Letter from Miami Tribe of Oklahoma on H.R. 5549, Indian Health Service Advance Appropriations Act

Summary

Chief Douglas G. Lankford writes for the Miami Tribe of Oklahoma in support of H.R. 5549, the Indian Health Service Advance Appropriations Act, introduced by the late Representative Don Young. The letter calls advance appropriations a budget-neutral, flexible fix for funding disruptions and says the bill improves on the FY 2022 Budget Resolution exception by covering every IHS account. It cites IHS-reported coronavirus cases per week rising since April 2022 and expects surges in fall and winter. The date is printed as July 31.2022, and the text is partly garbled.

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Full text

                          Vliami ~I Dbe ofOIc ahoma
                             P.O. Box 1^26-Minmi. Olclahoma
                               Ph: 0|5-;S4Z-I-M',^ Pax: 9]8-^-^l-7l60




 Via Email: Naomi.MigueK^mail.house.gov

 July 31.2022

The Honorable Teresa Leger Fernandez            The Honorable Jay Obernolle
('hair                                          Acfing Ranking Member
 Subcommittee for Indigenous Peoples of         Subcommiltee for Indigenous Peoples of
  the United States                              the United States
 Committee on Natural Resources                 Committee on Natural Resources
 U.S. House of Representatives                  U.S. House of Representatives
 1324 Longworth House Office Building           1329 Longworth House Office Building
 Washington. DC 20515                           Washington. DC 20515




RK: vSupport for H.R. 5549, the Indian Health Sen ice Advance Appropriations Act

Dear Chair Fernandez and Acting Ranking Member Obernolte:

On behalf of Leadership for the Miami Tribe of Oklahoma. I write to express the Miami Tribe's
support for H.R. 5549. the Indian Health Service Advance Appropriations Act. Introduced by the
late Representative Don Young and originally co-sponsored by Representatives McCollum.
Kilmer. Kind. Mullin, Cole, Johnson, and Strickland- the list of bi-partisan cosponsors for H.R.
5549 has grown to fifteen. The Tribe urges Congress to pass this bipartisan policy solution to end
the undue suffering of our people and unnecessary drain on taxpayer resources.

Advance appropriations for the Indian 1 lealth Service(IHS)are a bi-partisan and bi-cameral policy
initiative that increases tribal and federal government efficiency, reduces federal taxpayer waste,
and. most importantly. sa\'es Native lives b\’ providing more effective funding for health care
ser\ice in Indian Countiy. Since advance appropriations are inereK' ad\'ance agreements to pro\'ide
funding at a later date, they are a budget-neutral and tlexible solution to the outsized impacts of
funding disruptions on Indian Country, allowing Congress to respond to changing real-world
circumstances and challenges. The result is continuity of services that reduce bureaucratic
inefllciencies and uncertainty for 11 IS and for Tribal Nations.
The Biden-Harris Administration supports advance appropriations and mandatory funding for
IHS-a historic shift in the paradigm ofNation-to-Nation relations that seeks to restore the promises
made between our ancestors and the United States. Advance appropriations and mandatory funding
are not mutually exclusive requests. However, once IHS obligations are provided through
mandatory direct appropriations, there is no need for advance appropriations through the annual
regular appropriations process. Until such time that mandatory appropriations are provided,
advance appropriations are a fiscally responsible solution to the outsized impacts of disruptions
and uncertainty in funding on the Indian health care system.

H.R. 5549 is an improvement on the exception for IHS accounts provided in the FY 2022 Budget
Resolution because it includes all of the accounts for the Indian Health Service and notjust certain
accounts. This is an important improvement because of the nature of inherently federal functions.
Advance appropriations are not about more money in a single accounting period, they are about
advance agreements by Congress that provide certainty and continuity of services promote
efliciencies, and reduce taxpayer waste on costly duplicative tribal and federal budgetary
functions. If only certain funded accounts are provided continuity of services while necessary and
inherently federal IHS functions remain subject to the stops and starts of the annual appropriations
process, then Congress is not utilizing the policy of advance appropriations to maximize its best
fiscal features.

The coronavirus pandemic is not over, and funding certainty and stability are critical to saving
Native lives as we continue to combat the ongoing effects of COVID-19. The total number of
Coronavirus cases per week reported by IHS has been on the rise since April 2022. and experts
believe the actual infection numbers for the United Stales in the first week of .luly were about
seven times higher than the number of reported cases. Further, the seasonal cycle is a consistent
feature of respiratory viral infections, lending to the widely-held prediction that the virus will
exhibit some form of seasonality. This means that advance appropriations for IHS will provide
funding certainty and continuity ofservices for the fall and winter months when surges in patients'
needs due to respiratory illness and disruptions in federal funding are most probable. Simply,
advance appropriations will provide increased efliciency during times of increased need.

Advance appropriations for IFIS are a simple promise: a promise that the United States honors and
upholds its treaty and trust obligations; a promise that Congress will enact solutions that cease the
generational trauma and undue and unnecessary suffering of Native people; and a promise of
certainty and security for Native communities and our most vulnerable populations. As Congress
works to restore the promises made, all options must be on the table. Native lives cannot wait.

Most sincerely.




Douglas G. Lankford, Chief
Miami Tribe of Oklahoma

cc: tscribnot@,ncai.oni
    iwakeford@:ncai.org
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