representative Grijalva

    Question 1. The Department issued a final rule for the 
Implementation of the Native American Graves Protection and 
Repatriation Act that went into effect in January. Could you explain 
how the budget request will support the implementation of this new 
rule?

    Question 2. This year's budget request includes a budget proposal 
to transfer the Office of Subsistence Management (OSM) from the Fish 
and Wildlife Service to the Assistant Secretary for Indian Affairs. 
Could you expand on how this transfer would support the expansion of 
tribal co-management partnerships and the incorporation of Indigenous 
knowledge into subsistence management?

    Question 3. Are you able to provide us with a current estimate of 
the Bureaus of Indian Affairs and Indian Education's deferred 
maintenance backlog and how BIA and BIE are utilizing this budget 
request to work through the deferred maintenance backlog?

    Question 4. The FY25 budget request includes a proposal to shift 
funding from the Office of Hearings and Appeals Probate Hearings 
Division to the BIA from the Bureau of Trust Funds Administration. The 
Committee often hears from many tribes that they experience lengthy 
delays in completing probate cases due to the lack of available probate 
judges, leaving many tribal members having to wait up to 7 years for 
probate cases to be processed, even when the decedent has a will and 
often resulting in heirs dying before a decedent's probate is 
processed.

    4a) How will this proposal address the current delays and increase 
efficiency in handling probate cases?

    Question 5. The BIA's budget justification appropriately notes the 
critical need for additional funding for Tribal law enforcement and 
courts to serve their communities. I remain supportive of fully funding 
BIA programs to ensure that tribal communities have the resources they 
need yet historical underfunding has left many tribes without adequate 
funding for law enforcement. For example, for the Quechan Tribe in my 
district, tribal membership has grown significantly since its police 
department and tribal court were established. These crucial community 
services have been operating out of small buildings, which hinders the 
Tribe's ability to serve tribal members effectively and efficiently. 
The courthouse, for example, is currently a temporary modular structure 
and the Tribe has been exploring options to relocate the court at its 
own expense.

    5a) How will the increased funding in this budget request be 
distributed to Tribes to improve law enforcement and judicial 
infrastructure to meet the needs of growing tribal communities?

    Question 6. The Department was previously asked by Committee 
Republicans how Congress can assist the Department in providing more 
resources to tribal police departments for retention efforts without 
providing more funds.\1\ Do you believe there is a legislative path 
forward to address all the public safety needs in Indian Country, that 
does not include additional funding? How will public safety and 
infrastructure in Indian Country be further exacerbated by not fully 
enacting this budget request?
---------------------------------------------------------------------------
    \1\ May 25, 2023 IIA FY24 Budget Hearing--QFR from Rep. Hageman.

    Question 7. The FY25 budget includes $11 million for the Indian 
Land Consolidation Program. The primary goal of the Program is to 
strengthen tribal sovereignty and self-determination while reducing 
---------------------------------------------------------------------------
fractionation on Indian land.

    7a) If no action is taken to reduce fractionated interests, how do 
you expect the situation to look 10 years from now?

    7b) What is DOI doing to reduce the probate backlog? What are the 
current projections for its reduction over the next year?

    Question 8. How is BIA working to ensure transparent and fair 
property appraisals to ensure that Tribal members receive appropriate 
compensation for leasing their lands.

                                 ______
                                 

    Mrs. Radewagen. I thank the witness for their testimony. 
The Chair now recognizes the Honorable Carmen Cantor for 5 
minutes.

 STATEMENT OF THE HON. CARMEN CANTOR, ASSISTANT SECRETARY FOR 
 INSULAR AND INTERNATIONAL AFFAIRS, OFFICE OF INSULAR AFFAIRS, 
        U.S. DEPARTMENT OF THE INTERIOR, WASHINGTON, DC

    Ms. Cantor. Madam Chair and members of the Committee on 
Natural Resources, thank you for the opportunity to testify on 
the Fiscal Year 2025 budget request for the Office of Insular 
Affairs, OIA.
    OIA is responsible for administering the Federal 
Government's relationship with the territories of American 
Samoa; the Commonwealth of the Northern Mariana Islands, CNMI; 
Guam; and the United States Virgin Islands, USVI. OIA also 
administers the financial assistance provided to the Freely 
Associated States, FAS, of the Federated States of Micronesia, 
FSM; the Republic of the Marshall Islands, RMI; and the 
Republic of Palau under the Compacts of Free Association.
    The OIA request for current appropriations for 2025 is 
$119.1 million. This amount is a decrease of $4.4 million from 
the 2024 enacted current appropriation. Included in this 
current appropriation request are $91.4 million in 
discretionary funding and $27.7 million in mandatory funding. 
The President's 2025 budget request continues support for core 
OIA programs within the assistance to territories 
appropriation. These programs provide the territories with 
much-needed funding for the delivery of public services such as 
health and education, infrastructure investments, and technical 
assistance.
    The 2025 budget request for OIA's operational account is 
$11.5 million, an increase of $1.3 million over the 2024 
enacted level. This account provides OIA the staff and other 
resources we need to support the delivery and oversight of over 
$700 million a year in current and mandatory financial 
assistance to our territories and the Freely Associated States.
    The President's 2024 budget requested an increase of 
$544,000 to offset increases for fixed costs. This increase was 
not funded in OIA's 2024 enacted appropriation. The 2025 budget 
once again requests this increase, along with an additional 
$508,000 for 2025 fixed costs and $200,000 for NEPA support and 
compliance. The requested funding level for this account will 
maintain our current services and ensure mission delivery.
    OIA also requests an increase of $500,000 for the Brown 
Tree Snake Control Program in the 2025 budget request. Rising 
costs underlie the need for increased funding to maintain the 
program's 100 percent inspection rate, the key to successful 
brown tree snake interdiction programs in Hawaii, Guam, and 
CNMI.
    The U.S. territories and Freely Associated States face 
significant challenges related to infrastructure and 
resiliency. The President's budget supports these priorities 
for the insular areas by providing technical expertise and 
investments aimed to fortify and adapt both their public 
infrastructure and natural resources. OIA's technical 
assistance for $23.3 million, Energizing Insular Communities, 
$15.5 million; Coral Reef Initiative and Natural Resources, 
$2.8 million; Capital Improvement Project, $28.7 million; and 
Maintenance Assistance Programs, $4.4 million, all contribute 
to strengthening island communities.
    Mandatory funding for the Capital Improvement Project 
Program has not been increased or adjusted for inflation since 
the program's current authorization in 1996, and significant 
increases in construction and labor costs continue to erode the 
impact of the program on infrastructure needs in the 
territories. Considering this, the 2025 budget request includes 
$1 million in discretionary funding to provide additional grant 
funding to the territories as they continue to address critical 
needs for infrastructure improvement.
    For 2025, permanent mandatory commitments include an 
estimated $380 million for fiscal payments to Guam and the U.S. 
Virgin Islands. Guam is estimated to receive $80 million in 
income tax payments attributable to military and Federal 
personnel stationed in Guam. The USVI is estimated to receive 
around $300 million for excise taxes paid to the Federal 
Government on rum produced in the USVI.
    The Administration thanks Congress for passing the Compacts 
of Free Association Amendments Act of 2024, which extends $6.5 
billion in economic assistance to the Freely Associated States 
for another 20 years. Strong ties between the United States and 
the Pacific Islands, individually and collectively, form the 
foundation of U.S. engagement in the Pacific. The Department of 
the Interior is pleased to play once again a lead role as we 
move into the implementation phase of this newly-amended 
agreement.
    Madam Chair, it is a pleasure to appear before your 
Subcommittee to discuss the 2025 budget request for the Office 
of Insular Affairs. Thank you.

    [The prepared statement of Ms. Cantor follows:]
 Prepared Statement of Carmen G. Cantor, Assistant Secretary--Insular 
         and International Affairs, Department of the Interior

    Madam Chair and members of the Committee on Natural Resources, 
thank you for the opportunity to testify on the fiscal year 2025 budget 
request for the Office of Insular Affairs (OIA). OIA is responsible for 
administering the Federal government's relationship with the 
territories of American Samoa, the Commonwealth of the Northern Mariana 
Islands (CNMI), Guam, and the United States Virgin Islands (USVI). OIA 
also administers the financial assistance provided to the freely 
associated states (FAS) of the Federated States of Micronesia (FSM), 
the Republic of the Marshall Islands (RMI), and the Republic of Palau 
under the Compacts of Free Association.

        Overview of the Fiscal Year 2025 Current Budget Request

    The OIA request for current appropriations for 2025 is $119.1 
million. This amount is a decrease of $4.4 million from the 2024 
enacted current appropriation. Included in this current appropriation 
request are $91.4 million in discretionary funding and $27.7 million in 
mandatory funding.

    The President's 2025 budget request continues support for core OIA 
programs within the Assistance to Territories appropriation. These 
programs provide the territories with much needed funding for the 
delivery of public services such as health and education, 
infrastructure investments, and technical assistance.

    The 2025 budget request for OIA's operational account is $11.5 
million, an increase of $1.3 million over the 2024 enacted level. This 
account provides OIA the staff and other resources we need to support 
the delivery and oversight of over $700 million a year in current and 
mandatory financial assistance to our territories and the freely 
associated states. The President's 2024 budget requested an increase of 
$544,000 to offset increases for fixed costs. This increase was not 
funded in OIA's 2024 enacted appropriation. The 2025 budget once again 
requests this increase along with an additional $508,000 for 2025 fixed 
costs and $200,000 for NEPA support and compliance. The requested 
funding level for this account will maintain our current services and 
ensure mission delivery.

    OIA also requests an increase of $500,000 for the Brown Tree Snake 
Control Program in the 2025 budget request. Rising costs underlie the 
need for increased funding to maintain the program's 100 percent 
inspection rate--the key to successful Brown Tree Snake interdiction 
programs in Hawai'i, Guam, and CNMI.

    The U.S. territories and freely associated states face significant 
challenges related to infrastructure and resiliency. The President's 
budget supports these priorities for the insular areas by providing 
technical expertise and investments aimed to fortify and adapt both 
their public infrastructure and natural resources. OIA's Technical 
Assistance ($23.3 million), Energizing Insular Communities ($15.5 
million), Coral Reef Initiative and Natural Resources ($2.8 million), 
Capital Improvement Project ($28.7 million), and Maintenance Assistance 
programs ($4.4 million) all contribute to strengthening island 
communities.

    Mandatory funding for the Capital Improvement Project program has 
not been increased or adjusted for inflation since the program's 
current authorization in 1996, and significant increases in 
construction and labor costs continue to erode at the impact of the 
program on infrastructure needs in the territories. Considering this, 
the 2025 budget request includes $1.0 million in discretionary funding 
to provide additional grant funding to the territories as they continue 
to address critical needs for infrastructure improvement.
Fiscal Payments
    For 2025, permanent mandatory commitments include an estimated $380 
million for fiscal payments to Guam and the USVI. Guam is estimated to 
receive $80 million in income tax payments attributable to military and 
Federal personnel stationed in Guam. The USVI is estimated to receive 
around $300 million for excise taxes paid to the Federal government on 
rum produced in the USVI.
2024 Compacts of Free Association
    The Administration thanks Congress for passing the Compacts of Free 
Association Amendments Act of 2024, which extends $6.5 billion in 
economic assistance to the freely associated states for another 20 
years. Strong ties between the United States and the Pacific Islands, 
individually and collectively, form the foundation of U.S. engagement 
in the Pacific. The Department of the Interior is pleased to play once 
again a lead role as we move into the implementation phase of this 
newly amended agreement.

    Madam Chair, it is a pleasure to appear before your subcommittee to 
discuss the 2025 budget request for the Office of Insular Affairs.

                                 ______
                                 

Questions Submitted for the Record to the Hon. Carmen Cantor, Assistant 
            Secretary for Insular and International Affairs,
                    U.S. Department of the Interior

The Honorable Carmen Cantor did not submit responses to the Committee 
by the appropriate deadline for inclusion in the printed record.

            Questions Submitted by Representative Westerman

    Question 1. The budget justification for the OIA continues to pick 
winners and losers in the energy sector by promoting taxpayer money for 
renewable energy, which is clearly seen through the OIA's Energizing 
Insular Communities program. The Biden administration is bypassing an 
all-of-the-above energy strategy by electing to prioritize renewables 
over more reliable sources.

    1a) Do you agree that the territories should have access to 
reliable energy?

    1b) Do you agree that the territories should be able to have self-
determination in choosing the right energy options that fit their 
needs?

    1c) Are you aware that U.S. territories such as the USVI continue 
to suffer from frequent outages despite transitioning to solar and wind 
energy?

    1d) Will you commit to expanding energy options for the territories 
and not just the ones that the Biden administration deems as 
politically favorable?

    Question 2. The budget requests an increase in discretionary 
funding to American Samoa Operations, Capital Improvement Projects, the 
Office of Insular Affairs, Technical Assistance, Brown Tree Snake 
Control, the Coral Reef Initiative, Natural Resources, and Energizing 
Insular Communities grants. According to your written testimony, these 
increases reflect an increase in costs to carry out these programs. 
However, it is not clear how the OIA calculated the funding levels in 
its request.

    2a) Can you please elaborate on how the OIA came up with these 
costs?

    2b) Were these increases requested by outside agencies? If so, what 
has the OIA done to ensure that these increases are justified and are 
fiscally responsible?

    Question 3. There have been recent reports that the Federated 
States of Micronesia's (FSM) government signed ten memorandums of 
understanding (MOUs) with the People's Republic of China's (PRC) 
government. The PRC pledged to support the FSM with $14 million (USD) 
to fund multiple projects. This is especially concerning as several of 
these MOUs are for cooperation on infrastructure and economic 
development, areas that the COFAs are meant to address. There are 
serious concerns about how COFA funds could be used, directly or 
indirectly, to fund the PRC and PRC-linked entities for carrying out 
projects under these MOUs.

    3a) Is the Secretary of the Interior and the OIA aware of this news 
and agree that this is alarming?

    3b) Has the DOI approached the FSM government about this news and 
raised its concerns with how they could affect COFA implementation?

    3c) How will the DOI ensure that COFA funding is not going to be 
used to fund the PRC and any PRC projects?

    Question 4. On May 1, 2024, Secretary Haaland stated that the DOI 
is working to appoint their required members to the Compact's Economic 
Management and Trust Fund committees.

    4a) Can you provide us with an update on the appointment process?

    4b) Can the DOI commit that they will appoint highly qualified, 
senior-level members who have strong expertise in financial and 
economic management to these committees?

    Question 5. The renewed COFA's included provisions for the 
authorization of veterans' services to the FAS. As Co-chair of the 
Interagency Group, the Secretary of the Interior is tasked with 
coordinating federal agency implementation of the COFA provisions. You 
mentioned in your testimony that OIA has been collaborating with 
members of the Interagency Group to provide veterans access to these 
services.

    5a) Can you provide us with an update on the status of the 
implementation of veterans' services provisions?

    5b) Can you confirm that the Secretary of the Interior has begun 
coordination with the Secretary of Veterans Affairs to ensure that 
these provisions are carried out in the manner they were intended?

    Question 6. In the new Compact legislation, Congress mandated the 
formation of the Interagency Group on Freely Associated States. The 
purposes of the Interagency Group are to coordinate federal activity in 
or relating to the FAS, and to provide policy guidance and oversight to 
federal agencies with respect to COFA implementation. The Secretary of 
the Interior, as Co-Chair of the group, holds the responsibility to co-
lead regular meetings of the group and to facilitate and coordinate the 
group's work. You mentioned in your testimony that the Interagency 
Group had their first meeting, and that the DOI appointed their 
representatives to the Interagency Group.

    6a) Who are the representatives that the DOI appointed to the 
Interagency Group?

    6b) Can you confirm that these representatives are at a senior-
level and appropriate for the group? It is important that these 
representatives are at the most senior level possible in order to 
ensure proper coordination and to provide a clear signal to our FAS 
allies that we remain committed to the COFA.

    6c) Does the group plan to meet more than once this year? If so, 
when?

                                 ______
                                 

    Mrs. Radewagen. I thank the witness for their testimony. 
The Chair now recognizes the Honorable Roselyn Tso for 5 
minutes.

  STATEMENT OF THE HON. ROSELYN TSO, DIRECTOR, INDIAN HEALTH 
    SERVICE, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, 
                      ROCKVILLE, MARYLAND

    Ms. Tso. Good afternoon, Madam Chair and members of the 
Subcommittee. Thank you for the opportunity to testify on the 
President's Fiscal Year 2025 budget request for the Indian 
Health Service.
    I also want to first acknowledge and thank you for your 
work over the years to grow the Indian Health Service budget 
and prioritize health for Indian Country. We are especially 
grateful for the work in maintaining IHS advanced 
appropriations for Fiscal Year 2024. This is an historic 
achievement that has significantly changed delivery of health 
care for Indian Country.
    I am also happy to report that, because of the 2024 
advanced appropriations, IHS has made 100 percent of payments 
to eligible tribes through their contracts and compacts in the 
first 2 weeks of the Fiscal Year.
    I also appreciate the opportunity to share with you steps 
that I have taken as the IHS Director to improve transparency, 
accountability, and oversight of the agency.
    As we seek additional funding and new funding authorities, 
it is critical that the Indian Health Service improve internal 
operations to ensure safe, high-quality health care, protect 
and support its relationships with tribes and tribal 
organizations. To ensure that I fully understand the challenges 
and accomplishments throughout Indian Country, I value the time 
to visit with tribal leaders across the country to gain their 
input and perspective.
    In support of building a high-performing organization, I 
have implemented the first agency work plan in January 2023 
that achieved three major accomplishments, including a Total 
System Safety Strategy, IHS patient safety policy, and 
improvements to the Purchased and Referred Care program such as 
establishing updated medical priority levels, establishing a 
financial monitoring tool, and staff training to obligate PRC 
dollars in a timely manner.
    I know this Subcommittee held a legislative hearing on the 
Purchased and Referred Care Improvement Act for 2024. I am 
committed to the work with the Subcommittee and drafters of 
that legislation to improve and streamline the PRC program.
    Building on the work plan, our 2024 work plan outlined 
steps IHS is taking to address priorities, as well as mitigate 
risk. The agency work plan addresses a wide range of issues, 
including patient safety, human capital, operations, finance, 
and compliance. The work builds on our efforts to meet the GAO 
high-risk list and removal of the high-risk list for the Indian 
Health Service.
    With Congress' support, the IHS budget has grown by 69 
percent in the last decade. We know that this type of growth is 
challenging to accomplish in this constrained discretional 
funding environment. Over the years, the work with our tribal 
and urban partners underscores our shared goal to improve 
health outcomes for all American Indians and Alaska Natives. It 
is with this shared goal in mind that the Administration 
approached the 2025 budget request for the Indian Health 
Service.
    We know that, despite our shared goals and shared efforts, 
IHS is still underfunded, which I believe that Chair Hageman 
and the Ranking Member have mentioned before. This underfunding 
of the Indian Health Service system directly contributes to the 
stark health disparities in tribal communities. For example, 
the life expectancy of American Indians and Alaska Natives born 
today is 9.9 years less than all American races.
    Long-standing health disparities were also compounded by 
the pandemic, with American Indians and Alaska Natives 
experiencing disproportionate rates of COVID-19 infections, 
hospitalizations, and death. That is why the budget proposes to 
build on the enactment of advanced appropriations by funding 
the IHS as discretionary in 2025, and then, beginning in 2026, 
the budget would make funding for IHS mandatory.
    As we work towards securing stable, predictable, and 
adequate funding to meet the needs of Indian Country, we are 
committed to working closely with our stakeholders.
    Thank you for the opportunity to speak with you today, and 
I am happy to answer any questions.

    [The prepared statement of Ms. Tso follows:]
  Prepared Statement of Roselyn Tso, Director, Indian Health Service, 
                Department of Health and Human Services

    Good afternoon Chairman Hageman, Ranking Member Leger Fernandez, 
and Members of the Subcommittee. Thank you for your support and for 
inviting me to speak with you about the President's Fiscal Year (FY) 
2025 Budget Request for the IHS.
    The Indian Health Service (IHS) is an agency within the Department 
of Health and Human Services (HHS) and our mission is to raise the 
physical, mental, social, and spiritual health of American Indians and 
Alaska Natives (AI/ANs) to the highest level. This mission is carried 
out in partnership with AI/AN Tribal communities through a network of 
over 600 Federal and Tribal health facilities and 41 Urban Indian 
Organizations (UIOs) that are located across 37 states and provide 
health care services to approximately 2.8 million AI/AN people 
annually.
    On March 11, 2024, the White House released the President's FY 2025 
Budget, which builds on the historic enactment of advance 
appropriations for the IHS by taking a two-pronged approach. In FY 
2025, the Budget proposes to fund all IHS accounts (other than the 
Special Diabetes Program for Indians) as discretionary, building on the 
advance appropriations already enacted. Beginning in FY 2026, the 
Budget would make all funding for IHS mandatory. The action taken in 
the FY 2025 President's Budget demonstrates the Administration's 
continued commitment to strengthening the nation-to-nation 
relationship. This historic proposal addresses long-standing challenges 
that have impacted communities across Indian Country for decades.
---------------------------------------------------------------------------
    \1\ Government Accountability Office Report--Indian Health Service: 
Spending Levels and Characteristics of IHS and Three Other Federal 
Health Care Programs, https://www.gao.gov/assets/gao-19-74r.pdf
---------------------------------------------------------------------------
    The Indian Health system is chronically underfunded compared to 
other healthcare systems in the U.S.1,2 Despite substantial 
growth in the IHS discretionary budget over the last decade, 69 percent 
from FY 2013 to the current FY 2024 enacted level, the growth has not 
been sufficient to address the well documented funding gaps in Indian 
Country. These deficiencies directly contribute to stark health 
disparities faced by tribal communities. AI/ANs born today have an 
average life expectancy that is 10.9 years fewer than the U.S. all-
races population.
---------------------------------------------------------------------------
    \2\ U.S. Commission on Civil Rights Report--Broken Promises: 
Continuing Federal Funding Shortfall for Native Americans, https://
www.usccr.gov/files/pubs/2018/12-20-Broken-Promises.pdf
---------------------------------------------------------------------------
    AI/AN life expectancy dropped from an estimated 71.8 years in 2019 
to 65.2 years in 2021--the same life expectancy as the general United 
States population in 1944.\3\ They experience disproportionate rates of 
mortality from most major health issues, including chronic liver 
disease and cirrhosis, diabetes, unintentional injuries, assault and 
homicide, and suicide. AI/AN people also have higher rates of 
colorectal, kidney, liver, lung, and stomach cancers than non-Hispanic 
White people.\4\ The pandemic compounded the impact of these 
disparities in tribal communities, with AI/ANs experiencing 
disproportionate rates of COVID-19 infection, hospitalization, and 
death.
---------------------------------------------------------------------------
    \3\ Centers for Disease Control and Prevention (CDC) Report--Life 
Expectancy in the U.S. Dropped for the Second Year in a Row in 2021, 
https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/
20220831.htm#::text=AIAN%20people%20had%20a%20life,total%20 
U.S.%20population%20in%201944
    \4\ CDC--Cancer Within American Indian and Alaska Native (AI/AN) 
Populations, https://www.cdc.gov/healthytribes/native-american-
cancer.html
---------------------------------------------------------------------------
Leadership Priorities

    In January, the IHS implemented the 2024 Agency Work plan \5\ and 
closed out the 2023 plan. The 2023 Agency Work Plan produced remarkable 
achievements across the Agency, including implementing the Total System 
Safety Strategy, the IHS Patient Safety Policy in November 2023 to 
support system level safety for the IHS workforce and patients, and 
improvements to the Purchased/Referred Care (PRC) program, such as new 
medical priority levels, a financial monitoring tool, and staff 
training to obligate PRC funding in a timely way.
---------------------------------------------------------------------------
    \5\ Indian Health Service--FY 2024 Agency Work Plan, https://
www.ihs.gov/sites/newsroom/themes/responsive2017/display_objects/
documents/factsheets/2024_Agency_Work_Plan_ Update.pdf
---------------------------------------------------------------------------
    The 2024 Agency Work Plan outlines steps the IHS is taking to 
address priorities as well as mitigate risks. The plan details critical 
actions that will ensure safe, quality, and patient-centered care, as 
well as improve IHS operations and communication. The IHS will achieve 
these goals through rigorous management and oversight of resources to 
ensure the health care needs of AI/ANs are met. The 2024 Agency Work 
Plan also includes actions that are necessary to meet the U.S. 
Government Accountability Office's criteria for being removed from 
their high-risk list.\6\
---------------------------------------------------------------------------
    \6\ Government Accountability Office--Key Practices to Successfully 
Address High-Risk Areas and Remove Them from the List, https://
www.gao.gov/products/gao-22-105184
---------------------------------------------------------------------------
    As I travel across Indian Country, I see the consequences of 
decades-long underfunding of the Indian health system. I see the 
promise of what could be accomplished with appropriate funding for the 
IHS in the achievements of IHS-operated hospitals and health clinics, 
Tribal Health Programs, and Urban Indian Organizations, despite 
resource limitations. I also see the immediate impact of predictable 
and timely funding through advance appropriations, including the IHS's 
fastest-ever distribution of annually appropriated funds and the 
continued focus on patient care uninterrupted by delays or potential 
lapses in appropriations. The FY 2025 President's Budget moves the 
federal government closer to meeting its responsibilities to Indian 
Country than ever before.
Advance Appropriations and Long-Term Funding Solutions

    The FY 2025 President's Budget builds on the historic enactment of 
advance appropriations. For FY 2025, the Budget includes $8.2 billion 
in total funding for the IHS, which includes $8.0 billion in 
discretionary funding, and $260 million in proposed mandatory funding 
for the Special Diabetes Program for Indians. This is an increase of 
$1.1 billion above the FY 2024 Enacted level.
    Advance appropriations represent an important step towards securing 
stable and predictable funding to improve the overall health status of 
AI/ANs and ensuring that the disproportionate impacts experienced by 
tribal communities during government shutdowns and continuing 
resolutions are never repeated. While the progress achieved through the 
enactment of advance appropriations will have a lasting impact on 
Indian Country, funding growth beyond what can be accomplished through 
discretionary spending is needed to fulfill the federal government's 
commitments to AI/AN communities. Funding for IHS has grown 
substantially in the last decade, but this growth is not sufficient to 
address the historic underinvestment and persistent health disparities 
in AI/AN communities.
    The Budget proposes to fully shift the IHS budget to mandatory 
funding in FY 2026. Under the mandatory proposal, IHS funding would 
grow automatically to address the growing cost of providing direct 
health care services, including pay costs, medical and non-medical 
inflation, population growth, key operational needs, and existing 
backlogs in both healthcare services and facilities infrastructure. 
This mandatory formula culminates in a total funding level of 
approximately $42 billion in FY 2034. In total, the mandatory formula 
would provide approximately $289 billion for the IHS over the budget 
window. When accounting for the discretionary baseline, the net cost of 
the proposal is approximately $208 billion over the budget window.
    The Administration continues to support mandatory funding for IHS 
as the most appropriate long-term funding solution for the agency and 
will continue to work collaboratively with tribes and Congress to move 
toward sustainable mandatory funding. Until this solution is enacted, 
it is critical that Congress continue to provide advance appropriations 
for IHS through the discretionary appropriations process to ensure 
funding for healthcare services and facilities activities are not 
disrupted.
    Mandatory funding for the IHS provides the opportunity for 
significant funding increases that would be difficult to achieve within 
the limitations of the discretionary appropriations process. Further, 
this mandatory funding proposal would ensure greater predictability 
that would allow IHS, tribal, and urban Indian health programs the 
opportunity for long-term and strategic planning. This increased 
stability and ability to conduct longer-term planning will improve the 
quality of healthcare, promote recruitment and retention of health 
professionals, and enhance management efficiencies for individual 
health programs and the Indian Health system at large. The request also 
responds to the long-standing recommendations of tribal leaders shared 
in consultation with HHS and IHS to make IHS funding mandatory.
    The Budget also exempts all IHS funding from sequestration, which 
is the legislatively mandated process of budget control consisting of 
automatic, across-the-board spending reductions to enforce budget 
targets to limit federal spending. Exempting the IHS budget from 
sequestration ensures funding for direct health care services for AI/
ANs is not reduced and is consistent with the treatment of other 
critical programs such as veterans' health care benefits.
    Lastly, the Budget proposes to reauthorize mandatory funding for 
the Special Diabetes Program for Indians and increase funding to $260 
million in FY 2025 and $270 million in FY 2026. This program has proven 
to be effective at reducing the prevalence of diabetes among AI/AN 
adults.\7\ Potential net savings to Medicare due to averted cases of 
diabetes-related end-stage renal disease were estimated to be up to 
$520 million over 10 years.\8\ The budget's proposed increases will 
enable the program to expand to additional grantees and allow local 
recipients to plan for larger and longer-term interventions more 
effectively.
---------------------------------------------------------------------------
    \7\ British Medical Journal--Prevalence of diagnosed diabetes in 
American Indian and Alaska Native adults, 2006-2017, https://
drc.bmj.com/content/8/1/e001218
    \8\ HHS Assistant Secretary for Planning and Evaluation Issue 
Brief--The Special Diabetes Program for Indians Estimates of Medicare 
Savings, https://aspe.hhs.gov/sites/default/files/private/pdf/261741/
SDPI_Paper_Final.pdf
---------------------------------------------------------------------------
Prioritizing High Quality Health Care

    The Budget prioritizes investments that advance high quality health 
care and tackle the stark healthcare inequities 2.8 million Americans 
in the country who are AI/AN face every day.
    In FY 2025, the Budget provides $345 million to offset the rising 
costs of providing direct health care services. These resources will 
help the IHS to maintain medical care levels and address increasing 
costs affecting the operating budgets of IHS, Tribal, and urban Indian 
health programs.
    Similarly, the Budget includes $153 million to fully fund staffing 
and operating costs at ten newly-constructed or expanded health care 
facilities opening in FY 2024 and FY 2025.\9\ These funds will expand 
the availability of direct health care services in areas where existing 
health care capacity is overextended. Beginning in FY 2026, the 
mandatory funding formula fully funds current services and staffing and 
operating costs for newly opening facilities in the out-years, which 
ensure that health care services are maintained and/or expanded.
---------------------------------------------------------------------------
    \9\ As the budget was developed before Congress completed action on 
full year FY 2024 appropriations, the request includes $61 million to 
fully-fund staffing costs of 7 new or expanded facilities eligible for 
funds in FY 2024. Congress provided this funding in the FY 2024 
Omnibus, so this funding would become recurring and these increases 
would not need to be provided again in FY 2025.
---------------------------------------------------------------------------
    In FY 2025, the Budget also makes targeted investments to address 
our Nation's most pressing public health challenges, which 
disproportionately impact AI/AN communities, including an additional 
$10 million to address HIV, Hepatitis C, and sexually transmitted 
infections and an additional $10 million to address opioid use in 
Indian Country.
    The Budget also makes numerous investments in high priority areas, 
such as the expansion of the successful National Community Health Aide 
Program and other activities that support high quality health care.
    Likewise, from FY 2026 to FY 2030, the Budget requests an 
additional $11.6 billion in mandatory funding for the Indian Health 
Care Improvement Fund to address the funding gap for direct healthcare 
services documented in the FY 2018 level of need funded analysis.\10\ 
The Budget would continue growth for direct services once the 2018 gap 
is addressed. This funding would be distributed using the Indian Health 
Care Improvement Fund formula. The formula targets appropriations to 
the sites with the greatest need, as compared to the benchmark of 
National Health Expenditure Data, which is maintained by the Centers 
for Medicare and Medicaid Services. The formula is the product of long-
standing consultation with Tribes.
---------------------------------------------------------------------------
    \10\ Indian Health Service--FY 2018 Indian Health Care Improvement 
Fund Workgroup Interim Report, https://www.ihs.gov/sites/ihcif/themes/
responsive2017/display_objects/documents/2018/
2018_IHCIF_WorkgroupInterimReport.pdf
---------------------------------------------------------------------------
    The Budget also prevents a sharp reduction in services by providing 
an additional $220 million in mandatory funding in FY 2026 to partially 
sustain the one-time American Rescue Plan Act investments that were 
appropriated to expand access to mental health and substance abuse 
prevention and treatment services, and to expand the public health 
workforce in Indian Country.
    Lastly, the Budget proposes dedicated funding to address 
disparities in cancer rates and mortality among AI/ANs, providing $108 
million in mandatory funding in FY 2026 for the Biden Cancer Moonshot 
Initiative. Through this initiative, the IHS would develop a 
coordinated public health and clinical cancer prevention program to 
implement best practices and prevention strategies to address incidence 
of cancer and mortality among AI/ANs.
Modernizing Critical Infrastructure

    In addition to funding for direct health care services, additional 
investments are needed to address substantial deficiencies in physical 
and information technology infrastructure across the IHS system. 
Outdated infrastructure poses challenges in safely providing patient 
care, recruiting and retaining staff, and meeting accreditation 
standards. The Budget includes critical funding increases to reduce or 
eliminate existing facilities' backlogs and modernize the IHS 
Electronic Health Record (EHR) through implementation of a new system.
    The current IHS EHR is over 40 years old, and the GAO identifies it 
as one of the 10 most critical federal legacy systems in need of 
modernization.\11\ The IHS relies on its EHR for all aspects of patient 
care including the patient record, prescriptions, care referrals, and 
billing public and private insurance for over $1 billion reimbursable 
health care services annually. As a result of EHR modernization, 
patients and staff can expect improved patient safety, improved patient 
outcomes, better disease management, enhanced population health, 
improved clinical quality measures, opioid tracking, patient data 
exchange, third party revenue generation, and agency performance 
reporting, among others. Additionally, the new system will be 
interoperable with the Department of Veterans Affairs, Department of 
Defense, tribal and urban Indian health programs, academic affiliates, 
and community partners, many of whom use different health information 
technology platforms.
---------------------------------------------------------------------------
    \11\ GAO-21-524T, INFORMATION TECHNOLOGY: Agencies Need to Develop 
and Implement Modernization Plans for Critical Legacy Systems, https://
www.gao.gov/assets/gao-21-524t.pdf
---------------------------------------------------------------------------
    In FY 2025, the Budget provides $435 million in discretionary 
funding for EHR modernization, an increase of +$245 million above 2024 
Enacted to support licensing, hosting, training, site remediation, 
implementation, and support costs to implement a modernized system. The 
Budget then builds funding for EHR by adding $1.3 billion in mandatory 
funding each year from FY 2026-FY 2030 to fully fund the modernization 
effort. Once the EHR modernization effort is fully funded, the Budget 
maintains sufficient resources for ongoing operations and maintenance 
of the new system.
    The Indian health system also faces substantial physical 
infrastructure challenges--IHS hospitals are approximately 39 years old 
on average, which is over three times the average age of hospitals in 
the United States. Infrastructure deficiencies directly contribute to 
poorer health outcomes for AI/ANs and limit services that can be 
provided. Starting in FY 2026, the Budget addresses these needs by 
fully funding the 1993 Health Care Facilities Construction Priority 
List over 5 years. The remaining projects on the list include the 
Phoenix Indian Medical Center, Phoenix, AZ; Whiteriver Hospital, 
Whiteriver, AZ; Gallup Indian Medical Center, Gallup, NM; Albuquerque 
West Health Center, Albuquerque, NM; Albuquerque Central Health Center, 
Albuquerque, NM; Sells Health Center, Sells, AZ; Alamo Heath Center, 
Alamo, NM; Bodaway Gap Health Center, The Gap AZ; and Pueblo Pintado 
Health Center, Pueblo Pintado, NM.
    Furthermore, the Budget includes an additional $454 million in 
mandatory funding over two years, from FY 2026 to FY 2027, to fully 
fund the medical equipment backlog. Many IHS hospital administrators 
report that old or inadequate physical environments challenged their 
ability to provide quality care and maintain compliance with the 
Medicare Hospital Conditions of Participation. The administrators also 
report that aging buildings and equipment is a major challenge 
impacting recruitment and retention of clinicians.
    Maintaining reliable and efficient buildings is also a challenge as 
existing health care facilities age and the costs to operate and 
properly maintain health care facilities increases. Many IHS and Tribal 
health care facilities are operating at or beyond capacity and their 
designs are not efficient in the context of modern health care 
delivery. The Budget tackles this challenge by fully funding the 2023 
Backlog of Essential Maintenance, Alteration, and Repair for IHS and 
Tribal facilities of $2.0 billion over two years, from FY 2026 to FY 
2027.
    The mandatory budget ensures that these facilities investments can 
be rapidly addressed by providing sufficient administrative support 
increases. Specifically, the Budget increases the Facilities and 
Environmental Health Support funding to account for the growth in 
Health Care Facilities Construction and Sanitation Facilities 
Construction (SFC). This ensures adequate staff to properly oversee and 
implement facilities projects, as well as a comprehensive environmental 
health program within IHS.
    Beginning in FY 2027, the Budget provides an additional $250 
million to address operation and maintenance costs for sanitation 
facilities projects, addressing long-standing recommendations from 
Tribes. In addition, the Budget dedicates $10 million in mandatory 
funding to support a nation-wide analysis to understand the cost 
implications of implementing Section 302 of the Indian Health Care 
Improvement Act (25 U.S.C. 1632), which authorizes funding for 
operations and maintenance costs for tribes who choose to directly 
complete their own SFC projects. The results of this analysis will be 
used and implemented as part of the updated mandatory formula 
structure. These funds would be used by IHS and tribes to ensure that 
existing SFC projects are reaching their maximum life-cycle and 
operations of these projects are sustainable for as long as possible.
Supporting Self-Determination

    IHS continues to support the self-determination of tribes to 
operate their own health programs. Tribal leaders and members are best 
positioned to understand the priorities and needs of their local 
communities. The amount of the IHS budget that is administered directly 
by tribes through Indian Self-Determination and Education Assistance 
Act contracts and compacts has grown over time, with over 60 percent of 
IHS funding currently administered directly by tribes. Tribes design 
and manage the delivery of individual and community health services 
through 22 hospitals, 330 health centers, 559 ambulatory clinics, 76 
health stations, 146 Alaska village clinics, and 7 school health 
centers across Indian Country. In recognition of this, the Budget 
maintains an indefinite discretionary appropriation for Contract 
Support Costs and Section 105(l) lease agreements with estimated 
funding levels of $979 million for Contract Support Costs and $349 
million for Section 105(l) Lease Agreements in FY 2025. The budget also 
includes appropriations language to allow IHS not more than $10 million 
for management and oversight activities in each of the CSC and Tribal 
Lease Payments indefinite discretionary appropriations. These resources 
are critical for providing appropriate technical assistance to tribes, 
supporting timely processing of CSC and Section 105(l) lease 
agreements, and overseeing these ever-growing programs. Starting in FY 
2026, the Budget would provide mandatory, indefinite funding for these 
accounts across the 9-year budget window to ensure these payments to 
tribes are fully funded.
Future Emergency Preparedness

    Throughout the COVID-19 pandemic, the IHS made incredible 
achievements to save lives and improve the health of AI/ANs across the 
nation. The IHS worked closely with our Tribal and Urban Indian 
Organization partners, state and local public health officials, and our 
fellow Federal agencies to coordinate a comprehensive public health 
response to the pandemic. Our number one priority has been the safety 
of our IHS patients and staff, as well as Tribal community members.
    COVID-19 has disproportionally impacted AI/ANs. Deficiencies in 
public health infrastructure exacerbated the impact of COVID-19 on AI/
ANs. To address the long-term impacts of COVID-19, in FY 2026 the 
Budget provides an additional $130 million in mandatory funding to 
support IHS patients in recovery from the long-lasting effects of the 
COVID-19 pandemic, including treatment for long haul COVID-19. Based on 
data from 14 states, age-adjusted COVID-19 associated mortality among 
AI/AN was 1.8 times that of non-Hispanic Whites.\12\ In 23 states with 
adequate race and ethnicity data, the cumulative incidence of 
laboratory-confirmed COVID-19 among AI/AN was 3.5 times that of non-
Hispanic Whites. In the state of Montana, COVID-19 incidence and 
mortality rates among AI/AN were 2.2 and 3.8 times those among White 
persons, respectively.
---------------------------------------------------------------------------
    \12\ CDC--COVID-19 Mortality Among American Indian and Alaska 
Native Persons--14 States, January-June 2020, https://www.cdc.gov/mmwr/
volumes/69/wr/mm6949a3.htm#::text=Based% 
20on%20data%20from%2014,persons%20aged%2020%E2%80%9349%20years
---------------------------------------------------------------------------
    Beginning in FY 2026, the Budget also establishes a new dedicated 
funding stream to address public health capacity and infrastructure 
needs in Indian Country. This funding will support an innovative hub-
and-spoke model to address local public health needs in partnership 
with tribes and urban Indian organizations. Establishing a new program 
to build public health capacity is a key lesson learned from the COVID-
19 pandemic, and a top recommendation shared by tribal leaders in 
consultation with HHS. This includes $150 million in FY 2026, and would 
grow for inflation in the out-years under the formula, for a total of 
$500 million over nine years.
    These resources are necessary to develop appropriate public health 
and emergency preparedness capacity in AI/AN communities to prevent 
these disproportionate impacts in the future. Tribes do not receive 
dedicated public health funding from the Federal government, and the 
IHS does not currently have sufficient funding to support ongoing 
public health and emergency preparedness infrastructure. As of 2021, 
only four tribal public health agencies are accredited through the 
Public Health Accreditation Board. Comparatively, 40 State and 305 
local public health agencies were accredited as of 2021.\13\ The 
proposal complements the Budget's proposed investments in public health 
readiness and pandemic preparedness by ensuring IHS and Tribal 
communities have comparable resources to prepare for the next pandemic.
---------------------------------------------------------------------------
    \13\ Office of Disease Prevention and Health Promotion--Increase 
the number of tribal public health agencies that are accredited, 
https://health.gov/healthypeople/objectives-and-data/browse-objectives/
public-health-infrastructure/increase-number-tribal-public-health-
agencies-are-accredited-phi-03/data
---------------------------------------------------------------------------
Legislative Proposals

    In addition to proposed investments to ensure IHS has adequate 
operational capacity, the budget also includes several legislative 
proposals that would provide IHS with critical new or expanded 
authorities to address operational issues. Many of these proposals seek 
to enhance the agency's ability to recruit and retain healthcare 
providers, and provide parity with other federal agencies to increase 
IHS' competitiveness when hiring for key positions. The IHS, as a rural 
health care provider, experiences difficulty recruiting and retaining 
health care professionals, physicians and other primary care clinicians 
in particular. Staffing shortages are particularly prevalent in the 
behavioral and mental health fields, which has only exacerbated the 
concurrent substance use crisis and suicide crisis that tribes across 
the country are facing in their communities. Workforce challenges--and 
the impacts on care that come with them--are one of the top concerns 
raised to the Department by tribes. The proposed legislative changes 
would: 1) Extend Title 38 personnel authorities, to enable IHS to offer 
specialized pay and benefits for health providers; 2) Provide tax 
exemption for recipients of IHS scholarship and loan repayment 
benefits, and allow these recipients to meet their service obligations 
on a half-time basis; 3) Enable IHS to fulfill mission-critical 
emergency hiring needs; 4) Provide IHS authority to hire and pay 
experts and consultants; 5) Enable IHS to provide on-call pay to its 
healthcare providers; and 6) Enable U.S. Public Health Service 
Commissioned Corps officers to be detailed to Urban Indian 
Organizations.
Closing

    The FY 2025 Budget makes critical strides toward the goal of 
ensuring stable and predictable funding to improve the overall health 
status of AI/ANs. The Budget is a historic step and a continuation of 
an ongoing conversation with tribes to ensure the IHS system is meeting 
the healthcare needs in Indian Country. HHS looks forward to working in 
consultation with tribes, urban Indian organizations, and Congress to 
refine the FY 2026 mandatory proposal through the legislative process 
to strengthen the Nation-to-Nation relationship.

                                 ______
                                 

 Questions Submitted for the Record to the Hon. Roselyn Tso, Director--
  Indian Health Service, U.S. Department of Health and Human Services

The Honorable Roselyn Tso did not submit responses to the Committee by 
the appropriate deadline for inclusion in the printed record.

            Questions Submitted by Representative Westerman

    Question 1. Your written statement stated the need for a modernized 
Electronic Health Record at the Indian Health Service. Can you provide 
further details on the ongoing modernization effort, and what further 
steps are needed for full implementation?

    Question 2. Can you provide further information on the 2024 IHS 
Agency Work Plan, specifically discussing how the 2024 Plan's goals 
align with the actions IHS needs to take to meet the criteria set forth 
by GAO to remove the IHS from GAO's High-Risk List?

    Question 3. The 1993 Priority List for the IHS construction 
projects has not been completed. Why has it taken over 30 years to 
finish this priority list?

    3a) Besides funding, what other considerations have impacted the 
delay in the completion of the list?

    3b) After the 1993 Priority List is completed, how will the IHS 
decide on new facility construction priorities? And how will the delays 
in the finalization of the 1993 Priority List impact the way the IHS 
moves forward this time?

    Question 4. Your written testimony stated that the IHS is working 
on to improve the Purchased and Referred Care program and obligate 
these funds in a timely manner.

    4a) Can you provide the Committee with the total number of PRC 
funds carried over from the last fiscal year for all regions? And is 
the amount carried over been more or less compared to fiscal year 2022?

    4b) What additional improvements to the PRC program is the agency 
working towards this fiscal year, particularly to ensure PRC funds are 
used in a timely manner?

    Question 5. The Subcommittee has heard concerns surrounding the 
recruitment and retention of healthcare workers at IHS facilities, 
especially in rural America.

    5a) What is the current vacancy rate, service-wide, for health care 
workers in federally managed health units?

    5b) How does this compare to tribally run health units?

    5c) What is the average timeline from job announcement to 
onboarding for a new hire? And what process barriers should be 
addressed to ensure timely hiring of healthcare workers?

             Questions Submitted by Representative Grijalva

    Question 1. One of the principles underlying IHS's budget 
justification is recruiting and retaining health care professionals.

    1a) Could you elaborate on the declining medical employee and 
trainee recruitment and retention rates within IHS facilities and what 
factors contribute to poor recruitment and retention rates?

    1b) Please expand on how lack of funding for the housing for 
medical professionals is affecting Indian Country, especially in rural 
tribal areas?

    1c) What strategies is IHS implementing to address recruitment 
issues and to promote staff retention?

    Question 2. This year's budget request includes an additional $10.3 
billion across 9 years to address Health Care Facilities Construction 
needs, including fully funding the remaining projects on the 1993 
Health Care Facilities Construction Priority List.

    2a) Could you provide the Committee with the number of projects 
remaining on this list, their status, and the cost needed to complete 
them?

    2b) How does the status of this list constrained IHS' healthcare 
facilities?

    2c) How does the limited capacity issue affect IHS' patient 
population relying upon those facilities?

    2d) After the completion of all priority construction projects, 
what will be the next steps for IHS? Does IHS have a plan of action for 
other facilities construction?

    Question 3. The Special Diabetes Program for Indians has been 
instrumental in addressing the diabetes epidemic in Indian Country. The 
FY2025 budget request includes $260 million in proposed mandatory 
funding for the Special Diabetes Program for Indians and two proposals 
to exempt the program from mandatory sequester and reauthorization for 
the program.

    3a) Could you briefly expand on the impact this program has had on 
addressing diabetes in tribal communities?

    3b) Why is it so important to exempt the program from mandatory 
sequesters?

    3c) What are the future ramifications to the health and well-being 
of tribal communities if the Special Diabetes Program is not 
reauthorized?

    Question 4. The Bipartisan Infrastructure Law (Public Law 117-58) 
and provided $3.5 billion for IHS through FY2022 and FY2026 for the IHS 
Sanitation Facilities Construction Program and the FY 2025 budget 
submission for Sanitation Facilities Construction is $200 million.

    4a) Could you briefly explain the importance of this program and 
how it contributes to money saved down the line in patient care?

                                 ______
                                 

    Mrs. Radewagen. I thank the witness for their testimony. 
The Chair will now recognize Members for 5 minutes for 
questions, and I will begin by recognizing myself.
    Secretary Newland, the President's Fiscal Year 2025 budget 
calls for an approximately $26 million increase for critical 
trust, natural resource activities, and investing in climate 
resilience and environmental justice. Does the Biden 
administration only support tribes who invest in so-called 
green energy, while punishing tribes who know how to balance 
the development of natural resources and conservation?
    Mr. Newland. Thank you for the question, Madam Chair. We 
are proud of the investments we are making in climate 
resilience and in tribal communities. We have invested more 
than $100 million in efforts this year alone through the 
Bipartisan Infrastructure Law and Inflation Reduction Act to 
help more than 100 tribes across the country prepare for the 
challenges and deal with the threats that they are facing now 
as a result of climate change.
    But with respect to energy development, I want to make sure 
that I get into the record some important facts here about the 
work that the Department is doing across Indian Country. Since 
the beginning of 2021, the Department and the Bureau of Indian 
Affairs has approved six renewable energy leases on tribal 
lands. In that same time frame, the Bureau of Indian Affairs 
has approved 565 so-called conventional energy development 
leases on Indian lands across Indian Country. So, I think, 
Madam Chair, the notion that the Department is picking winners 
and losers when it comes to resource development in Indian 
Country doesn't match the facts.
    And what we are trying to do is make sure that we are being 
supportive of tribes in developing their energy resources in 
the manner they choose, whether they are conventional energy 
resources or renewable energy resources, and trying to make 
sure that our activities and our investments are matching what 
tribes are asking us to do.
    Mrs. Radewagen. As previously discussed in this Committee 
at multiple hearings, several tribal members are in fear of 
testifying in front of Congress due to retaliation efforts by 
criminal drug cartels who have invaded tribal lands. These 
cartels have run rampant across Indian Country, particularly in 
the northwestern region of the United States.
    Can you discuss the interagency coordination that BIA is 
involved in to tackle the human and drug trafficking in Indian 
Country?
    Mr. Newland. Thank you, Madam Chair. It is very clear in my 
conversations with tribal leaders, and I have seen some of the 
tribal leader testimony in front of this Subcommittee, that 
many communities are facing challenges when it comes to drug 
trafficking and public safety in Indian Country, and that is 
why we have proposed such a significant increase in public 
safety and justice funding.
    When it comes to drug enforcement in particular, the Bureau 
of Indian Affairs has a division within our law enforcement 
agency called the Division of Drug Enforcement, and they 
coordinate with tribal law enforcement agencies, as well as 
other bureau law enforcement within the Department of the 
Interior on drug enforcement. And just in 2023, for example, 
just within the Division of Drug Enforcement, their work in 
Indian Country has led to the seizure of more than 33,000 grams 
of fentanyl across Indian Country, and almost 500,000 pill-form 
pills in fentanyl across Indian Country. That is a dramatic 
increase over what we saw just 5 and 6 years ago from the 
Bureau of Indian Affairs law enforcement.
    So, there is no doubt, Madam Chair, that this is a 
challenge that tribal communities are facing. We are doing our 
best with the resources we have to coordinate with other law 
enforcement agencies, including tribal law enforcement, to 
address drug trafficking in Indian Country. And I believe, with 
the President's budget request, we are going to continue to 
strengthen our ability to respond.
    Mrs. Radewagen. Thank you.
    Secretary Cantor, on March 6, 2024, Congress passed 
legislation that renewed the Compacts of Free Association with 
the Republic of Palau, Republic of the Marshall Islands, and 
the Federated States of Micronesia. How is the OIA working to 
implement the compacts?
    Ms. Cantor. Thank you very much for the question, and thank 
you for supporting the approval and the enactment of the 
compacts, the compact three.
    Implementation is well underway. Both the Secretary of 
State and the Secretary of the Interior designated their 
representatives to the interagency group on the Freely 
Associated States, and I would like to report that the group 
already had their first meeting about a week ago with a number 
of members from the interagency. It was a great, great meeting.
    In terms of economic assistance, I can report to the 
Committee today that for the FSM in particular we have 
completed a transfer of $231 million in USG contributions to 
the Compact Trust Fund. Funds that are available right now, we 
are awaiting for Palau to draw down $50 million, the 
contribution from the United States to the Compact Trust Fund 
for Fiscal Year 2024. We are also waiting for Palau to draw 
down funds for $10 million, the contribution of the U.S. 
Government for the Palau Fiscal Consolidation Fund. And today, 
on May 8, we are going to be transferring $191 million to the 
RMI Compact Trust Fund.
    So, everything, like I said, is going really well, 
considering that the amendment was just approved less than a 
month ago.
    So, thank you so much for the question.
    Mrs. Radewagen. I would now like to recognize the Ranking 
Member for her questions.
    Ms. Leger Fernandez. Thank you so very much.
    Director Tso, you have in your written testimony the 
importance of addressing behavioral health, mental health. We 
just heard about the importance of interdicting fentanyl, and 
how the BIA in working with other Federal agencies has 
significantly, those were important numbers.
    I would like you to get us the numbers that you just talked 
about, Assistant Secretary.
    But I think it is really important, you didn't have time to 
go into that in your opening. Can you just tell us a little bit 
more about why that is so key?
    And then I want to do a follow-up with regards to 
telehealth services regarding that.
    Ms. Tso. Thank you very much for the question. So, two 
things I would like to identify in response to that.
    One, in health care we are really looking at those social 
determinants of health. So, it is not just a person coming in 
for care and addressing that particular matter, it is all of 
that, what that person might be dealing with. And in this case, 
again, the need for mental health and behavioral health is just 
first and foremost for Indian Country.
    When I look across IHS, while a majority of these programs 
are contracted and compacted by tribes, there is still not a 
sufficient amount of funds there. Just yesterday, I was talking 
with a tribal leader that is trying to figure out in their 
tribal communities, housing is a huge issue, for example. So, 
there is no way to address the housing issues that we have as a 
result of substance use, or fentanyl, or the challenges that we 
have, so these homes are no longer livable. So, how do we 
address that issue so we can then look at the health part of 
that?
    The part that we are looking at is far more than how do we 
do the care that we need to do? We are talking about 
transportation across Indian Country in terms of getting our 
people into the care that they need. So, the needs are 
significant.
    And as I look into this more, I look across over at the 
Veterans Administration budget, just to give you an example of 
the vast difference there. They have close to $14 billion for 
mental health to address mental health for our precious 
veterans. The Indian Health Service has just under $4 million 
to address the needs that we have.
    Ms. Leger Fernandez. Thank you, because I am running out of 
time, but I think that that is really key.
    And you also have suggested legislative changes because one 
of the things we really need to do is increase personnel and 
find a way to recruit that in. I am very interested in doing 
that because that is an issue both in rural America and in 
Indian Country.
    And as you know, I also think it is very important to make 
sure we have telehealth services, which we learned in one of 
the Committee hearings we don't. I have some legislation to 
address that, as well, because we need to make sure that we get 
this health care through all the means.
    I want to go to Secretary Newland.
    I am pleased to see that you are proposing funding for the 
Indian water rights settlement. If we don't fund those, we are 
not living up to the commitments we have made. Can you quickly, 
because I do have a question for Honorable Cantor, but can you 
talk about the importance of fully funding the Indian water 
rights settlements that we have already agreed to? These aren't 
the ones that we have to get to, these are the ones we have 
already agreed to.
    Mr. Newland. Thank you, Congresswoman. And I think you 
ended on an important point, that Congress has approved and we 
have signed into law authorizations for these water 
settlements. But that is only half the promise. The other half 
is to fulfill those water settlements. And what we have 
proposed is a $2.8 billion mandatory funding proposal to fund 
those water settlements, and also within the budget we have 
included a request for $45 million to begin funding the 
Hualapai Tribe's water settlement, which was enacted last year.
    So, that $2.8 billion we have proposed would be spent over 
10 years; $2.5 billion of that would go to fund enacted water 
settlements, as well as water settlements that we have been 
working with the Subcommittee on and other Members of Congress 
to get enacted.
    Ms. Leger Fernandez. Thank you, that is great.
    And I am so sorry, Honorable Cantor, that I am not going to 
have enough time, but I do recognize that we provided 
infrastructure funding, and I think it was very powerful, your 
statement that we haven't adjusted it for inflation, not just 
for the last several years following the pandemic and Russia's 
invasion of Ukraine, where we have seen a lot, but this has 
been decades in the making. So, thank you for that.
    And I did want to ask about whether you have been able to 
advocate for a permanent increase in CIP funding. I will ask 
that you perhaps respond to that question in writing, so that 
we can make sure we get to that.
    And my apologies. We always have so many more questions. We 
are so curious about so many things, and not enough time.
    With that, I yield back.
    Mrs. Radewagen. I will now recognize Mr. Carl for 5 minutes 
for questions.
    Mr. Carl. Thank you, Madam Chair.
    Secretary Newland, I have brought this issue up numerous 
times, and it is concerning that the tribal public safety 
continues to face significant challenges, to say the least. The 
Bureau of Indian Affairs Office of Justice Services shoulders 
the responsibility of administrating public safety and justice 
programs aimed at funding law enforcement, corrections, and 
court services to ensure the safety of the tribal communities.
    However, questions have been raised about the OJS's 
effectiveness, particularly in combining drug trafficking and 
addressing the disproportional rates of violence experienced by 
the Native American and Alaskan Native communities. At a recent 
Oversight and Investigations Subcommittee hearing, it was 
revealed that illegal drug cartels are actively targeting 
Indian Country, posing a serious threat to tribal members and 
public safety. This highlights the critical need for securing 
our borders, including the southern borders, to prevent such 
criminal activities from entering vulnerable territories.
    Additionally, Native Americans and Alaskan Native adults 
suffer from a high victimization rate, with more than four in 
five individuals experiencing some form of violence in their 
lifetime. This highlights the urgent need for enhancing safety 
measures within the tribal community.
    Given these developments, how can the Bureau of Indian 
Affairs effectively address the challenges of recruiting and 
retention within law enforcement to ensure that the increased 
funding leads to significant improvements in the tribal public 
safety and justice services, especially in the light of the 
drug cartel targeting the Indian lands?
    Mr. Newland. Thank you, Congressman.
    First, I would like to just note that there has been a long 
history of criminals who target Indian people in Indian 
Country, whether that is sexual assault, other forms of 
violence, or drug trafficking. Often because of the 
jurisdictional maze that we have built up for law enforcement 
in Indian Country, it makes it harder to enforce the law in 
Indian Country than it is in other places. Depending on who the 
perpetrator is or the victim, a different law enforcement 
agency could be responsible for enforcing the law, and this is 
not a new problem that we are facing. But the challenges you 
have raised are very real, and those are challenges we are 
working to address.
    One of the things that makes it difficult for our BIA law 
enforcement officers serving 34 different tribes is that they 
are often overtaxed, where they are working 6, 12-hour shifts 
alone, without backup. They often struggle to find housing in 
the communities they serve. So, they are either paying too much 
for housing or they have to commute a long distance to work. 
And these investments, by increasing staffing within the Bureau 
of Indian Affairs law enforcement can help our retention just 
by getting people back-up so they don't have to work 72 hours a 
week on their own.
    Mr. Carl. Well, let me ask you this. What kind of 
technology are we providing these tribes to use to monitor this 
activity? Are we supplying them with drones and the technology 
to help that, or is it just everything is done old fashioned, 
by cars?
    Mr. Newland. Well, I think in a lot of communities, 
Congressman, our tribal law enforcement agencies and Bureau of 
Indian Affairs officers are dealing with equipment that is beat 
up and older than their counterparts in other agencies. And in 
a lot of places, their cell phones and their radios might not 
even work in these remote areas. So, we have to get our 
officers better equipment to help address a lot of these 
challenges.
    Mr. Carl. Well, we have to address these challenges. And I 
think the IT approach is certainly one of them. It works well 
at the border, when we use it, for information. And I think the 
tribes need it probably worse than anybody, because there are 
so many miles they are actually trying to cover with one or two 
people. It is unfair for them.
    Mr. Newland. Thank you.
    Mr. Carl. Thank you, and thank all the Members and speakers 
for being here today.
    Thank you. I will return my time.
    Mrs. Radewagen. The Chair will now recognize Mr. Sablan for 
5 minutes for questions.
    [Pause.]
    Mrs. Radewagen. The Chair will now recognize Ms. Stansbury 
for 5 minutes for questions.
    Ms. Stansbury. Thank you, Madam Chairwoman.
    First of all, I just want to say welcome and thank you to 
both of our Assistant Secretaries and to our Director. I 
believe that you three and your staff sitting behind you in the 
agencies that serve our sovereign nations and tribes, both here 
in the United States and in the Pacific, have among the hardest 
possible jobs in the Federal Government. So, I want to say 
thank you for your service. Thank you for everything that you 
do.
    Now I am going to ask you some hard questions because we 
wouldn't be having a hearing, especially on tribal issues, if I 
didn't do that.
    Assistant Secretary Newland, I want to start with 
education. One of the wonderful things that we have done in New 
Mexico is increase teacher pay at the local level across the 
state. But unfortunately, our teachers who are serving through 
our tribal schools and through our BIE system are not having 
pay equity with our local school districts. And it is crucial 
that we increase funding for ISEP so that we can have pay 
equity. So, I want to ask you very briefly, can you tell me in 
this budget increase that BIE is requesting, will that increase 
in ISEP help our schools under the BIE and tribal systems 
increase teacher salaries?
    Mr. Newland. Yes. Thank you, Congresswoman.
    Ms. Stansbury. Awesome. Happy Teacher Appreciation Day. If 
there is any reason to advocate for an increase in BIE funding, 
there it is. We need to pay our teachers an equitable salary.
    Secondly, I also want to ask about public safety. We have 
numerous issues around BIA public safety issues in New Mexico. 
I know you are well aware of the challenges that the Mescalero 
Apache are facing down south in New Mexico. We also have a 
number of requests from our Pueblos. As you just said, the 
issue has been ongoing for decades, probably since the 
inception of this program. But how can we increase recruitment 
and retention and quality of service in our BIA law 
enforcement?
    Mr. Newland. Thank you, Congresswoman, and thank you for 
your advocacy on these issues.
    I actually had the opportunity to meet with leadership from 
the Mescalero Apache Tribe yesterday on these issues. And we 
discussed a positive development, which is the upcoming 
completion of a new jail and detention facility there so they 
will not have to send their inmates to distant counties for 
jailing.
    I have said in this hearing already, Congresswoman, that 
simply getting more officers into tribal law enforcement as 
well as BIA law enforcement, where we have direct service 
responsibilities, will alleviate the pressure that our current 
officers face because they are so often working long shifts 
alone. And that helps with retention alone.
    And one of the other challenges we faced when we began our 
work a few years ago was that our BIA law enforcement officers 
were not paid on par with their counterparts in other bureaus 
at the Department of the Interior, and it is really hard to see 
value in your own work when your employer is valuing your 
paycheck less than your colleague's. So, we set out to make 
sure that that was an easy fix, or easy thing for us to 
address, to make sure BIA law enforcement officers, as the 
Congressman just said and as you alluded to, they have some of 
the toughest jobs in policing. They were paid at least on par 
with their colleagues in the rest of the Department of the 
Interior to help both with recruitment and retention.
    So, these are some of the things that we are working on to 
improve there.
    Ms. Stansbury. Thank you, Assistant Secretary. And I want 
to turn quickly to Director Tso.
    Thank you for your service, and I think we face a similar 
issue with the Indian Health Service. I hear it every single 
day. We don't have enough doctors, enough nurses, enough 
clinicians. I have a workforce development bill that I worked 
on with IHS and my colleagues in the Native American Caucus. 
How can we recruit and retain more talent into the IHS system 
and to our tribes that contract for these services?
    Ms. Tso. Thank you very much for that question, 
Congresswoman.
    A number of things that we are doing at the Indian Health 
Service is taking some bold steps to make sure that we are 
doing everything we can on the retention side. The recruitment 
is just as important, but we have to retain the workforce that 
we have today. I will give you a couple of examples.
    One is that, for example, our doctors that work in the ER, 
we have adjusted their schedules to where they can work any 20/
80. Any 20/80 is the hours in a year. So, how do we maximize 
that? How do we use that kind of a system to have the provider 
work the hours that they can work for us? And then maybe they 
want to do something else, and they can have another life, 
perhaps, from that. So, we are making adjustments there.
    We have also taken steps to do some housing stipends across 
Indian Country. Again, we know housing is a challenge for us. 
If they have to drive a little bit further, maybe we can help 
them with a housing stipend, just some creative things that we 
are doing.
    We are also looking at the A19s, and making sure that our 
scholarships are the same, that there is equity across even HHS 
reimbursement for our scholars.
    At Indian Health Service, it is taxed. When you go over to 
HRSA, they are not taxed. So, just getting those aligned to 
where we can have parity across HHS would be helpful.
    Ms. Stansbury. Great, thank you.
    Thank you, Madam Chairwoman.
    And thank you again for your service, and everything you do 
for Indian Country and for our islands.
    Mrs. Radewagen. The Chair will now recognize Mr. Moylan for 
5 minutes for questions.
    Mr. Moylan. Thank you, Madam Chair, for holding this 
hearing and giving me the chance to speak with Assistant 
Secretary Cantor about the upcoming budget for the Office of 
Insular Affairs, and exactly how they plan to spend it.
    Assistant Secretary Cantor, first I want to express my 
thank you for all the visits that you come to Guam and really 
working closely with our administration and me, as well. But, 
of course, I do have some concerns, and I have expressed 
previously my sincere concerns that Guam is not being 
adequately reimbursed for the cost of housing of COFA migrants.
    With the support of Chairman Westerman, we held a hearing 
on my bill, H.R. 6273, the Guam Host Community Compensation 
Act. That bill would reinstate compact impact payments, and 
require that those COFA migrants imprisoned on Guam be 
transferred to the Federal prisons to serve their sentence. We 
have a great deal of over-crowdedness in our prison, and this 
would have been very helpful.
    This is the first time in decades that Guam would not have 
access to compact impact reimbursement funds. This is crucial. 
The Governor has spoken about this. We have spoken about this, 
and it is devastating that we can't supply this. But both I and 
the Governor have been assured that the compact impact fairness 
would cover our cost of hosting migrants. That is the question 
I am going to relate to you.
    Secretary Cantor, on Guam there is a lot of skepticism that 
CIFA will actually benefit our island. Can you please tell me, 
how can CIFA help Guam defray the cost of hosting COFA 
migrants? Is there a dollar amount per year you can give me?
    Ms. Cantor. Thank you so much for the question, Delegate, 
and you are right, we have had a number of conversations about 
this topic, including my deputy, the witness a couple of months 
ago, and you and him had a conversation about this, as well.
    I cannot give you a number. I don't have that. I can tell 
you, like we have said in the past, that CIFA is going to 
address the issues that are related to the FAS migrants, 
citizens that are going not only to Guam and Hawaii, but they 
are already in the mainland.
    Mr. Moylan. Secretary, thank you, and I understand that 
part. And, of course, we welcome the FAS. We are appreciative. 
We need this to continue. But the number is important. That is 
what I am asking from you. If you can come back to me with that 
number, that is what I need to know, please.
    And then I would like to move on to the next question, 
Secretary Cantor. How does CIFA help offset the public safety 
concerns that my constituents have shared with me?
    Our Guam police department is being asked to police 
thousands of migrants with no financial support from the 
Department of the Interior. Will OIA be providing financial 
support for them to hire and equip more officers?
    Our vehicles are rundown. I visit my police officers. Our 
staffing is short. We are having difficulties. It is a constant 
occurrence. So, will the OIA provide financial support for them 
to hire and equip more officers for Guam?
    Ms. Cantor. Delegate, once again, we have offered to meet 
with you and members of your staff to discuss CIFA. It is a new 
law, and I am offering that again to you. I don't think that we 
can discuss this in the next 2 minutes, but it is an important 
issue and we are hearing your concerns.
    Mr. Moylan. I appreciate that, and we will have the further 
discussion. We want to keep this open. We want to resolve this. 
We want to do what is right. So, thank you.
    A final question. Thank you, Secretary Cantor, for this. It 
is related to education. CIFA does not cover any expenditures 
from the Guam Department of Education who have thousands of 
COFA migrants, children, in their already-over-crowded schools. 
Will OIA commit to providing expanded financial and technical 
assistance to the Guam Department of Education to help them 
make up these major shortfalls in their budget, help us with 
our education?
    Ms. Cantor. Delegate, you know, all the territories can 
apply to our technical assistance programs and maintenance 
assistance programs. Once again, this is CIFA-related. I offer 
to you a meeting with you and members of your team to continue 
this conversation.
    Mr. Moylan. I appreciate that. I understand we have $28 
million available, and we are going to get to the bottom of 
that so we can help at least that part.
    I am looking forward to your continuous visits. I am sure 
we can get this done. And I appreciate what you do, as well as 
the other panel here with you today. Thank you very much.
    Thank you, Madam Chair.
    Mrs. Radewagen. The Chair will now recognize Mr. Sablan for 
5 minutes for questions.
    Mr. Sablan. Thank you, Madam Chair. Good afternoon and 
welcome to our witnesses. I am going to start with Ms. Cantor.
    Last week, I thanked Secretary Haaland, who was here, and I 
want to thank you also today for the President's 2025 budget 
request that maintains or increases programs vital to the 
Northern Marianas and all the insular areas. One of these, the 
Energizing Insular Communities program, supports the shared 
goal for most of us on both sides of this aisle to reduce 
reliance on expensive, foreign oil and increase domestic energy 
production. Not only will this program reduce the supply chain 
risk that comes with dependence on foreign energy, but it also 
holds the potential to cut the cost of electricity for my 
constituents. And the President's budget restores the funding 
that was cut in the 2024 appropriation. So, again, thank you.
    That said, I am not satisfied with the way your office 
administers this program. Insular Affairs Director John Brewer 
testified here a few weeks ago that the purpose of the 
Energizing Insular Communities is to help, underscore help, the 
insular areas develop energy strategies. But you see, Public 
Law 113-235, authored by former Virgin Islands Representative 
Donna Christensen, and I, members of this Committee, clearly 
states it is the responsibility of your office to develop and 
implement these energy plans.
    Of course, it would be useless for your office to develop 
plans for the insular areas without consultation or buy-in from 
them. But OIA has never accepted that it is primarily your 
responsibility to develop these plans and report to Congress on 
whether these milestones are being met. And I should know, 
because I sponsored the law.
    Now, fortunately, in the Marianas and the other insular 
areas, I think people understand the risk of dependence on 
imported fossil fuels. They understand the economics now favor 
alternatives like wind and solar, which we have in abundance, 
of course, and we are taking action. But could we make this 
transition much faster and much more efficiently? We could make 
this if OIA provided the plans and the technical and financial 
expertise as Public Law 113-235 directs.
    Will you, Madam Secretary, will you commit to follow the 
law?
    Ms. Cantor. Yes. We commit to following the law always.
    Mr. Sablan. All right. Well, you haven't been for several 
years now. Madam Secretary, I am asking you to please, this is 
really important. People in my district are paying close to 
$0.50 an hour for one kilowatt of electricity. It is in the 
$0.30, $0.40 range.
    Ms. Cantor. Delegate, the law is clear that the insular 
area energy plants should reduce reliance on fossil fuel 
imports and develop renewable energy sources. The CNMI projects 
funded through the EIC----
    Mr. Sablan. I understand that, Madam Secretary. Please 
excuse me. I am saying the law. Before you give out money, the 
plan was to build a plan for energy in the insular areas. You 
haven't done that. You have given out grants. I mean, Santa 
Claus does that on Christmas. You haven't done that. So, will 
you follow the law? Because it is on record, the law as written 
by Donna Christensen and I. Will your office follow the law, 
please?
    Ms. Cantor. Delegate, we follow the law.
    Mr. Sablan. All right. Madam Secretary, as you all know, 
Mariana's governor, Governor Palacios, recently asked President 
Biden for consultations for 902. The Marianas economy has never 
recovered from COVID. Last week, one of our crown jewel hotels, 
a Hyatt, announced permanent closure. The Governor wants to 
talk about direct financial assistance like Congress provides 
the Government of American Samoa, and he wants help in reviving 
tourism. He needs more skilled labor to put infrastructure 
dollars to work.
    Can you tell me where the Administration stands on my 
governor's request for consultations, and whether you 
understand how dire the economic situation is in the Northern 
Marianas?
    Ms. Cantor. Yes, Delegate. I am aware that Governor 
Palacios sent a letter to President Biden. I received a copy of 
the letter. Governor Palacios and I actually spoke on the phone 
late last week. We are in the process of waiting for the White 
House to determine who the representative is going to be for 
these consultations. But we know that this is very important to 
the CNMI Government.
    Mr. Sablan. All right. Thank you, Madam Secretary. Again, 
really, thank you for what you do. I am not here to argue with 
you, but this thing is not something I bring up just here. It 
is every year. And I should know what the law is intending to 
do, because Donna and I wrote the law.
    Thank you, I yield.
    Mrs. Radewagen. The Chair will now recognize Mr. Case for 5 
minutes for questions.
    Mr. Case. Thank you, Madam Chair.
    Ms. Cantor, adding my congratulations for achieving the 
compacts, a lot of people had a piece of this. I see Mr. Nakoa 
behind you. He was one of many, but he was an important one of 
many. And I am only singling him out because he is from Hawaii, 
so I feel a special obligation to do that.
    But there comes a time at which we have to stop patting 
ourselves on the back and get it done. And it was very 
gratifying to hear your response to the Chair in terms of the 
progress you are already making in terms of, especially, the 
interagency working group trying to start to implement it. My 
questions are really just further along the lines of actual 
implementation, because I think the worst thing we could do at 
this point is to get it done and then let it lag. So, a couple 
of questions.
    First of all, I assume that the interagency working group 
is about working through the COFA side of the compacts, really, 
trying to get that done. But is there a similar effort, going 
to Mr. Moylan's questions, on CIFA to work through the specific 
issues that exist both generally with CIFA, in terms of how to 
actually turn the Federal bureaucracy to the idea that these 
are now Federal obligations to specific concerns that some of 
the compact resident communities, principal ones might face, 
including Guam and Hawaii?
    Do you have some kind of an interagency working group? How 
are you coordinating that? What is your schedule to implement 
the actual coverage? Do you have to go through a regulatory 
process at this point, or can you just turn it on, pretty much?
    Ms. Cantor. Congressman, thank you so much for the 
question, and also thank you for the support that you gave us 
through this process.
    And yes, Keone is one of the most valued members of my 
team, and I am very happy to know that he is from Hawaii, as 
you are.
    I guess I mentioned the IAG met for the first time last 
week. We have not discussed whether we are going to be 
discussing the CIFA issues. We are going to be watching what 
happens with CIFA. We do know for a fact that the FEMA benefits 
that CIFA residents, CIFA migrants can receive, the ones that 
were in Maui last year because of the fires, this was applied 
retroactively, and they were able to receive some of those 
benefits.
    But no, the answer is no, we haven't discussed the CIFA, 
but it is a good idea that I am going to take back and discuss 
with the other co-chair.
    Mr. Case. I think we need an organized plan on implementing 
CIFA as soon as possible. It is not quite as easy as it sounds. 
I am sure there are going to be a lot of questions. Thank you 
so much for the FEMA side of things, that was a very good 
development, but there are many other parts of CIFA, so I 
wouldn't want that to lag, for sure.
    This all happened fairly recently, and I am sure the 
President's budget was in development long before we actually 
achieved approval of the compacts. But does the President's 
budget anticipate needs arising out of COFA in Fiscal Year 
2025, or do you have to go back, and CIFA for that matter, or 
do you have to go back now and update your numbers for 
implementation of COFA and CIFA in Fiscal Year 2025?
    Ms. Cantor. We are going to be watching very closely. We 
haven't had any conversations yet, but if we do have to go back 
and make some adjustments and request some adjustments, we will 
do so.
    Mr. Case. OK.
    Ms. Cantor. Or in 2026.
    Mr. Case. Well, I am worried about 2025, because we are 
about to mark up those bills. I am on the Appropriations 
Committee, and I guess what I don't want to do is get through 
an appropriations season in the House and have to scramble 
before September 30 on a supplemental basis. Far better to know 
what the budget numbers are right now and get it into that 
process right now than play catch-up on it. That money has to 
last for the remainder of this year and for next year. So, if 
there are going to be expenditures that are not anticipated in 
the President's budget, we ought to know about them as soon as 
possible and get them into the mix. I would make that request 
back to you on a multi-agency basis, because it is not just 
your department.
    Ms. Cantor. Understood.
    Mr. Case. I am sorry. And then finally, I would highlight 
for you a particular issue that I think needs a little bit of 
expeditious implementation, and that is the provisions of the 
compacts that basically changed the construct that we follow 
for veterans, United States military veterans living in the 
compact countries. This is a persistent issue for those 
countries. We owe it to those veterans to treat them as any 
other veteran. The compact anticipated that those countries 
would now be able to provide that service on a reimbursable 
basis, and made other changes to really give them far more 
equity.
    What I am concerned about is that lag. I spoke with two out 
of the three presidents on this issue just in the last week, 
and they highlighted it to me, I didn't raise it. So, this is a 
critical issue for all three countries. I commend that to you 
as something that we need to move along, and also the same 
question as to the budgeting of that in Fiscal Year 2025, in 
particular.
    My time is up, but that is an important issue to not let 
get away from us.
    Ms. Cantor. No, and we are aware that this is a very 
important issue, not only for us, but the veterans and the 
presidents of the countries. We have been hearing from them, as 
well.
    Let me tell you that we have been collaborating with the 
members of the interagency, trying to figure out how to help 
and provide the improved access that they deserve and they have 
earned.
    Mr. Case. Thank you very much.
    Ms. Cantor. Thank you.
    Mrs. Radewagen. I thank the witnesses for their valuable 
testimony and the Members for their questions.
    The members of the Committee may have some additional 
questions for the witnesses, and we will ask you to respond to 
these in writing.
    Under Committee Rule 3, members of the Committee must 
submit questions to the Committee Clerk by 5 p.m. on Monday, 
May 13, 2024. The hearing record will be held open for 10 
business days for these responses.
    If there is no further business, without objection, the 
Committee stands adjourned.

    [Whereupon, at 3:25 p.m., the Subcommittee was adjourned.]

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