Questions for the Record — Hearing on H.R. 5549, Subcommittee for Indigenous Peoples (July 28, 2022)

Summary

Questions for the Record for a Legislative Hearing on H.R. 5549 before the Committee on Natural Resources Subcommittee for Indigenous Peoples of the United States, dated July 28, 2022, at 1:00 p.m. ET. The questions come from Rep. Grijalva and are addressed in turn to Elizabeth Fowler, Acting Director, Indian Health Service; Johnathan Nez, President, Navajo Nation; Kirk Francis, President, United South and Eastern Tribes Sovereignty Protection Fund; Fawn Sharp, President, National Congress of American Indians; and Maureen Rosette, Board Member, National Council of Urban Indian Health. They ask about advance appropriations for the Indian Health Service, funding gaps and the last partial government shutdown in 2018.

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“Questions for the Record — Hearing on H.R. 5549, Subcommittee for Indigenous Peoples (July 28, 2022).” Original at docs.house.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/hhrg-117-ii24-20220728-qfr101-13dc0ed89540-7437e68f98/, SHA-256 13dc0ed89540005798c4f6abc9967dec6a71699c2a8f2565c93bd3b594ede190.

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COMMITTEE ON NATURAL RESOURCES
SUBCOMMITTEE FOR INDIGENOUS PEOPLES OF THE UNITED STATES
1324 LHOB & CISCO WEBEX
July 28, 2022 at 1:00 p.m. ET

Questions for the Record

Legislative Hearing on H.R. 5549

Questions from Rep. Grijalva for Ms. Elizabeth Fowler, Acting Director, Indian Health Service

1. Why can’t IHS do an exception apportionment for Urban Indian Organizations during a
CR?

2. Has the Indian Health Service initiated any policies to prepare for future funding gaps?

3. President Biden’s FY2023 budget request included mandatory funding for the Indian
Health Service.
a. Can you explain how this is different from advance appropriations for the Indian
Health Service?
b. Do mandatory funds require authorization from Congress?
c. Are these mandatory funds subject to change in the future?

4. Are you able to further detail some of the obstacles that faced Indian Health Service
clinics during the last partial government shutdown in 2018?

Questions from Rep. Grijalva for Hon. Johnathan Nez, President, Navajo Nation & Navajo
Area Representative, National Indian Health Board

1. Can you speak more on the united front that tribal governments and organizations have
maintained when advocating for advance appropriations for the Indian Health Service?

2. How has annual budget uncertainty for the Indian Health Service impacted health care
providers in the Navajo Nation?

3. As a tribal leader, can you explain how securing advance appropriations for the Indian
Health Service would enable the federal government to better fulfill its trust obligations
to Indian Country?

4. During federal funding gaps for tribal programs, tribal governments must often utilize
their own funds to “keep the lights on.”
a. The last partial government shutdown occurred for 35 days back in 2018. What
were some actions that your tribal government had to undertake during this time?
b. If Navajo Nation had to cover any federal costs, were these added costs ever
addressed by the federal government after the shutdown ended
COMMITTEE ON NATURAL RESOURCES
SUBCOMMITTEE FOR INDIGENOUS PEOPLES OF THE UNITED STATES
1324 LHOB & CISCO WEBEX
July 28, 2022 at 1:00 p.m. ET

Questions for the Record

Questions from Rep. Grijalva for Hon. Kirk Francis, President, United South and Eastern
Tribes Sovereignty Protection Fund

1. Your testimony notes that the COVID-19 pandemic has demonstrated the need for a
comprehensive overhaul of tribal funding mechanisms.
a. Can you elaborate more on this observation?

2. Your testimony mentions the many consequences that tribal governments faced during
the last government shutdown in 2018.
a. Can you speak more on the difficulties that the United South and Eastern Tribes
Sovereignty Protection Fund’s (USET SPF) member tribal nations experienced
during this time?
b. What about within your own Nation?

3. In your experience, how does discretionary annual funding for the Indian Health Service
impact current tribal health disparities?

4. Your testimony notes that there is some confusion in Indian Country about which entity
in Congress has the authority to secure advance appropriations for the Indian Health
Service.
a. Can you elaborate more on this?

Questions from Rep. Grijalva for Hon. Fawn Sharp, President, National Congress of American
Indians

1. What are some stories that you’ve heard from the National Congress of American
Indian’s (NCAI) member tribal nations about their experiences during federal funding
gaps for tribal programs?
a. What about the experiences your own tribal government faced during government
shutdowns?

2. In what ways would securing advance appropriations for the Indian Health Service
streamline the budget process and reduce taxpayer waste?

3. In your experience, how would ensuring the continuity of care for Indian Health Service
clinics and programs help tribal governments better plan for longer-term objectives?

4. As your testimony states, the Indian Health Service is the only federal health care
provider that does not receive advance appropriations.
COMMITTEE ON NATURAL RESOURCES
SUBCOMMITTEE FOR INDIGENOUS PEOPLES OF THE UNITED STATES
1324 LHOB & CISCO WEBEX
July 28, 2022 at 1:00 p.m. ET

Questions for the Record

a. How does this current system contribute to further Broken Promises?

Questions from Rep. Grijalva for Ms. Maureen Rosette, Board Member, National Council of
Urban Indian Health

1. In what ways are urban Indian organizations impacted by the current appropriations
process for the Indian Health Service?

2. Can you speak on the National Council of Urban Indian Health’s (NCUIH) recent
advocacy for advance appropriations to both Congress and the Biden administration?

3. Can you elaborate on the issues experienced by urban Indian health care providers during
the last partial government shutdown in 2018?

4. You mentioned in your testimony that your health facility still has millions of dollars of
critical outstanding COVID-19 funding.
a. What funding are you referring to and how would an advance appropriations
policy for the Indian Health Service have helped with the pandemic?

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