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Health Care Legislation - S. 522 (3)
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Health Care Legislation - S. 522 (3)
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The original documents are located in Box 2, folder "Health Care Legislation - S. 522 (3)"
of the Bradley H. Patterson Files at the Gerald R. Ford Presidential Library.
Copyright Notice
The copyright law of the United States (Title 17, United States Code) governs the making of
photocopies or other reproductions of copyrighted material. Gerald Ford donated to the United
States of America his copyrights in all of his unpublished writings in National Archives collections.
Works prepared by U.S. Government employees as part of their official duties are in the public
domain. The copyrights to materials written by other individuals or organizations are presumed to
remain with them. If you think any of the information displayed in the PDF is subject to a valid
copyright claim, please contact the Gerald R. Ford Presidential Library.
U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
HEALTH.
OFFICE OF THE SECRETARY
of
STATE EDUCATION: SECURITY AND
8-13-76
The attached may be of interest to you.
USA
BRAD:
Per our conversation
Deputy J
Phone: 245-6787
Room 5443, HEW North
330 Independence Ave., SW.
Washington, D.C. 20201
HEALTH
COMPANY
THE SECRETARY OF HEALTH. EDUCATION, AND WELFARE
WASHINGTON, D. C. 20201
JUN 30 1976
FORD
The Honorable John J. Rhodes
Minority Leader
1717
House of Representatives
Washington, D. C. 20515
Dear Mr. Rhodes:
I understand that the House of Representatives will soon consider
H.R. 2525, the "Indian Health Care Improvement Act." I am deeply con-
cerned that you and your colleagues understand our position with regard
to this legislation.
In summary, we are strongly opposed to this legislation because it would
establish additional categorical programs and substantially exceed the
budget requests for program activities in the area of Indian health. We
believe that the Department and other Federal agencies are accomplishing
the major objectives stated in the bill.
The Administration has a long-standing commitment to improving the
health status of federally recognized Indians and Alaska natives. The
Indian Health Service (IHS) within this Department has the primary
responsibility for providing the necessary services; spending for IHS
activities has grown from $113 million in FY 1969 to an estimated outlay
of $349 million for FY 1977, an increase of 208 percent in eight years.
The special emphasis that our IHS program has received was recently
reiterated by the President in a message to the Congress in which he
mentioned it among several examples of Federal responsibilities in which
efforts would be concentrated. He stated in relation to his 1977 budget
proposals: "To provide improved health services to American Indians and
Alaskan natives, I am asking for $355 million. Spending by the Indian
Health Service alone in 1977 will result in over $685 per beneficiary,
or over $2,740 per Indian family of four." Since then, the President
has requested $35 million more for implementing authorities in the
"Indian Self-Determination and Education Assistance Act." Moreover,
these amounts do not include the broad range of services provided to the
eligible Indian population from other Federal health programs.
In light of this, I would hope that our record of strong opposition to
H.R. 2525 before the Committee on Interior and Insular Affairs and the
Committee on Interstate and Foreign Commerce is regarded as a positive
effort to see that scarce Federal health dollars are directed to the
areas of greatest need, and that the Congress will agree that existing
authorities are sufficient to continue addressing the health needs of
American Indians and Alaska natives.
Fage 2 - The Honorable John J. Rhodes
Title I of the bill would authorize several different programs to support
the training of Indian health manpower, among them a recruitment and
counseling program, a preparatory scholarship program, and a professional
scholarship program.
The Department shares your concern relating to the need for adequate
numbers of Indian health professionals. However, we believe that the
objectives of title I can be achieved under existing authorities for
recruitment of disadvantaged students (including Indians) and for scholar-
ships to students. We are unable to see a need to establish a multi-
plicity of duplicative narrow categorical programs for Indians when the
Federal government already administers several programs to accomplish
similar or identical purposes.
The Department now helps recruit Indian health professions students as
part of an overall effort to improve participation by disadvantaged
persons in health occupations. Special provisions for minority recruit-
ment are contained in the health manpower legislative authorities of
titles VII and VIII of the Public Health Service Act. Among the projects
carried out under these authorities have been a number to identify
potential Indian health professions students, help them prepare for
entrance into health professions schools, and assist them in completing
training.
Special consideration is given to Indians in the administration of the.
service-conditional National Health Service Corps Scholarship program.
In the current academic year there are a total of some 75 Indian recipients
of National Health Service Corps Scholarships (56 medical and 19 dental
students). Most of these individuals will do their obligated service in
the Indian Health Service. The Bureau of Indian Affairs in the Department
of the Interior also has a scholarship program.
In the Administration's health professions education bill, H.R. 11119,
we have proposed a broadened authority for project grants to assist
disadvantaged students, including Indian students, to undertake health
professions training. We have requested $5 million for such grants for
FY 1977. The scholarship program for students who agree to serve in
health manpower shortage areas would be modified and expanded, and our
1977 request for this authority is $35 million. We would strongly
prefer to continue giving special attention to the needs of Indian
students under general health professions education authorities such as
these, rather than having to operate within separate program limitations
and funding authorities for Indians.
Page 3 - The Honorable John J. Rhodes
Title II would add to already existing program levels and commitments
approximately $70 million for health services over a 3-year period, and
would also authorize approximately 1,100 new positions in the IHS. This
title is duplicative of existing basic authority in the "Snyder Act" (25
U.S.C. 13) to provide health services and is certainly unnecessary, as
the Department is not legally restricted in seeking as many positions as
necessary to accomplish its goals in the program.
Title III, which would authorize over $230 million during the 3-year
period for construction and renovation of IHS facilities, as well as
over $100 million for sanitation facilities in Indian homes and communi-
ties, also raises unrealistic expectations in terms of what the Federal
government can afford.
Title IV would amend the Social Security Act to provide Medicare and
Medicaid reimbursement to IHS facilities for services rendered to benefi-
ciaries of those programs. We support this general concept, but believe
it should be accomplished in separate legislation, particularly since we
are opposed to other provisions of title IV. Under this title, IHS
hospitals that do not meet current fire and safety or other standards
would be granted a one-year period to come into compliance with program
requirements, during which time they would be required to use all such
reimbursements for that purpose. We believe that this provision might
be interpreted as tolerating inadequate standards for the Indian popu-
lation served by these institutions. We believe present Medicare regula-
tions, which permit the participation of selected hospitals in rural or
underserved areas if they are making efforts to improve, best achieve
the upgrading of health care without requiring the Secretary to accept
all institutions under arbitrary time constraints. We also oppose the
provision that would prohibit consideration of third party reimburse-
ments in determining appropriation levels for IHS facilities. We believe
the Executive Branch and the appropriation committees of the Congress
should be able to consider all receipts to IHS facilities in setting
funding requirements.
Title IV of H.R. 2525 also contains a provision for 100 percent Medicaid
reimbursement for services provided to Indians in IHS facilities. We
oppose this provision on the bases of equity and cost: the Federal
reimbursement rate for title XIX services is determined by a State's per
capita income; at present it ranges from 50 to 83 percent. To the
extent that a State has an Indian population, and to the extent that
population is poor, the Federal match will be higher. However, to
provide a 100 percent match for services to Indians would be inequitable
to other poor recipient groups, and to those States with many families and
individuals at poverty levels, who happen not to be Indians. Such a
policy would have undesirable implications for the financing of other
public assistance programs that require matching contributions.
Page
4
The Honorable John J. Rhodes
Title V would provide for a program of contracts with Indian organiza-
tions in urban areas for the purpose of making health services more
accessible to Indians. This would expand upon existing authority in the
previously mentioned "Snyder Act" (25 U.S.C. 13) for the Department to
assist Indians in meeting their health needs. It seems to us that
Indians who choose not to live on reservations should be able to take
advantage of the broader programs of the Department which assist States
and localities, such as Community Health Centers, as well as our health
financing programs, Medicaid and Medicare.
We also intend to work with existing State and local social service
agencies to assure that urban Indians are an important outreach target
as part of the ongoing activities of those agencies.
Title VII would establish a reporting requirement for the Secretary of
this Department. We view such a requirement as unnecessary. Our experi-
ence has been that appropriations and oversight hearings by the Congress
during its regular deliberations on substantive legislation and on
appropriations requests are much more effective and informative than
reports.
We would like to emphasize again that the Department, through the Indian
Health Service, is moving as rapidly as we believe feasible toward the
goal of raising the health status of Indians to at least a level equal
to that of the non-Indian population. We believe the President's budget
requests represent a positive commitment to this goal. In addition,
through the recent Indian Self-Determination and Education Assistance
Act (P.L. 93-638), the Indians themselves are working with the Depart-
ment in achieving this objective. However, H.R. 2525 does not in our
view present desirable program solutions to Indian health needs and its
authorizations of appropriations are excessive. It would authorize
approximately $465 million over a 3-year period, at a time when both
Congress and the President are seeking ways to hold down Federal spend-
ing. Such additional expenditures would either increase the size of the
Federal deficit or would require more than $465 million in increased
taxes or offsetting expenditure reductions. We believe that the Congress
is as concerned as the Administration about the necessity to control
spending, and in this context we have opposed the overall appropriation
levels authorized in H.R. 2525. Thus, because of its unnecessary cate-
gorical provisions for Indian health program activities and its excessive
authorization levels, we strongly object to H.R. 2525.
We are advised by the Office of Management and Budget that there is no
objection to the presentation of this report and that enactment of
H.R. 2525 would not be consistent with the objectives of the Adminis-
tration.
Sincerely,
FORD
&
Raijone hyneh
LIBRARY
Under Secretary
HEALTH.
EDUCATION SECURITY
THE UNDER SECRETARY OF HEALTH, EDUCATION, AND WELFARE
WASHINGTON, D.C. 20201
USA
AUG 23 1976
Mrs. LaDonna Harris
President
Americans for Indian Opportunity
1816 Jefferson Place, N.W.
Washington, D.C. 20036
Dear Mrs. Harris:
Thank you for your recent letter regarding the current health problems
faced by American Indians. We share your view that there is a contin-
uing need for extended Indian health services.
Statistics reveal that Indian Health programs have been effective: for
example, since 1955, the Indian and Alaska Native infant death rate
has been reduced 70 percent; the death rate from certain diseases of
early infancy is down 69 percent, from gastritis and related diseases
83 percent, and from influenza and pneumonia 67 percent. These gains
reflect greater survival rates for infants and Indian people of all ages.
In spite of these advances, we agree that much remains to be done. A
number of constructive steps are already underway. For instance, the
Indian Health Service has received an $11.2 million increase in its
fiscal year 1976 program budget. This increase is one indication
of the importance placed on this program by the Administration,
especially in the face of an emphasis on budget austerity throughout
Government.
While it is true that the number of Indian homes to be served by
sanitation facilities will be less in fiscal year 1977 than in fiscal
year 1976, a review of the overall budget indicates a significant in-
crease in support for Indian health, and this support has been indicated
in past years as well.
Public Law 94-303, approved June 1, provides an additional $3 million
for Indian health services to cover unforeseen increases in the costs
of contract medical care. These funds will help alleviate situations
such as you describe in Albuquerque, where only emergency operations
could be funded under contract.
FORD LIBRARY &
Page 2 - Mrs. LaDonna Harris
I fully believe that our existing legislative authorities can be
utilized in finding solutions to the Indian health problems. Please
be assured that we intend to explore every possible alternative for
using these authorities to assist Indians in alleviating their
health problems. It is our belief that many provisions of the Indian
Health Care Improvement Act are not necessary and would raise fiscal
expectations which are incapable of fulfillment.
As you indicate in your letter, good health care depends, in part,
on good health facilities. I am pleased to report that continued
progress has been and is being made in upgrading Indian Health Service
physical plants. For instance, since 1955, 17 hospitals, 20 health
centers and 85 field stations have been constructed.
A new 80-bed hospital at Claremore, Oklahoma, will open in early spring
of 1977. Planning is completed for a new hospital at Acoma-Laguna-
Canconcito (Acomita), and replacement hospitals at Santa Fe, New Mexico,
and Whiteriver, Arizona, with phased construction funds now available for
the Acomita and Santa Fe facilities. Planning is completed for expanding
and modernizing the hospital at Shiprock, New Mexico. Funds for the
second phase planning and installation of pilings were appropriated in
1976 for the Bethel, Alaska, replacement facility. A master planning
study has been completed and a modernization project is proposed for
the facility at Browning, Montana. Master plan studies recently com-
pleted for Rosebud, South Dakota, Sacaton, Arizona, and Red Lake,
Minnasota, recommended replacement facilities in lieu of modernization.
Planning funds for replacement facilities at Red Lake, Minnesota, and
Cherokee, North Carolina, and a new facility at Ada, Oklahoma, are avail-
able and construction will start shortly. In fiscal year 1976 planning
and first phase construction funds were appropriated for the health
center at Lummi, Washington. The Menominee, Wisconsin, Health Center
was also funded for planning and construction in fiscal year 1976.
The IHS has regained some hospital accreditations, and is continuing
efforts to receive accreditation for all of its hospital facilities.
It should be recognized, however, that some hospitals will not meet the
accreditation standards because of age or other physical shortcomings.
These hospitale will be replaced or modernized as expeditiously as
possible.
GERALD ARVORIT FORD
Page 3 - Mrs. LaDonna Harris
The President has recently submitted to the Congress a fiscal year
1977 budget amendment expressly for the purpose of implementing
P.L. 93-638, the Indian Self-Determination and Education Assistance
Act. This Department has a strong commitment to the concepts of
this law, and we intend to do everything possible to make its
implementation a reality.
Indians have the right to enjoy the highest possible health status
which combined private and public efforts can provide. We intend
to pursue every reasonable and prudent effort to alleviate the unmet
health needs of the Indian people, and we will urge that the highest
possible priority be given to programs which will help to elevate
the health status of Indians to the level of other Americans.
Sincerely yours,
/s/Marjorie Lynch
Marjorie Lynch
Under Secretary
proHR2525
STATES POSTA
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PRESIDENT GERALD FORD
WHITE HOUSE DC 20500
DEAR MR PRESIDENT
ALL MEMBERS OF THE SMALL TRIBES OF THEORGANIZATION OF WESTERN
WASHINGTON INC,
CHEHALIS
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,5.522
RESPECTFULLY REQUEST OF YOU TO SIGN INTO LAW HR 2525 THAT HAS RECENTLY
BEEN PASSED BY THE US HOUSE OF REPRESENTATIVES AND THE US SENATE
RESPECTFULLY YOURS
JOSEPH E CLOQUET
HEALTH ADMINISTRATOR
LEO J LACLAIR
EXECUTIVE DIRECTOR
SMALL TRIBES ORGANIZATION OF WESTERN WASHINGTON INC
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5058524267 MGM TDBN PUEBLO NM 103 09-01 1113A EST
PRESIDENT GERALD FORD
2000 PENNSYLVANIA AVE
WASHINGTON DC 20201
BP
P
REGARDING S.522-THE INDIAN HEALTH CARE IMPROVEMENT ACT
DEAR PRESIDENT FORD
AS CHAIRMAN FOR THE EIGHT NORTHERN INDIAN PUEBLO COUNCIL OF NORTHERN
NEW MEXICO. OUR PUEBLO PEOPLE EARNESTLY FEEL AND STRONGLY URGE SUPPORT
PASSAGE OF S.522.
WE FEEL THAT THIS IS ACT IS ONE OF THE MOST IMPORTANT BILLS TO BE
ENACTED, WITH YOUR FINAL APPROVAL, BY YOUR ADMINISTRATION,
MAY THE GREAT SPIRIT GIVE YOU WISDOM TO HELP YOUR PEOPLE. THANK YOU IN
BEHALF OF MYSELF AND THE EIGHT NORTHERN GOVERNORS. SINCERELY
GOVERNOR WALTER DASHENO
CHAIRMAN OF EIGHT NORTHERN INDIAN PUEBLO COUNCIL
11:13 EST
MGMCOMP MGM
FORD LIBRARY & GERALD
5241 (R5-75)
TO REPLY BY MAILGRAM, SEE REVERSE SIDE FOR WESTERN UNION'S TOLL FREE PHONE NUMBERS
WHITE HOUSE
MAIL ROOM
1976 SEP 2 AM 11 18
TO REPLY BY MAILGRAM, PHONE WESTERN UNION ANY TIME, DAY OR NIGHT:
FOR YOUR LOCAL NUMBER, SEE THE WHITE PAGES
OF YOUR TELEPHONE DIRECTORY
OR
DIAL (TOLL FREE) 800-257-2241
(EXCEPT IN NEW JERSEY 800-632-2271)
OR DIAL WESTERN UNION'S INFOMASTER SYSTEM DIRECTLY:
FROM TELEX
6161
FROM TWX
910 420 1212
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PMS PRESIDENT GERALD FORD
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12 THE STAFF OF THE ROUND VALLEY INDIAN JOB CENTER, INCORPORATED WOULD
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EARNESTLY ENCOURAGE YOU TO SUPPORT HR 2525, THE INDIAN HEALTH CARE
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IMPROVEMENT ACT. AFTER TWO CENTURIES, CONDITIONS ON THE RESERVATIONS
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ARE STILL DESPERATELY CRUCIAL. PLEASE, PLEASE FOR THE HEATLH OF OUR
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PEOPLE.
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SINCERELY
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THE CABAZON BAND MISSION INDIANSURGE YOU TO SIGN SENATE BILL 522 THE
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INDIAN HEALTH CARE AND IMPROVEMENT ACT THE CABAZON BAND MISSION
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INDIANS ARE A PROJECT MEMBER OF THE RIVERSIDE-SAN BERNARDINO COUNTY
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INDIAN HEALTH BOARD WHO RECEIVE HEALTH CARE FROM THE LOCAL PROJECT
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so THEREFORE AGAIN WE URGE YOU TO SIGN THIS IMPORTANT BILL SINCERELY
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JOSEPH R BENITEZ, CHAIRMAN CASAZON BAND MISSION INDIANS
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SENATE BILL 522 THE INDIAN HEALTH CARE AND IMPROVEMENT ACT THE
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RIVERSIDE/SAN BERNARDINO COUNTY INDIAN HEALTH IS A PROJECT NEMBER OF
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16 THE CALIFORNIA RURAL INDIAN HEALTH BOARD SERVING 40,000 PLUS INDIANS
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IN CALIFORNIA MEDICAL DENTAL PROGRAMS THEREFORE WE URGE THAT YOU
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19 GIVE EVERY CONSIDERATION TO THIS BILL SINCERELY
FORM 0805 PRINTED BY THE STANDARD REGISTER COMPANY, U. S. A. S.A.
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THE EMMITT ST MARIE CHAIRMAN FOR THE BOARD
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DEAR MR PRESIDENT, UNITED SOUTHEASTERN TRIBES INCORPORATED STRONGLY
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SUPPORT HOUSING BILL 2525, INDIAN HEALTH CARE EMPLOYMENT ACT. WE
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STRONGLY URGE YOU TO SIGN THIS BILL AS SOON AS POSSIBLE RESPECTFULLY
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YOURS
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JONATHAN ED TAYLOR, USET PRESIDENT, EASTERN BAND OF CHEROKEE
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INDIANS PO BOX 455 CHEROKEE NC 28719
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PMS PRESIDENT GERALD FORD
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I STRONGLY URGE THAT YOU SIGN INTO LAW THE INDIAN HEALTH CARE
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IMPROVEMENT ACT BENEFITS TO BE DERIVED BY INDIAN PEOPLE THROUGH THIS
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ACT ARE DESPARATELY NEEDED
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ROCHELLE SMITH COORDINATOR OF INDIAN AFFAIRS OFFICE PIERRE
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SOUTH DAKOTA
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WHITE HOUSE
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RE INDIAN HEALTH CARE IMPROVEMENT ACT. DEAR SIR WE WOULD LIKE
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TO ENCOURAGE AND SUPPORT YOU IN SIGNING THE INDIAN HEALTH
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CARE IMPROVEMENT ACT. WHICH IS ON YOUR DESK FOR SIGNATURE.
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WE INDIAN PEOPLE ARE IN DIRE NEED OF SERVICES THAT THIS BILL
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WILL GIVE US.
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SINCERELY
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SOUTH DAKOTA UNITED INDIAN ASSOCIATION
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PMS PRESIDENT GERALD R FORD
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AS HEALTH COORDINATOR FOR THE MICCOSUKEE TRIBE OF INDIANS OF FLORIDA
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AND HEALTH BOARD CHAIRMAN OF THE UNITED SOUTHEAST TRIBES YOUR
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SIGNATURE ON S-522 THE INDIAN HEALTH CARE AND IMPROVEMENT ACT IS
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HEREBY ENDORSED AS A MUCH NEEDED AND LONG AWAITED STEP IN THE
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DIRECTION TO UP-GRADING HEALTH CARE FOR THIS COUNTRIES FIRST
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AMERICANS
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PEGGY BARNETT
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FLORIDA I URGE YOU TO SIGN S-522 THE INDIAN HEALTH CARE AND
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IMPROVEMENT ACT YOUR SUPPORT IS NEEDED TO PASS THIS LONG AWAITED
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CRITICAL LEGISLATION
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MR PRESIDENT WE URGENTLY REQUEST THAT YOU SUPPORT AND SIGN INTO LAW
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5.522, THE INDIAN HEALTH CARE AND IMPROVEMENT ACT. RESPECTFULLY
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THE ROSEBUD SIOUX TRIBE IS IN FULL SUPPORT IN REGARD TO INDIAN
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HEALTH IMPROVEMENT ACT
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ED DRIVING HAWK CHAIRMAN OF THE ROSEBUD SIOUX TRIBE
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HONORABLE PRESIDENT GERALD FORD,
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REPRESENTING THE GREAT SAN CARLOS APACHE TRIBE OF SAN CARLOS AZ
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I AM MAKING A SPECIAL REQUEST FOR YOUR POSITIVE
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ACKNOWLEDGEMENT OF HOUSEBILL H.R. 2525 DURING THE
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200TH YEAR BICENTENNIAL CELEBRATION OF THE UNITED STATES
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GOVERMENT IT WOULD ONLY BE PROPER FOR HISTORY TO BE MADE IN
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ALLOWING THE INDIAN HEALTH CARE IMPROVEMENT ACT TO BECOME LAW.
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HERE ON THE SAN CARLOS APACHE RESERVATION WE ARE IN GRAVE
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SERVICE. EVERY WORD IN THE OBJECTIVE OF THE BILL, AS STATED IN
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THE DECLARATION OF POLICIES ARE TRUE. MR PRESIDENT, LET IT BECOME
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LAW, WHICH WILL SHOW THAT YOUR ADMINISTRATION DO SEE THE
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SPECIAL NEEDS OF THE FIRST AMERICANS.
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THE 19 NEW MEXICO PUEBLOS STRONGLY REQUEST YOU SIGN THE INDIAN
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WE THE COLORADO RIVER INDIAN TRIBE CONSIDER THE INDIAN HEALTH CARE
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IMPROVEMENT ACT A MOST SIGNIFICANT INDIAN HEALTH MEASURE AND VITAL
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TO THE NEEDS OF ALL INDIANS TODAY AND WHEREAS WE HAVE DECIDED THAT
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ALL INDIAN HEALTH PROGRAM ARE MUCH NEEDED ON OUR RESERVATIONS WE
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HEREBY REQUEST THAT YOU SIGN THIS BILL INTO LAW WHEN IT APPEARS
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BEFORE YOU FOR APPROVAL. YOUR ADMINISTRATION HAS SUPPORTED THE
FORM 0805 PAINTER ST THE COMPANY,
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INDIAN PEOPLE FOR HIGH QUALITY EDUCATIONAL OPPORTUNITIES AND
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AVAILABLE ECONOMY. WE FURTHER APPEAL TO YOU FOR THE HIGHEST QUALITY
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OF MEDICAL SERVICES TO OUR PEOPLE. WE EXTEND OUR SINCERE WISHES TO
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YOUR ADMINISTRATION
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ANTHONY DRENNAN SR, CHAIRMAN TRIBAL COUNCIL COLORADO RIVER.
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DRAFT SIGNING STATEMENT
I am today signing H.R. 2525, the Indian Health Care Improvement
act. I do this because the well-recognized need for improvement
in Indian health manpower, services and facilities outweighs the
defects in the bill itself.
Over the past twelve years the Government of the United States
has made promises to its citizens that it would end or cure some
of the nation's egregious social problems. Many of those promises
were overstated.
Over the past two hundred years, the Government has made
promises to Indian people. Some of those promises were deceptions:
they were never kept at all.
In signing this bill I want neither to overstate nor to deceive.
The proper committees of the House and the Senate have studied
the Indian health care delivery system during both the 93rd and 94th
Congresses. In spite of the fact that our Executive Branch spending
for Indian Health Service activities has grown from $113 million in
1425.6
FY 1969 to $354.9 million in FY 1977, Indian people still lag behind
the American people as a whole in having their health needs met.
The careful documentation the Committees have provided is what
has persuaded me to sign this bill.
H. R. 2525 itself is but an authorization; it asks the President
of 1977 and 1978 and 1979, and it asks the 95th and 96th Congresses
2
to aim at spending
,
, and
respectively for
Indian health. It insists that the number of federal employees in
the Indian Health Service grow from
today to
by
FY 1980.
Indian people and American citizens generally should understand
that a Presidential signature on this bill today does not guarantee
that Presidential budgets of the years to come will inevitably
propose the amounts authorized and does not guarantee at all that
future Congresses will appropriate the amounts set forth.
H.R. 2525 is a statement of direction of effort toward meeting a
and
clear need,
as such, it meets with my full approval.
H.R. 2525 is also, however, a bill replete with authorities which
which are not needed, with narrow categorical specifications which
are inimical to good public administration and with mandated
personnel add-ons which diminish flexibility for executive
management. Title V of H.R. 2525 risks initiating new and
uneeded health programs for urban Indians; I am asking the Secretary
of Health, Education and Welfare to administer Section 503 (a) (9)
with great caution, since it is preferable that urban Indian people
receive health care from existing local facilities than to start up
duplicative programs at unnecessary cost.
Since Title VII of this bill provides for reports to the Congress
from the Secretary, including a review of progress and an assessment
of the bill's programs, I believe the Administration can in this way
-3---
bring to the attention of the Congress any changes then needed
to improve the provisions of H.R. 2525.
Indian health needs are great; I am signing this bill to helpmeet
those needs. But in signing H.R. 2525 I confirm my equal duty
to all the taxpayers of the nation to avoid excessive costs in even
the most laudatory of assistance programs.
THE WHITE HOUSE
WASHINGTON
September 3, 1976
MEMORANDUM TO:
SARAH MASSENGALE
FROM:
BRAD PATTERSON
Bal
SUBJECT:
Draft Signing Statement for
the Indian Health Bill
I have tried my hand at a draft, as per our recent conversation.
The dilemma is rather acute here; how to compose a signing
statement which is properly cautionary, but which does not
put such a wet blanket on the approval that we take all the
credit away from ourselves for signing it at all. The easy
way out would be just to sign the bill (and maybe have a ceremony)
but doing that in this case might undermine the credibility
of HEW and OMB which, for good reasons, have taken a clearly
negative position on this bill for three years running.
Let's discuss with each other and then with OMB.
Whan always agreed to Fuiduen -ldle seua
Much for 1170 Health Nemage Thoupana - Hard AM /p do administratively
Title IV - adm pasition
TabI- in effect certrictive of Sungder at
is and All and to welear areas
THE WHITE HOUSE
WASHINGTON
September 3, 1976
MEMORANDUM TO:
SARAH MASSENGALE
FROM:
BRAD PATTERSON
SUBJECT:
Draft Signing Statement for
the Indian Health Bill
I have tried my hand at a draft, as per our recent conversation.
The dilemma is rather acute here; how to compose a signing
statement which is properly cautionary, but which does not
put such a wet blanket on the approval that we take all the
credit away from ourselves for signing it at all. The easy
way out would be just to sign the bill (and maybe have a ceremony)
hutsdoing that in this case might undermine the credibility
of HEW and OMB which, for good reasons, have taken a clearly
negative position on this bill for three years running.
Let's discuss with each other and then with OMB.
FORD LIBRARY & 01V
OFFICE OF
THE SECRETARY OF THE INTERIOR
9/9/76
TO:
BRAD PATTERSON
FROM:
Loren Rivard
SUBJ:
Indian Health Bill
Enclosed are memos from both Commissioner
Thompson and John Powell which should be
helpful to you.
OF THE INTERIOR
United States Department of the Interior
BUREAU OF INDIAN AFFAIRS
WASHINGTON, D.C. 20245
March
3,
1849
IN REPLY REFER TO:
Legislation
BCCO - #5365
SEP
2 1976
Memorandum
To:
Loren Rivard
From:
Commissioner of Indian Affairs
Subject: S. 522 (H.R. 2525), Indian Health Care Improvement Act
I recommend that the President sign S. 522 when it becomes enrolled. If
it is felt necessary, he could issue a signing statement outlining
appropriate objections and concerns with the bill which has been approved
by HEW and OMB.
A veto of S. 522 could badly damage the Administration's relations with
Indian leaders, Indian people generally, and those who are supportive of
the American Indian because of past wrongs done to Indians, and sympa-
thetic to their present situation. Considerable effort and time has been
devoted by Indian people to achieving passage of the bill.
It should be noted that there is every indication that a veto of S. 522
would be overridden. (See John Powell's August 25 note to you).
As the result of reductions in the authorizations in the bill by the
House Interstate and Foreign Commerce Committee, the bill now authorizes
$475 million in appropriations over a 3-year period whereas the Senate
passed version would have authorized $1.6 billion over a seven-year period.
The Minority Views in the Interstate and Foreign Commerce Committees Report
on the bill includes the following pertinent paragraph:
"There is a risk that opposition to the approaches taken in
H.R. 2525 will be viewed as a lack of concern about Indian
health needs and a lack of commitment to their resolution.
Our support of the goals of this bill and our Committee
amendments belies any such interpretations. Modifications
in the bill, in our opinion, simply do not go far enough to
&OKD
insure a realistic building upon the progress that has been
made in recent years".
REVOLUTION
AMERICAN
BICENTENNIAL
1776-1976
©
TM
The Interstate and Foreign Commerce Committee voted unanimously to
favorably report with amendments which were adopted by the House. The
Committee's report includes the following in its Findings and Recommend-
ations:
"The Committee was impressed with the evidence presented in
hearings *** concerning the lack of adequate numbers of health
care personnel to serve the Indian population in the Indian
Health Service, with the disturbing statistics on the generally
poorer health level of the American Indian in comparison with
the general population, [and] with the deplorable state of many
of the Indian Health Service facilities "
"The need for improved health care for Indians is clear to the
Committee. They endorse the concept embodied in H.R. 2525 that
the Congress and the nation make a commitment to the American
Indian to bring the level of Indian health, and the quality of
health care facilities and health professions manpower serving
Indians, to a level equal to that enjoyed by other Americans".
Enactment of a bill such as the Indian Health Care Improvement Act can
be attributed to the lack of adequate concern by the Executive Branch
for a number of years. For example, of the 51 IHS hospitals, 26 do not
meet the standards for national hospital accreditation and 20 cannot
pass fire and safety requirements. The average age of the hospitals is
21 years with the oldest having been built in 1909. Of the 9 IHS
hospitals built in the last 10 years, 3 were requested by the Admini-
stration and 6 were the result of congressional add-ons. HEW acknow-
ledges that 21 of the hospitals should be replaced.
It is facts like the above which render ineffective further Administra-
tion opposition to a legislative initiative to remedy the situation.
However, if the President should decide that he must veto the bill, I
would strongly urge that the veto message include specific steps which
he is taking (including commitments to request additional funding in
next January's budget submission to the Congress) to achieve the purposes
and goals of the bill.
Moris Thompson
FORD
LIBE
OF THE INTERIOR
United States Department of the Interior
OFFICE OF THE SECRETARY
March
3
1849
WASHINGTON, D.C. 20240
AUG 25 1976
NOTE TO: Loren Rivard
SUBJECT: HR 2525 (S 522)
This responds to your request for comments on Brad Patterson's
inquiry concerning the Indian Health Care bill. His note of
August 17 raises two questions: 1) Is a veto of HR 2525 sustainable?
and 2) What is our view of an Indian reaction to such a veto?
Since HR 2525 (and its companion S 522) passed both Houses by
overwhelming margins, (Senate, by unanimous consent without debate;
House, 310-9) a veto would be difficult to sustain. Moreover,
there was substantial minority support for this legislation in
both Houses. Senate sponsers included: Bartlett, Domenici, Fannin,
Goldwater, Hatfield, Stevens, and Dole. House sponsers included:
Wilson (Cal.), Young (Alaska), Esch, Rhodes, Conlan, Steiger (Ariz.),
and Lujan.
The BIA believes that a veto would produce a considerable adverse
reaction in the Indian community. In addition, while the Department
has supported the Administration position in opposition to this
legislation, we have always expressed an appreciation for the need
to improve Indian Health Care programs.
John
Legislative Counsel
AMERICAN REVOLUTION
7776-1976
September 10, 1976
MEMORANDUM FOR:
SARAH MASSENGALE
FROM:
BRAD PATTERSON
SUBJECT:
Indian Health Bill - Draft Signing
Statement
I would suggest a couple of amendments to the draft which I
sent you the other day:
1. At the end of the fourth paragraph (and for the
beginning of the fifth) insert the following:
The Second Session of the 94th Congress has also
greatly improved this bill from its earlier form: its
cost has been reduced from $1. 6 billion to $480 million
and the number of years of specifically authorized
funding have been cut from seven to three. These
improvements, and the bipartisan support which the
improved bill enjoys, make S 522 much more
acceptable.
% 522 is, of course, but an authorization;
2. Re-identify the bill as S-522 throughout the statement.
(The bill passed the Senate yesterday with a couple of amendments,
78-0).
Let's discuss soon.
BALO e 178817 FORD
THE WHITE HOUSE
WASHINGTON
September 23, 1976
Sarah -
I think we can be a little
more positive about the Indian Health Care
Improvement Act, and therefore propose
an alternative Signing Statement here in
draft.
Suggest we discuss with each
other and then with OMB.
What do you think about a Signing
Ceremony? I have a contingency list of invitees
Dead
CC: Mrs. Kilberg
FORD LIBE
DRAFT SIGNING STATEMENT FOR S 522
I am today signing S 522, the Indian Health Care Improvement
Act.
This bill is not without its faults, but after personal review
I have determined that the well-documented needs for improvement in
Indian health manpower, services and facilities outweigh the defects in
the bill itself.
There has never been any question throughout my Admi isgration
about the validity of the Congressional Findings in S 522.
There have been differences with the Congress of course about the
best methods for meeting the needs identified in those Findings. Earlier
versions of this bill contained many undesirable provisions.
But the Congress, after careful and bipartisan review, has
modified S 522 and has in my opinion corrected the features which would
hav e been unacceptable.
The proper Committees of the House and Senate have studied
the Indian health care delivery system during both the 93rd and 94th
Congresses. In Service spite of the fact that our Executive Branch spending
for Indian Health activities has grown from $113 million in FY 1969 to
$425.6 million in FY 1977, Indian people still lag behind the American
people as a whole in having their health needs met. I am persuaded to
sign this bill because of the careful documentation that
the Committees have made and because of my own personal conviction that
our First Americans must no longer be last in opportunity.
FORD
The authorizations in this bill may be beyond what future
Presidents or future Congresses may be willing or able to approve;
there are unneeded authorities given and narrow program categories
mandated. But S 522 is a statement of direction of effort toward meeting
a clear need, and as such it meets with my persenal approval.
Title V of S 522, however may risk initiating new and unneeded
health programs for urban Indians; I am asking the Secretary of Health,
Education and Welfare to administer Section 503 (a) (9) with great caution,
since it is preferable that urban Indian people receive health care
from existing local facilities than to start up duplicative programs at
unnecessary cost.
Since Title VII of this bill provides for future reports to the
Congress from the Secretary, including a review of progress and as assess-
ment of the bill's progress, I believe the Administration can in this way
bring to the attention on the Congress any changes then needed to improve
-2-
the provisions of S 522.
I am proud to point out that this new statute is only the
latest in a distinguished series of legislative, executive and judicBal
actions in the past few years which ha ve totally reversed the shameful
policies of the past towards American Indiah people. The restorations
of Blue Lake, of the Yakima lands, of the Menominees, the Alaska Native
Claims Settlement Act, the Indian Financing Act and the Indian Self-
Determination Act, the government's vigorous defense of Indian natural
resources and water rights, the resulting milestone Court decisions such
as McClanahan, Washington, Mazurie, Stevens and Bryan, the tripling
and quadrupling of agency budgets for Indian programs -- are rectifying
the sorry past and are eaabling our American Government to hold its head
high where our American Indian citizens are concemed.
There is much more to do, but this Act and the chain of
statutes and policies of which it is a link have marked a new direction
of which I am proud and which I shall continue.
^
GRF
Allen, Henry, Chairman, Board of Directors, North Central
Oklahoma Inter-Tribal Health Council, Inc.
Allen, Jim, President, Inter-Tribal Council of Eight North-
eastern Tribes
American Academy of Family Physicians, Carl B. Hall, M.D. - Pres.
Thomas Jacobsen, M.D
American Association of Colleges of Pharmacy, Tom S. Muja - Pres.
American Medical Association, Richard Palmer - Pres.
American Dental Association, Robert B. Shira, D.D.S. - Pres.
American Optometric Association, Ronald Fair, O.D. - Pres.
American Psychological Association, Wilbert J. McKeachie, Ph. D. - Pres.
American Speech and Hearing Association, Daniel P. Boone, Ph. D. -
Pres. of Board; Kenneth 0. Johnson, Exec. Sec.
Banashley, Fred, Sr., Chairman, White Mountain Apache Tribe,
Whiteriver, Arizona
Bartlett, Honorable Dewey T., a U.S. Senator from the state of
Oklahoma
Bear Don't Walk, Marjorie, Director, National Institute of
Health Grant, Native American Studies, University of Montana
Belindo, John, Executive Director, National Indian Health Board
Benally, Hhuley, Gallup Health Advisory Board Office
Bernal, Paul, vice Chairman, All Indian Pueblo Council
Bia, Emmett, Council Delegate, Many Farms, Arizona
Blueye, Henrietta, Seattle Indian Health Board
Burch, Leonard, Chairman, Southern Ute, Colorado
Cannon, Bob, Executive Director, Comanche County Improvement
Foundation, Inc.
*
Chino, Wendell, President, National Tribal Chairmen' Association,
Chairman, Mescalero Apache
FORD
Cottier, Belva, Executive Director, San Francisco Native
American Health Service
Cox, Claude, Chief, Creek Nation
Crawford, Earl, Tribal Sanitation Representative of the Cherokee
Nation
Dashee, Alvin, Vice Chairman, Hopi Tribal Council
Deegan, Charles, Jr., Acting Chairman, National Off-Reservation
Indian Health Programs
Dole, Honorable Robert, a U. S. Senator from the state of Kansas
Dressler, Effie, Chairman, Western Nevada Indian Health Board, Inc.
Ducheneaux, Frank, House consultant, Subcommittee on Indian
Affairs, Committee on Interior and Insular Affairs
Fannin, Honorable Paul J., a U. S. Senator from the state of
Arizona
Forrest, Erin, Chairman, National Tribal Chairmen's Association
Health Committee
Garcia, Merle, Governor, Pueblo of Acoma
Gerard, Forrest J., Staff Assistant, Subcommittee on Indian
Affairs, Committee on Interior and Insular Affairs
Goodbear, Howard, Chairman, United Tribes of Western Oklahoma
and Kansas; Elnita Rank, Chairman, United Sioux Tribes of
South Dakota; Robert Hoag, President, Seneca Nation of Indians;
Tom Pable, Chairman, Montana Inter-Tribal Policy Board
Hawkins, George, President, National Indian Board on Alcohol and
Drug Abuse OKLA
House, Benjamin A., Crownpoint, New Mexico
Jackson, Honrable Henry M., a U. S. Senator from the state of
Washington
Jackson, May, Creek and Seminole Tribe
Jennings, Don, Executive Director, Association of American Indian
Physicians CKLA
Johnson, Emery A., M. D., Assistant Surgeon General, Director,
Indian Health Service
Keen, Ralph, Former Business Manager of the Cherokee Nation
King, Eloise, Chairperson, Governor's Indian Advisory Council,
Tumwater, Washington
White, Ada, Chairman, Billings Area Indian Health Board
Lavis, Rick, AA to Fannin
FORD
Little Axe, Danny, United Indian Tribes of Western Oklahoma
and Kansas
Issac, Calvin J., Chief, Mississippi Band of Choctaw Indians
McKenzie, Dr. Taylor, Navajo Health Authority, Dean/Executive
Director
Muschenheim, Dr. Carl, Chairman, National Committee on Indian
Health of the Association of American Indian Affairs
Old Person, Earl, Blackfeet Tribe
Overton, James, Governor, Chickasaw Nation - Oklahoma
Red Eagle, Ed, Sr., Chairman, North Central Oklahoma Inter-
Tribal Health Council, Fairfax, Oklahoma
Reyes, Luana, Seattle Indian Health Beard
*
Rhoades, Dr. Everett R., Past President of the Association of
American Indian Physicians OKLA
Sampson, Melvin, Vice Chairman, National Indian Health Board WASH
Sarracino, Emmett, Director, Health Program, Los Angeles, California
Sekaquaptewa, Abbott, Chairman, Hopi Tribal Council
Skubitz, Joe, Congressman from the State of Kansas
Smith, Frank, Assistant Deputy Director, Cook Inlet Native
Association
Smith, Le@nard, Executive Director, California Indian Health
Council
Starr, Hickory, Jr., Project Director, Central Oklahoma American
Indian Health Council, Inc.
Sundust, Perry, Chairman, Phoenix Area Indian Health Board
Swimmer, Ross, former General Counsel, Cherokee Nation now
Principal Chief, Cherokee Nation
Tafoya, Paul, Governor, Santa Clara Pueblo, New Mexico
Tanana Chiefs Health Authority
Tanyan, Ed, Chief, Seminole Tribe, Oklahoma, Chairman,
Oklahoma City Area Indian Health Board
Taylor, Jonathan, Vice-Chairman, Cherokee, North Carolina
Tiepelman, Dennis A., Executive Director, Mauneluk Association,
Kotzebue, Alaska, to Subcommittee on Indian Affairs
Tinker, Sylvester J., Principal Chief, Osage Tribe of Indians,
Pawhuska, Oklahoma
Tommie, Howard, Chairman, National Indian Health Board
Tonasket, Mel, President, National Congress of American Indians
Trimble, Charles, Executive Director, National Congress of
American Indians
Waln, Sonny, Chairman, Rosebud Sioux Tribe Health and Welfare
Committee
Wauneka, Annie
Webb, Gordon S., Member, Nez Perce Tribe of Idaho, San Francisco,
California
Williams, Cecil, Chairman, Executive Health Staff
Wood, Rosemary, RN MS, American Indian Nurses' Association, Inc.
Youpee, William, Executive Director, National Tribal Chairmen's
Association
Bergman, Abraham, M.D., Childrens' Hospital, Seattle, Wn.
Kemberling, Sidney, M.D., Chigrman of Indian Health Committee,
American Academy of Pediatrics
*
Koomen, Jacob, M.D., Association of State and Territorial
Health Officials - Chairman
Don Young
Lloyd Meads
Paul Rogers
IHS draft
DRAFT
The Indian Health Care Improvement Act promises to assist
the Administration in providing the Indian people with the
authorities and program support necessary to meet their
health needs. Further, it is consistent with long-
standing positions and statements of the Executive Branch
regarding its concern for, and resolve to meet the
problems of Indian health.
Title I of this Bill relates to three initiatives under-
taken within the Executive Branch, including HEW. First,
in 1970, the former President in his Indian message to the
Congress expressed keen awareness of need for increased
numbers of Indians trained in the health professions.
Second, in 1975, former Secretary Weinberger asked the
Health Resources Administration to conduct a study on ways
in which the needs for Indian health manpower could be
met. It was indicated that administrative means for
meeting these needs would be most desireable. The study,
however, revealed that suitable and feasible administrative
means were not available. Thirdly, it was thought that
giving preference to Indians within existing national
scholarship program budgets would be a good way to increase
the Indian health manpower pool. The OGC, however, said
there is no legal authority to do this. Thus, the
Administration, long interested in increasing the Indian
health manpower pool, found that there was no administratively
2
feasible way of meeting this need within the framework
of existing structures and authorities.
Congress, in Title I of this Act, has provided a legal
means to do what has been denied to the Administration
because of administrative and legal complications. The
title provides Indian preference, rather than massive new
programs, for professional scholarships, and is, therefore,
consistent with the Administration's basic approach to the
problems of Indian health manpower.
Titles II and III, respectively, relate to health services
for Indian people, and health facilities needed to deliver
those services. The titles set forth a phased approach to
meeting needs in these areas. The Executive Branch has long
held there is a need for such a phased approach for meeting
unmet needs for services, and for appropriate health
facilities. For example, in 1970, former Assistant
Secretary for Planning and Evaluation, Lawrence Lynn,
testified that an incremental approach to meeting unmet
Indian health needs is desireable and referred to a plan
which was to be developed by the Department. For
whatever reasons, this plan was not submitted to the
Congress. Titles II and III, therefore, confirm and support
a longstanding HEW approach to resolving problems of unmet
needs for Indian health services and facilities.
3
It is true that Titles II and III specify with precision the
needs, and numbers and dollars to be addressed to these
needs. It is noteworthy, however, that the Congress has
done so in a way that provides certain flexibilities for
the Executive Branch over the seven-year life of the Bill.
Congress has given HEW three years to work with these numbers
and dollars. At the end of that time the Department,
based on its three years of experience, can go back to the
Congress with the recommendations for the last four years of
the bill's life.
The Administration supports Title IV of the bill. Should
the President choose to sign the bill into law, he would
in fact, be reaffirming the Administration's position on
this Title.
Title V, basically, is a restrictive title pertaining to
urban Indians. The current law governing IHS operations does
not preclude full-blown Indian Health Service operations
throughout the country including urban areas. S.522 limits
this potentially unlimited scope of IHS operations.
Further, it assists urban Indians to participate in programs
designed to serve all people in need. Both of these
features are consistent with the Administration's position
that urban Indians should be fully aware of, and full
participants in the health programs available to the
general public, on the same basis as anyone else who
qualifies, rather than establishing a massive, special
Federal health services to Indian people.
4
Title VI would authorize a feasibility study relative to the
establishment of an Indian medical school. Several years
ago, former Secretary Richardson took the initiative in
exploring the need for an Indian medical school. This
title does not offer to build these schools as it
originally did; rather, it authorizes the aforementioned
study. Again, this title is consistent with earlier actions
by the Executive Branch.
It is clear from the aforegoing that each of the titles
in this bill, rather than being in conflict with, or alien
to Executive Branch initiatives, aims positions, and
practices, their relative to Indian health needs, and, indeed,
parallel in many cases, some pioneering initiatives on the
part of the Administration.
There is every reason to believe that the Administration's
concern about Indian health needs continues to be at a
very high level as it long has been Illustratively, as
recently as July 16, 1976, President Ford, in remarks to
a group of Indian leaders, established a higher than ever
level of expectations of his Administration among the Indian
community. Unquestionably, Indian leadership and community
membership throughout the country look with great hope and
confidence to the President to meet these expectations and
provide relief for their longstanding problems. It is
crystal clear that they would find his signing this bill into
5
law to be completely consistent with previous Executive
Branch initiatives and the public positions he has taken.
It would be a solid affirmation of his credibility with
the First Americans.
THE
THE NAVAJO NATION
WINDOW ROCK, ARIZONA 86515
PETER MacDONALD
CHAIRMAN
SEP 27 1976
Dear President Ford:
BP
It has come to our attention that the INDIAN HEALTH
CARE IMPROVEMENT ACT has been approved by both Houses of the
United States Congree and the Bill has been forwarded to you
for consideration.
On behalf of the Navajo People, as well as that of
other Indian People, and the upgrading of the level of their
Health, which is at present far below National Norms, and
in the spirit of your stated intentions to work with and
improve the well-being of these people, I respectfully urge
that you carry out your commitment to the Indian People of
America by signing immediately into Law the INDIAN HEALTH
CARE IMPROVEMENT ACT. The Navajo People, specifically,
look and appeal to you to honor the trust America holds for
the American Indian People and Treaties made to guarantee
this trust.
Peter MacDonald
Navajo Tribal Council
President Gerald R. Ford
United States of America
The White House
Washington, D.C.
Replat
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THE WHITE HOUSE
WASHINGTON
September 27, 1976
MEMORANDUM FOR THE PRESIDENT
FROM:
BRADLEY H. PATTERSON, JR
THROUGH:
WILLIAM J. BAROODY, JR.
SUBJECT:
S. 522 -- The Indian Health Care
Improvement Act
I respectfully recommend that you sign S. 522 and issue
the attached statement (Tab A)
Most of my reasons for this recommendation are not re-
flected in the Enrolled Bill Memorandum; they are as
follows:
1. For seven years there has been an unbroken
series of Presidential actions which have
reversed and rectified the past decades of
neglect for Native Americans. It has been
a brilliant executive/legislative accomplish-
ment in which you and a bipartisan Congress
fully share. A veto of this bill would be
the first turnaround in that seven-year
record and, as such, would have symbolic
impact greater than the merits of the bill
considered by themselves.
2. This symbolic impact could not come at a
more inopportune time.
(a) Our experience with Indian matters
FORD LIBRARY s GERALD
from Alcatraz to Wounded Knee has shown
us that while the Indian community itself
is small, the latent interest in and
sympathy for Indian people in the population
generally is widespread, is undiscriminating
and is a magnet for media exploitation.
The symbolic force of a veto here risks
galvanizing that latent sympathy into an
attention-getting political backlash among
2
conservative and independent people, as
well as among Democrats.
(b) Carter's staff is keeping close track
of Indian matters; (he has sent Messages to
all the recent Indian meetings.) A veto of
this bill will raise the whole area of Indian
affairs up into his target sights.
(c) You have just (properly) vetoed a less
important bill on early retirement for non-
Indian federal employees. The two vetoes
together will have a synergistic effect.
Three weeks from today the National Congress
of American Indians assembles in Salt Lake
City; vetoing the Indian Health bill will
convert the Conference into a minor political
disaster for us in addition to its longer
term negative opinion effect among Indian
leaders.
3. The bill is only an authorization measure. While
it is true that the Indian community and the
Indian Health Service will be encouraged by your
signature to recommend appropriations for the full
amounts, you and OMB can handle any unjustified
requests through the budget machinery, and in that
discriminating way next December rather than
through the sledgehammer of a veto in October,
protect the budget from excesses. The draft
statement (Tab A) makes it clear that your signing
the bill does not constitute overpromising or
making a commitment to budget the amounts authorized.
4. Contrary to the impression which may be given at
the bottom of page 6 of the Enrolled Bill Memoran-
dum, Republican support for this bill is strong;
a veto (unless it is of the "pocket" variety) will
be overridden.
(a) Joe Skubitz, ranking on the House Interior
Committee, joined in the successful effort to
have the earlier version of the bill amended,
stating:
If the amendments are adopted, it is a bill
which I personally believe the President
can sign in good conscience
I can truthfully say that the Interstate
3
committee has done its best to report
a responsible bill, which in our judg-
ment, should be both fiscally and
philosophically acceptable to the
administration."
(b) On House passage, the following members
of the Minority of the House Interior Committee
joined Mr. Skubitz in voting for the bill:
Messrs. Bauman, Clausen, Johnson, Lagomarsino,
Pettis, Smith and Symmes.
(c) Congressman Rhodes is a co-sponsor of the
bill and has written you a special letter urging
you to sign it.
(d) Senators Dole, Fannin, Goldwater, Bartlett,
Domenici, Stevens and Hatfield are supporters
of the amended bill.
5. We are on somewhat slippery grounds in opposing the
final, amended bill. In unusual steps, both Ranking
Member Skubitz and Ranking Member Fannin went out
of their way to castigate HEW generally and
Secretary Mathews personally for being unwilling
earlier on to sit down with the Committees and
staffs to work out an acceptable compromise. 53
weeks ago, Senators Fannin and Bartlett had lunch
with Secretary Mathews to start this process, but
HEW never followed up. The Skubitz and Fannin
statements are attached here as Tab B.
6. The Indian Health facilities lack more than "eight-
foot-wide halls". When the House and Senate Com-
mittee reports pointed out that 25 out of 51 IHS
hospitals failed of accreditation by the Joint
Commission on Accreditation of Hospitals, they
added:
"Many of them are old one-story, wooden
frame buildings with inadequate electricity,
ventilation, insulation and fire protection
systems and of such insufficient size as to
seriously jeopardize the health and safety
of patients and staff alike."
4
7. I share Paul O'Neill's concern about special
health programs for urban Indians, but the
draft signing statement recommended here
includes a special instruction to Secretary
Mathews to use the bill's authority to avoid
duplication.
FORD LIBRARY & GERALD
DRAFT SIGNING STATEMENT FOR S 522
I am today signing S 522, the Indian Health Care
Improvement Act.
This bill is not without its faults, but after
personal review I have determined that the well-documented
needs for improvement in Indian health manpower, services
FORD LIBRARY
and facilities outweigh the defects in the bill itself.
There has never been any question throughout my
Administration about the validity of the Congressional
Findings in S 522.
There have been differences with the Congress of
course about the best methods for meeting the needs identified
in those Findings. Earlier versions of this bill contained
many undesirable provisions.
But the Congress, after careful and bipartisan
review, has modified S 522 and has in my opinion corrected
the features which would have been unacceptable.
The proper Committees of the House and Senate have
studied the Indian health care delivery system during both
the 93rd and 94th Congresses. In spite of the fact that our
Executive Branch spending for Indian Health Service activities
has grown from $113 million in FY 1969 to $425.6 million in
FY 1977, Indian people still lag behind the American people
as a whole in having their health needs met. I am persuaded
to sign this bill because of the careful documentation that
the Committees have made and because of my own personal
conviction that our First Americans must no longer be last
in opportunity.
2
The authorizations in this bill may be beyond what
future Presidents or future Congresses may be willing or able
to approve; there are unneeded authorities given and narrow
program categories mandated. But S 522 is a statement of
direction of effort toward meeting a clear need, and as
such it meets with my personal approval.
Title V of S 522, however, may risk initiating new
and unneeded health programs for urban Indians; I am asking
the Secretary of Health, Education and Welfare to administer
Section 503 (a) (9) with great caution, since it is preferable
that urban Indian people receive health care from existing
local facilities than to start up duplicative programs at
unnecessary cost.
Since Title VII of this bill provides for future
reports to the Congress from the Secretary, including a
review of progress and as assessment of the bill's progress,
I believe the Administration can in this way bring to the
attention OF the Congress any changes then needed to improve
the provisions of S 522.
I am proud to point out that this new statute is
only the latest in a distinguished series of legislative,
executive and judicial actions in the past few years which
have totally reversed the shameful policies of the past
towards American Indian people. The restorations of Blue
Lake, of the Yakima lands, of the Menominees, the Alaska
Native Claims Settlement Act, the Indian Financing Act and
3
the Indian Self-Determination Act, the government's vigorous
defense of Indian natural resources and water rights, the
resulting milestone Court decisions such as McClanahan,
Washington, Mazurie, Stevens and Bryan, the tripling and
quadrupling of agency budgets for Indian programs -- are
rectifying the sorry past and are enabling our American
Government to hold its head high where our American Indian
citizens are concerned.
There is much more to do, but this Act and the
chain of statutes and policies of which it is a link have
set a new direction of which I am proud and which I shall
continue.
Gerald R. Ford
15498
CONGRESSIONAL RECORD
September 9, 1976
depth and recommended approval of the
tion, I have no further objection to the
INDIAN
HEALTH
CARE
IMPROVE-
Senate-passed bill, S. 522, as amended.
House amendment with the understand-
MENT ACT
The House concurred by a vote of 310 to 9.
ing that the Indian Health Service will
By this vote, the House committed itself
have the authority to determine scholar-
to strengthening our Indian health care
ship recipients and the distribution of
program and joined with the Senate in
scholarships among those health care
making Indian health care a matter of
professions that are either in demand or
highest importance.
expected to be in demand within the
As amended by the House, S. 522 was
Indian Health Service.
modified only to the extent of its com-
Mr. President, as we move to conclude
mitment. As passed by the Senate, S. 522
the final action on the Indian Health
had authorized the expenditure of $1.6
Care Improvement Act, there hangs over
billion over 7 years. This approach was
this much needed legislation the threat
neither arbitrary, unreasonable or exces-
of a veto. This threat deeply concerns
sive as it had been our policy to limit the
me; but let me be very .clcar that I do
impact of these much needed expendi-
not intend to stand idly by in the event
tures while assuring a strong commit-
of a veto.
ment to eliminating the deficiencies in
This threat has existed since Congress
manpower, patient care services and
began its consideration of the Indian
facilities. In approving this 7-year pro-
Health Care Improvement Act. The post-
gram, the Senate had sought to avoid
tion of the Department of Health, Edu-
those problems that might occur with a
cation, and Welfare has always been
short-term crisis program.
negative. In letter after letter, in state-
The House, after careful deliberation,
ment after statement, the Department
determined that it would be unwise to
has never changed its mind that this
make such a long-term commitment. It
legislation was unnecessary, too expen-
amended S. 522 by authorizing the ex-
sive, excessive in scope, and inconsistent
penditure of approximately $500 million
with the objectives of the administration.
over a 3-year period. It did, however,
The Department has failed to even
commit itself to reviewing the balance of
practice the art of compromise, concilia-
the 7-year plan following the initial 3-
tion, and cooperation in the development
year authorization period. Nevertheless,
of this bill. On two occasions in this and
the bill, as amended, remains virtually
the last Congress, my staff met with de-
intact in terms of its basic structure.
partmental officials to discuss agree-
The Senate had designed a bill which
ment on this bill. Their attitude was
contained a series of programs which
clearly negative and exhibited an un-
were interrelated and complementary.
willingness to work out an acceptable
This approach, to which the House
compromise. Senator BARTLETT and I
Mr. FANNIN. Mr. President, I concur
agreed, is fundamental to successfully
even. met with Secretary Mathews to
with the distinguished chairman of the
overcoming the overall problems in the
encourage support and to possibly open
committee.
Indian health care delivery system.
communications on resolving the De-
For nearly 2½ years, the Congress has
Therefore, because the House retained
partment's posture of opposition. It was
been considering legislation to strengthen
the basic structure developed by the
my impression following this meeting
the quality of Indian health care serv-
Senate and is committed to reviewing the
that the Department was interested in
ices. Beginning with hearings in 1973
balance of the 7-year plan following the
the problems of the Indian Health Serv-
on the shortages in Indian health man-
3-year authorization period, I can accept
ice and in discussing possible approaches
power, the Congress has, through hear-
S. 522 as amended and urge my Senate
to their solution both within nad without
ings, investigations, and GAO studies,
colleagues, without reservation, to ap-
the context of the Indian Health Care
confronted Indian health care deficien-
prove this much needed legislation.
Improvement Act. Yet, progress toward
cies and needs. It would serve no useful
There is one issue, however, in the bill
agreement was conspicuous by its ab-
purpose to remind the Senate once again
which needs to be discussed so that the
sence. The Department made no effort
of these problems, except to say that
record is quite clear as to congressional
whatsoever to produce any alternatives
these problems remain unresolved, await-
intent. During its consideration of title I,
and, in fact, I never heard from Secre-
ing resolution.
dealing with manpower, the House Inter-
tary Mathews on the subject again. In
In response, the Senate Interior Com-
state and Foreign Commerce Committee
view of the unbending opposition by the
mittee developed the Indian Health
approved an amendment to establish the
Department, the Congress had no choice
Care Improvement Act which the Sen-
section 104, health scholarship program
but to proceed as best it could in devel-
ate on two occasions approved unani-
within the National Health -Service
oping legislation that would address the
mously. This legislation was designed to
Corps program. This amendment was
very critical health care problems faced
expand, under a carefully developed
unacceptable initially to the Senate be-
by Indian citizens.
plan, the level of health care services
cause it created a situation in which the
Time and again the Department indi-
provided to Indian people. In addition,
Indian Health Service would be unable
cated that this legislation would create
the bill addressed the crisis in manpower
to control the program. It was definitely
undue expectations among the Indian
facing the IHS and the inadequate and
the intent of the Senate to provide the
people. Yet, what expectations does the
unsafe facilities which the IHS must
Indian Health Service with sufficient au-
Department provide to Indian people
utilize in treating Indian citizens. The
thority to manage its own manpower
themselves when their own budget re-
Senate in approving this legislation was
programs as developed within title I, so
quests for IHS contains funds which are
confident that its approach, which was
that it would not have to rely on other
inadequate to effectively address patient
comprehensive in scope, addressed in a
existing programs which have proven
care needs and the obvious need for bet-
reasonable way the neglect which limited
unable to meet IHS needs. The amend-
ter facilities. For example, since fiscal
resources had fostered within the Indian
ment by the House appeared to have
year 1969, through fiscal year 1977, the
Health Service. In doing so, the Senate
weakened that approach causing us great
Department has on its own requested
committed itself to establishing better
concern. In response, the House agreed
only enough funds to construct two re-
health care for Indian citizens as a pri-
to a further amendment which would
placement hospitals. Yet, as the Con-
ority concern of the Federal Govern-
insure that the Indian Health Service
gress knows, the needs of the IHS facili-
ment.
could write the prescription for its man-
ties far exceed the level of that support.
In the House, three major authorizing
power needs while allowing the National
In summary, the Department's posi-
Committees, Interior and Insular Affairs,
Health Service Corps to administer the
tion on this legislation is without merit
Interstate and Foreign Commerce and
details of the scholarship application and
and this troubles me. Despite the De-
Ways and Means examined this issue in
funding process. In view of this clarifica-
partment's opposition to S. 522, its own
statements reflect the concern that the
the same conclusion was reached in both
quality of care that IHS is able to pro-
instances-that there clearly exists a
vide Is inadequate. In a recent letter, for
very great need for a comprehensive
example, to Congressman RHODES, the
health care plan to meet the unmet
House minority leader, the Undersecre-
health care needs of the Indian people
tary of HEW, Marjorie Lynch, acknowl-
of this country.
edges that fact by stating that the De-
The staffs of both Houses of this Con-
partment, and I quote, "is working to-
gress have worked long and diligently to
ward raising the health status of Indi-
devise such a plan, and in my opinion
ans to at least a level equal to that of
have come up with an excellent one. This
the non-Indian population." This ad-
plan, S. 522, addresses the long-standing
mission by the Department itself that
and often neglected responsibility of the
Indian health care is inadequate makes
Federal Government, that is, the respon-
their opposition to this legislation some-
sibility to provide health care services
what mystifying.
to native Americans in this country. The
In my opinion, the Department and
health care needs of this segment of the
Congress agree that Indian health care
population have heretofore been given
services are inadequate. Where we dis-
piecemeal attention, an approach which
agree is the speed with which we should
I feel has contributed considerably to
address the problem. Congress is in a
their present day health status. Al-
mood, however, to move ahead more rap-
though the Indian Health Service has in
idly than the Department. In view of the
recent years made significant advances
needs which have been so completely
in its efforts to provide quality health
documented both within Congress and in
care to the Indian people, the unmet
the Department itself, we are at a loss
health needs are still alarmingly high.
to understand why the Department feels
Their health needs far exceed that of
so compelled to drag its feet in ad-
the general population.
dressing this problem.
Even though the Department of
Mr. President, this legislation has en-
Health, Education, and Welfare is just
joyed broad bipartisan support within
as much aware of this fact as I, it op-
the Congress as well as among virtually
poses enactment of this much needed
every important national health orga-
legislation. It would not be difficult for
nization. But more importantly, it is sup-
me to understand HEW's position on this
ported wholeheartedly by the Indian peo-
bill if the health care status of Indian
ple themselves as better health is their
people were on a par with that of the
number one priority. Only the Depart-
general population, but recognizing the
ment stands in lone opposition to this
great unmet need that clearly exists in
much needed legislation.
the quality of health care services deliv-
Mr. President, it is my hope that Presi-
ered to Indian people and recognizing
dent Ford will recognize the importance
that the responsibility for correcting this
of this legislation. The Congress has pro-
grave situation is clearly that of the
duced a reasonable piece of legislation
Federal Government, I find the position
which will assure a better health care de-
of HEW on this bill to be unconscion-
livery system for our Indian people. In
able.
that spirit, I hope the Persident will ap-
Both Senator FANNIN and I have met
prove the Indian Health Care Improve-
with Secretary Matthews and others in
ment Act as a positive commitment to-
the Department of HEW to point out to
ward securing a better life for our Indian
them the merits of this bill, but our
citizens.
efforts were to no avail. HEW has still
Mr. President, I feel very keenly about
not seen the need to support this legis-
this legislation. It is legislation that will
lation and, in fact, has indicated that it
be of great value to our Indian people. I
will recommend a veto if the bill is pre-
do not consider there is anything more
sented to the President for approval.
important to our Indian people than
Mr. President, I have been a strong
their health care.
supporter of this bill from its inception,
Mr. President, I want to commend the
and I will continue to lend my support
outstanding leadership of my chairman,
to it until it is signed into law by the
Senator JACKSON, in assisting in the de-
President of the United States. I feel
velopment of this legislation. His lead-
strongly that the Federal Government
ership and concern for resolving the
has failed to provide an adequate Indian
problems of Indian health care programs
health bill. Enactment of S. 522 elim-
will long be remembered.
inates many of the existing deficiencies
Mr. President, I urge adoption of the
in Indian health care services.
Senate amendment and approval of S.
522 as amended.
I yield to the Senator from Oklahoma.
Mr BARTLETT Mr. President, it is
with great pleasure that I rise today in
support of S. 522, the Indian Health
FORD
Care Improvement Act, as passed by the
House with the clarifying and substan-
tive changes offered in the Fannin/Jack-
son amendment. I sincerely hope the
GERALD
Senate will, as it has done twice before,
act favorably and expeditiously on this
measure. I can see no need to debate the
issues involved in this bill to any degree
here today because they have been
thoroughly discussed by the Senate twice
before in the Interior Committee, and
FOR IMMEDIATE RELEASE
September 29, 1976
Office of the White House Press Secretary
THE WHITE HOUSE
TO THE HOUSE OF REPRESENTATIVES:
Just before adjourning for the final weeks of the
election campaign, the Congress has sent me H.R. 14232, the
Departments of Labor, and Health, Education, and Welfare
appropriations for fiscal year 1977 which begins October 1.
This last and second largest of the major Federal appro-
priation bills to be considered by this Congress is a
perfect example of the triumph of election-year
politics over fiscal restraint and responsibility to the
hard-pressed American taxpayer.
Contained in this bill are appropriations for numerous
essential domestic programs which have worthy purposes. My
budget for these purposes totaled $52.5 billion, $700 million
more than this year. Since 1970 expenditures for these pro-
grams have increased at a rate 75% greater than the rate of
growth in the overall Federal Budget. Therefore, my 1977
proposals included substantial reforms in the major areas
covered by these appropriations designed to improve their
efficiency and reduce the growth of Federal bureaucracy and
red tape.
The majority in control of this Congress has ignored
my reform proposals and added nearly $4 billion in additional
spending onto these programs.
The partisan political purpose of this bill is patently
clear. It is to present me with the choice of vetoing these
inflationary increases and appearing heedless of the human
needs which these Federal programs were intended to meet, or
to sign the measure and demonstrate inconsistency with my
previous anti-inflationary vetoes on behalf of the American
taxpayer.
FORD
It is to present me with the dilemma of offending the
CALD
voting groups who benefit by these government programs, or
offending those primarily concerned with certain restrictions
embodied in the bill.
I am sympathetic to the purposes of most of these
programs. I agree with the restriction on the use of
Federal funds for abortion. My objection to this legisla-
tion is based purely and simply on the issue of fiscal
integrity.
I believe the American people are wiser than the Congress
thinks. They know that compassion on the part of the Federal
Government involves more than taking additional cash from
their paychecks. They know that inflationary spending and
larger deficits must be paid for not only by all Federal
taxpayers but by every citizen, including the poor, the
unemployed, the retired persons on fixed incomes, through
the inevitable reduction in the purchasing power of their
dollars.
I believe strongly in compassionate concern for those
who cannot help themselves, but I have compassion for the
taxpayer, too. My sense of compassion also says that we
more
2
shouldn't ask the taxpayers to spend their money for a tangled
mess of programs that the Congress itself has shown all too
often to be wasteful and inefficient -- programs which all
too often fail to really help those in need.
The Congress says it cares about cutting inflation and
controlling Federal spending.
The Congress says it wants to stop fraud and abuse in
Federal programs.
The Congress says it wants to end duplication and overlap
in Federal activities.
But when you examine this bill carefully you discover that
what the Congress says has very little to do with what the
Congress does.
If the Congress really cared about cutting inflation and
controlling Federal spending, would it send me a bill that
is $4 billion over my $52.5 billion request?
If the Congress really wanted to stop fraud and abuse in
Federal programs like Medicaid, would it appropriate more
money this year than it did last year without any reform?
If the Congress really wanted to end duplication and
overlap in Federal activities, would it continue all of
these narrow programs this year -- at higher funding levels
than last year?
If the Congress really wanted to cut the deficit and
ease the burden on the taxpayer, would it ignore serious
reform proposals?
The resounding answer to all of these questions is no.
GORALD FORD LIBRARY
Our longtime ally, Great Britain, has now reached a
critical point in its illustrious history. The British
people must now make some very painful decisions on
government spending. As Prime Minister Callaghan courageously
said just yesterday, "Britain for too long has lived on borrowed
time, borrowed money and borrowed ideas. We will fail if we
think we can buy our way out of our present difficulties by
printing confetti money and by paying ourselves more than we
earn.
"
I cannot ask American taxpayers to accept unwarranted
spending increases without a commitment to serious reform.
I do not believe the people want more bureaucratic business
as usual. I believe the people want the reforms I have
proposed which would target the dollars on those in real
need while reducing Federal interference in our daily lives
and returning more decision-making freedom to State and local
levels where it belongs.
I therefore return without my approval H.R. 14323, and
urge the Congress to enact immediately my budget proposals
and to adopt my program reforms.
GERALD R. FORD
THE WHITE HOUSE,
September 29, 1976.
# # #
THE WHITE HOUSE
WASHINGTON
September 30, 1976
MEMORANDUM FOR JUDY JOHNSTON
Subject: Comment on the 9/30 Draft
Signing Statement on S 522
I realize that a good deal of the
language in my September 27 draft has been
dropped out, but I do recommend that a few
bits of it be put back, i.e.:
a) The paragraph on urban Indians is,
I think, quite important so that
this program does not grow out of
control. It could lead to many
false expectations if it is not
included here.
FORD i LIBRARY GERALD
b) I would reinsert the first sentence,
at least, of my next-to-last
paragraph. Perhaps delese "totally"
and shameful".
c) Then I would close with my original
last paragraph. I expect to send this
signing statement to many Indian
groups and organizations; it sets
the righttone at the end.
Bradley Jad H. Patterson, Jr.
S. 522 - Indian Health Care Improvement Act Signing Statement
I am today signing S. 522, the Indian Health Care Improvement
Act.
This bill is not without its faults, but after personal review
I have determined that the well-documented needs for improvement in
Indian health manpower, services and facilities outweigh the defects
in the bill.
While spending for Indian Health Service activities has grown
from $107 million in FY 1969 to an estimated $417 million in FY 1977,
Indian people still lag behind the American people as a whole in
achieving and maintaining good health. I am signing this bill
because of my-own conviction that our First Americans must not be
last in opportunity.
Some of the authorizations in this bill are duplicative of existing
authorities and there is an unfortunate proliferation of narrow
categorical programs. But still, S. 522 is a statement of direction
of effort and, as such, it meets with my personal approval.
Title VII of this bill provides for future reports to the Congress
from the Secretary of Health, Education and Welfare, including a
review of progress under the terms of the new Act. I believe the
Administration can in this way bring to the attention of the Congress
any changes needed to improve the provisions of S. 522.
On balance, this bill is a positive step and I am pleased to
sign it.
H 8072
CONGRESSIONAL RECORD-HOUSE
SKUBITZ:
July 30, 1976
death rates, greater disease, and more
dian health situation in the light of the
primary jurisdiction over the bill and
frequent infant deaths than non-
program's successes and failures.
who also serves on the committee which
Indians.
The Interstate amendments will reduce
handles health matters.
It is the Congress which must under-
the first year construction allocations
I can truthfully state that the Inter-
take the necessary initiative here.
for medical facilities.
state committee has done its best to
It is the Congress which must commit
Although I believe that the $67 million
report a responsible bill, which, in ou
itself to a serious program for Indian
provided is still far too much, it is a sig-
judgment, should be both fiscally an
health improvement.
nificant improvement over the Interior
philosophically acceptable to the admin
But H.R. 2525, unless amended, is not
Committee's recommendation of $124
istration.
the answer.
million.
If the President later concludes that
The legislation is irresponsible, for it
Finally, the amendments to be offered
this Indian health package is unaccept-
makes firm commitments of staggering
will strike the provision which creates an
able or too costly, I respectfully suggest
amounts of taxpayers' money for up to
American Indian medical school.
that such a position should have been
7 years, when not even the best of ex-
With the adoption of these amend-
expressed weeks ago by the Office of the
perts is able to estimate with accuracy
ments I feel that H.R. 2525, although not
Secretary of Health, Education, and
Indian health needs or medical costs
perfect, nevertheless is an acceptable bill
Welfare.
that far in the future.
and provides a program which will take
Mr. YOUNG of Alaska Mr. Chairman
The legislation is pure puffery. for the
giant strides toward improving the
I yield such time as be may consume to
committee makes bold promises which it
Indian health situation.
the distinguished minority leader, the
knows no Appropriations Committee
If the amendments are adopted, it is
gentleman from Arizona (Mr. RHODES)
could fully endorse and which no ad-
a bill which I personally believe the Pres-
(Mr. RHODES asked and was given
ministration in its right fiscal mind could
ident can sign in good conscience.
permission to revise and extend his
tolerate.
If the amendments are not adopted,
remarks.)
For many years the Interior Commit-
Congress will send to the President an
Mr. RHODES Mr. Chairman, the bill
tee has had nearly exclusive jurisdiction
irresponsible bill bloated with ineffi-
we are considering today. HR. 2525, de-
over Indian matters.
ciency, waste, and duplication.
serves the support of this Congress. It
Thus, the committee has responsibility
Approving H.R. 2525 without amend-
provides for long unmet health care
to the Indian people to present their case
ing it plays "chicken" with the White
needs of our American Indian popula-
in a wise and defensible manner.
House and invites a veto.
tion.
To be taken seriously, the committee
We gain nothing by losing an Indian
Since the mid-1800's, Indian health
should recommend seriously.
health program to a successful veto.
care has lagged behind that available to
Ever given the state of Indian health,
Even more importantly, the Indian
our general population and serious dis-
I still cannot defend a 434-percent in-
population gains nothing. despite our
ease has afflicted our Indian people and
crease over the President's budget re-
rhetoric, promises, and intentions.
shortened their lifespan. This bill is sim-
quest for first year funds for construction
Let us be realistic, let us agree to com-
ilar to H.R. 7852 which I introduced. It
of Indian health facilities.
mit ourselves to a comprehensive pro-
simply is an effort to remedy the inade-
I cannot defend $16.8 million for an
gram which will bring the level of Indian
quacies of Indian health care.
Indian school of medicine that is not
health up to the standards of the non-
Basically the bill outlines a 7-year pro-
even endorsed by the Indians.
Indian population.
gram to upgrade Indian health care de-
I cannot defend a 7-year package
Let us agree on a proposal which both
livery. It provides for new hospitals
which totals $1.2 billion when this com-
the administration, the Congress, and the
where none exist, and modernization of
mittee has no idea what Indian health
American people-Indian or otherwise-
obsolete facilities. It would provide safe
needs will be in 1983, when this commit-
will recognize as serious and reasoned
water supplies and adequate sanitary
tee has no idea what medical costs or
legislation
waste disposal systems
technology will be in 1983, when this
Mr. Chairman, I will support H.R.
The bill would encourage Indians tc
committee has not the slightest notion
2525 if the House accepts the Interstate
participate more actively to manage-
as to whether this program will solve In-
amendments.
ment of health care programs. and to
dian health problems-in 7 years-or
I hope the administration has adopted
seek help from community health assist-
times 7" years.
a similar position.
ance facilities.
I cannot defend this committee "wash-
I just want to say a few more words
It provides for participation in medi-
ing its hands" of the bill and putting all
on this matter.
care ad medicaid programs through the
the heat on the President.
It is almost an understatement to say
Indian Health Service. In addition, it
If he vetoes this irresponsible bill he
I have been distressed and frustrated in
would establish an Indian School of
gets the criticism when, in reality, this
working with the administration on this
Medicine to insure that properly trained
committee deserves it.
legislation.
Indian physicians and other health per-
You may call this bill a "commitment
I can accept the fact that often the
sonnel will be available in the future.
to Indian health."
position adopted by the administration
Mr. Chairman, this is a sound approach
I call it an evasion of legislative re-
is different from my own.
to the unmet health care needs of our
sponsbility.
I recognize that as inevitable, for in
Indian people: It encourages them to be
Mr. Chairman, I followed this bill
the final analysis, we are accountable to
part of the system; to.participate in co-
through both the Interior and Interstate
two different constitutencies.
operative Federal and local programs,
Committees.
But I cannot accept the uncooperative
and to provide health care manpower,
Needless to say, I was very disappointed
spirit I have encountered in dealing with
now in seriously short supply.
with the bill as reported by the Interior
the Department of Health, Education,
The Indian Health Care Improvement
Committee.
and Welfare about this bill.
Act has attracted strong bipartisan sup-
However, the amendments to HR. 2525
I would like to state, for the record,
port in both houses of the Congress. ]
to be presented by the Interstate Com-
the Department's position on this bill,
believe this is a good bill, a practical and
mitte go a long way toward correcting
but I honestly do not know what it is.
constructive move to help deserving peo-
many of the bill's inadequacies.
A number of times I called the Secre-
ple meet a major challenge. I urge that
Most importantly, the authorization
tary's office to ascertain the administra-
my colleagues support H.R. 2525 so this
has been reduced from 7 years to 3.
tion's opinion but, unfortunately, Mr.
worthwhile program may begin.
May I emphasize to my colleagues that
Mathews has been either "too busy" or
The CHAIRMANS Does the gentleman
such a 3-year authorization does not
"out of the office" so much that, at
from Alaska (Mr. YOUNG) desire to yield
mean that the Indian health program
present, I have no idea what HEW wants.
further time?
will be abruptly terminated after only 3
Perhaps Mr. Mathews has seen fit to
Mr. YOUNG of Alaska Not at this
years.
communicate to other Members of this
time, Mr. Chairman.
Instead, the Congress commits itself to
House the administration's position, but
The CHAIRMAN. Does the gentleman
a realistic and rational 3-year program,
he has ignored completely the ranking
from Florida (Mr. ROGERS) desire to yield
and then prumises to reevaluate the In-
Republican on the committee with
time?
THE WHITE HOUSE
WASHINGTON
September 28, 1976
MEMORANDUM FOR: JIM CANNON
Bobbi
FORD & STVHER LIBRARY
FROM:
BOBBIE GREENE KILBERG
SUBJECT:
S. 522 - Indian Health Care
Improvement Act
I recommend that the President sign the Indian Health
Care Improvement Act for the following reasons:
(1) S. 522 would provide Medicare and Medicaid
reimbursement for Indian Health Service hospitals.
HEW states that this would enable Native Americans to
effectively use the Medicare and Medicaid benefits for
which they are eligible.
(2) In arguing against new categorical programs,
states that all of the proposed program activities
could be conducted under the broad flexible legislative
authorities of the Snyder Act and other laws. However,
in fact, many of these program activities are not being
conducted under those legislative authorities, either
because of a lack of Departmental or bureaucratic
initiative and creativity or because of active policy
position.
(3) The trust responsibility which the Federal
government has to federally recognized tribes is unique
and must be weighed very carefully before turning down
programmatic legislation.
(4) It is my perception that Indian life expectancy
rates are significantly lower and Indian infant mortality
rates are significantly higher than the rates for the
general population in the United States. Dan McGurk
says that this statement cannot be borne out when one
liminates alcoholism, suicide and accident rates. Ted
rrs, however, had consistently asserted that the figures
-2-
were still substantially different from the national
average even when alcoholism, suicide and accidents
are not counted. Further, S. 522 would authorize new
programs specifically aimed at the alcoholism, suicide
and accident rates which take such a serious toll in
Indian lives. According to the OMB memo, S. 522 pro-
grams would include mental health (including community
and inpatient mental health services, model dormitory
mental health services, therapeutic and residential
treatement centers, and the training of traditional
Indian practitioners in mental health) and alcoholism
treatment and control.
(5) I strongly agree with Brad Patterson's state-
ment that the physical defects in Indian health facili-
ties are not limited to the lack of 8 foot-wide halls,
as No. 4 of OMB's arguments against approval might imply.
From my personal experience, I think a tour of Indian
health facilities would reveal buildings and equipment
in such condition as to raise serious questions
about the health care and safety of patients.
(6) While S. 522 contains a significantly higher
authorization than OMB believes is warranted, OMB does
indicate that more realistic appropriations levels can
probably be achieved through the budget process.
(7) While I agree with OMB's criticism of the
urban Indian provision in S. 522, I would not recom-
ment veto of the bill because of it.
(8) It is my understanding that Congress will
override a Presidential veto and that a majority of
Republican Senators and Congresspersons will vote for
that override. This includes Congressman Rhodes, who
has written the President requesting that he sign the
bill; Senator Fannin, ranking minority member of the
Senate Interior & Insular Affairs Committee; and
apparently Congressman Skubitz, ranking minority member
of the House Interior & Insular Affairs Committee, and
Senators Dole, Goldwater, Bartlett, Domenici, Stevens
and Hatfield.
(9) As a political matter, a veto of this bill
will be portrayed as direct Presidential action against
the improvement of health care for the Native American
community, a group which the majority of people in this
-
-3-
country still has substantial empathy for. The fact
that we have made significant progress in the area of
Indian health care and are devoting substantial resources
to it will be lost in the negative headlines.
CC: Phil Buchen
FORD LIBRARY
THE WHITE HOUSE
WASHINGTON
SARAH MASSENGALE'S OFFICE CALLED WITH
LIST OF NAMES OF CONGRESSIONAL PEOPLE
WHO CALLED IN REGARDING INDIAN HEALTH
BILL.
JOHN RHODES
PAUL FANNIN
BOB DOLE
BARRY GOLDWATER
TED STEVENS
MARK HATFIELD
DEWEY BARTLETT
PETER DOMENICI
BOB PACKWOOD
-
memorandum
OF CALL
TO:
Brad
YOU WERE CALLED BY-
YOU WERE VISITED BY-
OF (Organization)
Sarah Massingale
PLEASE CALL
PHONE NO.
CODE/EXT.
WILL CALL AGAIN
IS WAITING TO SEE YOU
RETURNED YOUR CALL
WISHES AN APPOINTMENT
MESSAGE
add Soon Steger
Don Clausea
to list
RECEIVED BY
DATE
TIME
STANDARD FORM 63
REVISED AUGUST 1967
GPO :1980--c68--16--80341-1 332-389
63-108
GSA FPMR (41 CFR) 101-11.6
RESTRICTED USAGE
BHP-4
RE: Indian Health Care Improvement Act (S.522)
THE WHITE HOUSE
WASHINGTON
, 1976
Dear /s/
In response to your expression of
interest in the Indian Health Care
Improvement Act (S. 522), I am very
pleased to tell you that the Presi-
dent has just signed this significant
piece of legislation.
I enclose a copy of the President's
Signing Statement and with it goes
the President's appreciation to you
for your own support on this important
matter.
Cordially,
Bradley H. Patterson, Jr.
FORD LIBRARY &
///s///
10/1/76 - plr
///////
proofed plr/cbs
///////
Enclosure
(Rec. 10/1/76)
BHP:
BHP-4
FOR IMMEDIATE RELEASE
OCTOBER 1, 1976
Office of the White House Press Secretary
THE WHITE HOUSE
STATEMENT BY THE PRESIDENT
I am signing S. 522, the Indian Health Care
Improvement Act.
This bill is not without its faults, but after personal
review I have decided that the well-documented needs for
improvement in Indian health manpower, services and facilitie's
outweigh the defects in the bill.
While spending for Indian Health Service activities has
grown from $128 million in FY 1970 to $425 million in FY 1977,
Indian people still lag behind the American people as a whole
in achieving and maintaining good health. I am signing this
bill because of my own conviction that our First Americans
should not be last in opportunity.
Some of the authorizations in this bill are duplicative
of existing authorities and there is an unfortunate pro-
liferation of narrow categorical programs. Nevertheless,
S. 522 is a statement of direction of effort which is
commendable.
Title VII of this bill provides for future reports to the
Congress from the Secretary of Health, Education, and Welfare,
including a review of progress under the terms of the new Act.
I believe the Administration can in this way bring to the
attention of the Congress any changes needed to improve the
provisions of S. 522.
On balance, this bill is a positive step and I am pleased
to sign it.
CORD LIBRARY is
#
#
#
#
September 30, 1976
STATEMENT BY THE PRESIDENT
I am today signing S. 522, the Indian Health Care
Improvement Act.
This bill is not without its faults, but after personal
review I have decided that the well-documented needs for
improvement in Indian health manpower, services and facilities
outweigh the defects in the bill.
While spending for Indian Health Service activities has
grown from $128 million in FY 1970 to $425 million in FY 1977,
Indian people still lag behind the American people as a whole
in achieving and maintaining good health. I am signing this
bill because of my own conviction that our First Americans
should not be last in opportunity.
Some of the authorizations in this bill are duplicative
of existing authorities and there is an unfortunate pro-
liferation of narrow categorical programs. Nevertheless,
S. 522 is a statement of direction of effort which is
commendable.
Title VII of this bill provides for future reports to the
Congress from the Secretary of Health, Education, and Welfare,
including a review of progress under the terms of the new Act.
I believe the Administration can in this way bring to the
attention of the Congress any changes needed to improve the
provisions of S. 522.
On balance, this bill is a positive step and I am pleased
to sign it.
brald R. Ford
GERALD LIBRANY FORD
BRIEFING MATERIALS
for
THE INDIAN HEALTH CARE IMPROVEMENT ACT
P.L. 94-437
1080 LIBRARY is 076839
Provided by the
INDIAN HEALTH SERVICE
October 14. 1976
PUBLIC LAW 94-437
INDIAN HEALTH CARE IMPROVEMENT ACT
TITLE I INDIAN HEALTH MANPOWER
Title I of the Bill would authorize the Secretary of Health, Education
and Welfare, acting through the Indian Health Service: to make grants
to public or non-profit or tribal organizations for the recruitment of
Indian persons having a potential for health professional careers; to
provide grants by Indian Health Service to Indians for up to two years
of conpensatory pre-professional education; to provide Indian Health
Scholarships to be awarded to persons who will eventually provide
services to Indians, with selection by IHS and priority for Indians;
to entitle those receiving professional scholarship grants to employ-
ment in the Indian Health Service during the non-academic portions
of the year without regard to employment ceilings; and to authorize
appropriations for continuing educational allowances for health
professional employees of the Indian Health Service.
FY 1978
FY 1979
FY 1980
Health Professions Recruitment
Program
$ 900,000
$ 1,500,000
$ 1,800,000
Health Professions Preparatory
Scholarship
800,000
1,000,000
1,300,000
Health Professions Scholarship
Program
5,450,000
6,300,000
7,200,000
IHS Extern Programs
600,000
800,000
1,000,000
Continuing Education Allowance
100,000
200,000
250,000
7,850,000
9,800,000
11,550,000
TITLE II HEALTH SERVICES
Title II of the Bill would authorize additional appropriations totaling
over $84 million to eliminate the backlog of unmet health services
needs.
10,025,000
Patient Care
8,500,000
16,200,000
Field Health
3,350,000
5,550,000
Dental
1,500,000
1,500,000
Mental Health (Community Mental
Health
1,300,000
2,000,000
Inpatient Mental Health
400,000
600,000
Model Dormitory Mental Health
Services
1,250,000
1,875,000
Therapeutic and Residential
Treatment Centers
300,000
400,000
Training of Traditional Indian
Practitioners
150,000
200,000
Treatment and Control of
Alcoholism
4,000,000
9,000,000
9,200,000
Maintenance and Repair
3,000,000
4,000,000
$14,025,000
28,750,000
41,525,000
TITLE III HEALTH FACILITIES
FORD LIBRARY
Title III would authorize additional appropriation authority of
$234 million over the next three years for construction and renova-
tion of Indian Health Service facilities and $103 million for sanita-
tion facilities for Indian homes and communities.
FY 1978
FY 1979
FY 1980
Hospitals
$67,180,000
73,256,000
49,742,000
Health Centers and Health
Stations
6,960,000
6,226,000
3,720,000
Staff Housing
1,242,000
21,725,000
4,116,000
Safe Water and Sanitary Waste
Disposal
43,000,000
30,000,000
30,000,000
$118,382,000
131,207,000
87,578,000
TITLE IV ACCESS TO HEALTH SERVICES
Title IV of the Bill would authorize Medicare and Medicaid eligible
Indian persons served by Indian Health Service facilities to partici-
pate in those programs by having those programs reimburse the Indian
Health Service for services it provides.
TITLE V HEALTH SERVICES FOR URBAN INDIANS
Title V would establish a program of contracts with Indian organizations
in urban areas for the purpose of making health services more
accessible to the Urban Indian population.
5,000,000
10,000,000
15,000,000
TITLE VI AMERICAN INDIAN SCHOOL OF MEDICINE FEASIBILITY STUDY
Title VI would provide for a study to determine the extent of need
and the feasibility of establishing a school of medicine to train
Indians to provide health services for Indians.
TITLE VII MISCELLANEOUS
Title VII would require the Secretary to report annually to the
President and the Congress on progress made in effecting the purposes
of this Act; would authorize regulations. and a preparation of a plan
to implement the Act; and would authorize the Secretary to enter into
leases with Indian tribes for periods not in excess of twenty years.
TOTAL
145,257,000 179,757,000 155,653,000
Administration of Gerald R. Ford
PRESIDENTIAL DOCUMENTS
Weck Ending Friday, October 1, 1976
Indian Health Care
Improvement Act
Statement by the President on Signing 522 Into Law.
October 1, 1976
I am signing S. 522, the Indian Health Gare Improve
ment Act
This bill is not without its faults; but after personal
review I have decided that the well-documented needs
for improvement in Indian health manpower, services,
and facilities outwcigh the defects in the bill.
While spending for Indian Health Service activities
has grown from $128 million in FY-1970 to $425 million
in FY.1977, Indian people still lag behind the America
people as a whole in achieving and maintaining good
health 1 am signing this bill because of mybown con
viction that our: first Americans should noti bealast inst in
opportunity.
Some of the authorizations in this bill are duplica
tive of existing authorities, and there is an unfortunate
proliferation of narrow categorical programs. Neverthe-
less, S. 522 is a statement of direction of cffort which
is commendable.
Title VII of this bill provides for future reports to the
Congress from the Secretary of Health, Education, and
Welfare, including a review of progress under the terms
of the new act. I believe the administration can in this
way bring to the attention of the Congress any changes
needed to improve the provisions of S. 522.
On balance, this bill is a positive step, and I am
pleased to sign it.
NOTE: As enacted, the Indian Health Care Improvement Act is
Public Law 94-437.
P.L. 94-437: AUTHORIZATION vs. APPROPRIATION
FORD is. LIBRARY GERALD
Public Law 94-437, the Indian Health Care Improvement Act, is landmark
legislation with great potential for helping to overcome long-standing
health problems of American Indians and Alaska Natives.
This Act is an example of what is known as authorization legislation.
This means that it provides the legal authority to spend Federal funds
for the purposes set forth in the Act. It does not, however, make
those funds available. Funds will become available only through other
Acts of Congress, i.e., appropriations acts.
Authorization legislation authorizes spending funds needed for prescribed
actions. Appropriations legislation makes the needed funds available.
For this reason, program improvements authorized by P.L. 94-437 will
begin to-happen only after funds are made available through the appro
priations. process.
FORD LIBRARY j GERALD
S. 522 as passed by Congress
and presented to the Presid
for signature
Congressional Record
United States
of America
PROCEEDINGS AND DEBATES OF THE 94th CONGRESS, SECOND SESSION
Vol. 122
WASHINGTON, THURSDAY, SEPTEMBER 16, 1976
No. 140
House of Representatives
SENATE AMENDMENT TO S. 522. IM-
PROVING SERVICES AND FACILI-
TIES OF FEDERAL INDIAN HEALTH
FORD i LIBRARY GERALD
PROGRAMS
Mr. MEEDS. Mr. Speaker, I ask
unanimous consent to take from the
Speaker's desk the bill (S. 522) to im-
plement the Federal responsibility for
the care and education of the Indian
people by improving the services and
facilities of Federal Indian health pro-
grams and encouraging maximum par-
ticipation of Indians in such programs.
and for other purposes. with a Senate
amendment to the House amendment
thereto, and concur in the Senate
amendment to the House amendment.
The Clerk read the title of the bill.
The Clerk read the Senate amend-
ment to the House amendment, as fol-
lows:
In lleu of the matter proposed to be in-
serted by the House engrossed amendment.
insert:
That this Act may be cited as the "Inden
Health Care Improvement Act".
FINDINGS
of its special responsibilities And 10:31 obli-
for education or training In the health
Src. 2. The Congress finds that-
gation to the American Indjan people. to
fessions and encouraging and ns isting
(a) Federal health services to maintain
meet the national goal of providing the high-
(A) to chroll in schools of medicine,
and improve the health of the Indians are
est possible health status to Indians and to
athy, dentistry. veterinary medicine,
memenant with and required by the Ped-
provide existing Indian health services with
tometry. podiatry. pharmacy. public
ral Government's historical and unique
all resources necessary to effect that policy.
nursing. or allied health professions: or 1B
legal relationship with, and resulting re-
DEFINITIONS
If they are not qualified to enroll In
sponsibility to, the American Indian people.
SEC. 4. For purposes of this Act-
school. to undertake such postsecondary
(b) A major national goal of the United
(a) "Secretary", unless otherwise desig-
cation or training ns may be required
States is to provide the quantity and quality
nated. means the Secretary of Health, Edu-
qualify them for enrollment:
of health services which will permit the
cation. and Welfare.
(2) publicizing existing sources of financi
health status of Indians to be raised to the
(b) "Service" means the Indian Health
and available to Indians enrolled in
highest possible level and to encourage the
Service.
school referred to In clause (1) (A) of
maximum participation of Indians in the
(c) "Ind:ans" or "Indian", unless other-
subsection or who are undertaking train!-
planning and management of those services.
wise designated. means any person who is a
(c) Federal health services to Indians have
necessary to qualify them to enroll in any
member of An Indian tribe. as defined in
such school: or
resulted in a reduction in the prevalence
subsection (d) hereof. except that. for the
(3) establishing other programs which
and Incidence of preventable illnesses among,
purpose of sections 102, 103, and 201 (c) (5).
Secretary determines will entinnce and
and unnecessary and premature death of,
such terms shall mean any Individual who
tate the enrollment of Indians. and the 811')-
Indians.
(1), irrespective of whether he or she lives
sequent pursuit and completion by them
(d) Despite such services. the unmet health
on or near A re-ervation. is a member of a
courses of study. in any school referred to
needs of the American Indian people are
severe and the health status of the Indians
tribe, band. or other organized group of In-
clause (1)(A) of this subsection.
dians, Including those tribes, bands. or
(b) (1) No grant may be made under
is far below that of the general population
of the United States. For example. for In-
groups terminated since 1940 and those rec-
section unless an application therefor
dians compared to all Americans in 1971.
ognized now or in the future by the State in
been submitted to. and approved by, the Sec-
the tuberculosis death rate was over four
which they reside. or who is n descendant, in
retary. Such application shall be in
the first or second degree, of any such mem-
form. submitted In such manner, and cor -
and one-half times greater, the influenza
her. or (2) is nn Eskimo or Alcut or other
tain such information. as the Secretary
and pneumonia death rate over one and one-
half times greater, and the infant death rate
Alaska Native. or (3) is considered by the
by regulation prescribe: Provided, That
approximately 20 per centum greater.
Secretary of the Interior to be an Indian for
Secretary shall give a preference to appli
any purpose. or (4) is determined to be an
tions submitted by Indian tribes or
(e) All other Federal services and pro-
Indian under regulations promulgated by
organizations.
grams in fulfillment of the Federal respon-
sibility to Indians are jeopardized by the low
the Secretary.
(2) The amount of any grant under U.
health status of the American Indian people.
(d) "Indian tribe" means any Indian tribe,
section shall be determined by the Secretary
(f). Further improvement in Indian health
band. nation. or other organized group or
Payments pursuant to grants under this see-
Is imperiled DF-
community. including any Alaska Native ril-
tion may be made in advance or by way o:
(1) Inadequate, outdated. inefficient. and
lage or group or regional or village corpora-
reimbursement, and at such intervals and 0:
undermanned facilities. For example. only
tion as defined established pursuant to
such conditions as the Secretary finds neces-
twenty-four of fifty-one Indian Health Serv-
the Alaska Native Claims Settlement Act (85
sarr.
Ice hospitals are accerdited by the Joint
Stat. G88). which is recognized as eligible
(c) For the purpose of making payments
Commission on Accreditation of Hospitals:
for the special programs and services pro-
pursuant to grants under this section, there
only thirty-one meet national fire and safety
vided by the United States to Indians be-
are authorized to be appropriated $900.0
codes: and fifty-two locations with Indian
cause of their status rs Indians.
for fiscal year 1978. $1,500,000 for fiscal
populations have been identified as requir-
(c) "Tribal organization" means the
1979. and $1,800,000 for fiscal year 1930.
either new or replacement health centers
elected governing body of any Indian tribe
fiscal years 1981. 1932, 1983. and 1984
.1 stations. or clinics remodeled for im-
or any legally established organization of In-
are authorized to be appropriated for such
proved or additional service:
dians which is controlled by one or more
payments such sums P.S. may be specifically
(2) shortage of personnel. For example,
such bodies or by A board of directors elected
authorized by an Act enacted after this
About one-half of the Service hospitals, four-
or selected by one or more such bodies (or
HEALTH PROFESSIONS PREPARATORY SCHOOL AR-
fifths of the Service hospital outpatient
elected by the Indian population to be served
SHIP PROGRAM FOR INDIANS
clinics. and one-half of the Service health
by such organization) and which includes
Sec. 103. (a) The Secretary. acting through
clinics meet only 80 per centum of staffing
the maximum participation of Indians in all
standards for their respective services:
phases of its activities.
the Service, shall make scholarship grants
Indians who
(3) insufficient services in such areas as
(f) "Urban Indian" means any individual
(1) have successfully completed their
laboratory, hospital inpatient and outpa-
who resides in All urban center. AS defined
tient. eye care and mental health services.
in subsection (g) hereof. and who meets one
high school education or high school equiv-
alency: and
and services available through contracts with
or more of the 10:11 criteria in subsection (c)
private physicians, clinics, and agencies. For
(1) through (4) of this section.
(2) have demonstrated the capability u
successfully complete courses of study in
example. about 90 per centum of the surgical
(g) "Urban center" means any community
schools of medicine, osteopathy, dentistry
operations nceded for otitls media have not
which has a sufficient urban Indian popu-
veterinary medicine, optometery, pod:
been performed, over 57 per centum of re-
lation with unmet health needs to warrant
pharmacy, public health, nursing. or
quired dental services remain to be provided,
assistance under ille V, as determined by the
health professions.
and about 98 per centum of hearing aid re-
Secretary.
(b) Each scholarship grant made
quirements are uninet:
(h) "Urban Indian organization" means a
this section shall be for A period not to
(1) unrelated support factors. For exam-
nonprofit corporate body situsted in an
ceed two nendemic years. which years
ple. over seven bundred housing units are
urban center. composed of urban Indians,
be for compensatory preprofessional educa-
needed for staff at remote Service facilities;
and providing for the maximum participa-
tion of any grantee.
(5) lack of access of Indians to health
tion of all interested Indian groups and in-
(c) Scholarship grants made under the
services due to remote residences, underel-
dividuals, which body is espable of legally
section may cover costs of tuition. books
oped or underdeveloped communication sud
cooperating wilds other public and private
transportation, board, and other necessary
transportation systems. and difficult, some-
entities for the purpose of pérforming the
related expenses.
times severe, climate conditions: and
activities described In section 503(a).
(d) There are authorized to be appropri-
(6) lack of safe water and sanitary waste
TITLE I-INDIAN HEALTH MANPOWER
ated for the purpose of this section: $800,000
disposal services. For example, over thirty-
seven thousand four hundred existing and
PURPOSE
for fiscal year 1978, $1,000.000 for fiscal year
1979. and $1,300,000 for fiscal year 1980.
forty-cight thousand nine hundred and sixty
Src. 101. The purpose of this title is to
fiscal years 1981, 1982, 1983, and 1984 the
planned replacement and renovated Indian
augment the inadequate number of health
are authorized to be appropriated for the
housing units need new or upgraded water
professionals serving Indians and remove the
purpose of this section fuch sunis 85 may Le
and sanitation facilities.
multiple barriers qiv the entrance of health
specifically authorized by an Act enacted a:-
181 The Indian people's growth of confi-
professionals into the Service and private
ter this Act.
dence in Federal Indian health services is
practice among Indians.
HEALTH PROFESSIONS SCHOLARSHIP PROGRAM
revealed by their increasingly heavy use of
HEALTH PROFESSIONS RECRITTMENT PROGRAM
such services. Progress toward the goal of
1015 INDIANS
SEC. 104. Section 235(1) of the Public
better Indian health is dependent on this
Health Service Act (42 U.S.C. 234(1)) 1
Src. 102. (a) The Secretary. acting through
attnued growth of confidence. Both such
amended (1) by inserting "(1)" after "(!)".
the Service. shull make grants to public or
yress and such confidence are dependent
and (2) by adding at the end the following:
nonprofit private health or educational en-
improved Federal Indian health services.
"(2) (A) In addition to the surus author-
titles or Indian tilles or tribal organizations
Ized to be appropriated under paragraph (1)
DECLARATION OF POLICY
to assist such entitles in meeting the costs
to carry out the Program. there are author-
Src. 3. The Congress hereby declares that
of
Ized to be appropriated for the flacal your
It is the policy of this Nation, in fulfillment
(1) identifying Indians with & potential
ending September 30, 1978, $5,450,000; for
the fiscal year ending September 30. 1979,
CONTINUING EDUCATION ALLOWANCES
health services: sums and positions as pro-
$6,300,000: for the fiscal year ending Septem-
Sec. 106. (a) In order to encourage physi-
vided in subsection (e) for fiscal year 1973.
ber 30, 1980. $7,200,000: and for fiscal years
clans, dentists. and other health profes-
$1,300,000 and thirty positions for fiscal year
1991. 1982. 1983. and 1984 such sums as may
sionals to Join or continue In the Service
1979, and $2,000,000 and thirty positions for
specifically authorized by an Act enacted
and to provide. their services in the rural
fiscal year 1980.
it the Indian Health Care Improvement
and remote areas where a significant portion
(B) Inpatient mental health services: sum
Act, to provide scholarships under the Pro-
of the Indian people resides. the Secretary,
and positions as provided In subsection (e)
gram to provide physicians. osteopaths, den-
acting through the Service, may provide al-
for fiscal year 1978. $400.000 and fifteen po :-
tists. veterinarians, nurses. optometrists,
lowances to health professionals employed
tions for fiscal year 1979. and $600,000 and
podiatrists, pharmacists. public health per-
in the Service to enable them for a period
fifteen positions for fiscal year 1980.
sonnel. and allied health professionals to
of time each year prescribed by regulation
(C) Model dormitery mental health serv-
provide services to Indians. Such scholar-
of the Secretary to take leave of their duty
Ices: sums and positions as provided in sub-
ships shall be designated Indian Health
stations for professional consultation and
section (e) for fiscal year 1978, $1,250,000 and
Scholarships and shall be made in accord-
refresher training courses.
fifty positions for fiscal year 1979. and 1-
ance with this section except as provided in
(b) There are authorized to be appro-
875,000 and fifty positions for fiscal year 1080.
subparagraph (B).
printed for the purpose of this section:
(D) Therapeutic and residential treatment
"(B)(1) The Secretary. acting through the
$100,000 for fiscal year 1978. $200,000 for tis-
centers: sums and positions as provided in
Indian Health Service, shall determine the
cal' year 1979. and $250.000 for fiscal year
subsection (e) for fiscal year 1978. $300.000
individuals who receive the Indian Health
1980. For fiscal years 1981. 1982. 1983, and
and ten po:itions for fiscal year 1979. and
Scholarships. shall accord priority to appli-
1984 there are authorized to be appropriated
$400,000 and five positions for fiscal year 1950.
cants who are Indians. and shall determine
for the purpose of this section such sums as
(E) Training of traditional Indian practi-
the distribution of the scholarships on the
may be specifically authorized by an Act en-
tioners in mental health: sums as provided
basis of the relative needs of Indians for
acted after this Act.
in subsection (e) for fiscal year 1978. $150,000
additional service in specific health profes-
TITLE II-HEALTH SERVICES
for fiscal year 1979, and $200,000 for fiscal year
sions.
1980.
"(II) The active duty service obligation
HEALTH SERVICES
(5) Treatment and control of alcoholism
prescribed by subsection (e) shall be met
SEC. 201. (a) For the purpose of eliminat-
among Indians: $4,000,000 for fiscal year 1972.
by the recipient of an Indian Health
ing backlogs in Indian health care services
$9,000,000 for fiscal year 1979, and $9,200,000
Scholarship by service in the Indian Health
and to supply known. unmet medical, sur-
for fiscal year 1980.
Service. in a program assisted under title
gical, dental. optometrical. and other Indian
(6) Maintenance and repair (direct and
V of the Indian Health Care Improvement
health needs. the Secretary is authorized to
indirect) sums and positions as provided in
Act. or in the private practice of his pro-
expend. through the Service, over the seven-
subsection (e) for fiscal year 1978. $3,000.00
fession if. as determined by the Secretary in
fiscal-year period beginning after the date of
and twenty positions for fiscal year 1979. and
accordance with guidelines promulgated by
the enactment of this Act the amounts all-
$4,000,000 and thirty positions for fiscal year
him. such practice is situated in a physician
thorized to be appropriated by subsection
1980.
or other health professional shortage area
(c). Funds appropriated pursuant to this
(7) For fiscal years 1981, 1982, 1983. and
and addresses the health care needs of & sub-
section for each fiscal year shall not be used
1984 there are suthorized to be appropriated
stantial number of Indians.
to offset or limit the appropriations required
.for the Items referred to in the preceding
"(C) For purposes of this paragraph. the
by the Service under other Federal laws to
paragraphs such sums as may be specifically
term 'Indians' has the same meaning given
continue to serve the health needs of In-
authorized by an Act enacted after this Act.
that term by subsection (c) of section 4 of
dians during and subsequent to such seven-
For such fiscal years. positions are authorized
the Indian Health Care Improvement Act
fiscal-year perfod. but shall be in addition
for such Items (other than the Items referred
and Includes individuals described in clauses
to the level of appropriations provided to the
to in paragraphs (4) (E) and (5)) as may
(1) through (4) of that subsection.".
Service under this Act and such other Fed-
specified in an Act enacted after the date
INDIAN HEALTH SERVICE EXTERN PROGRAMS
eral laws in the preceding fiscal year plus an
the enactment of this Act.
C. 105. (a) Any individual who receives
amount equal to the amount required to
(d) The Secretary. acting through the
1. cholarship grant pursuant to section 104
cover pay increases and employee benefits
Service. shall expend directly or by contract
shall to entitled to employment in the Serv-
for personnel employed under this Act and
not less than 1 per centum of the funds 3p-
ice during any nonacademic period of the
such laws and increases in the costs of serv-
propriated under the authorizations in each
year. Feriods of employment pursuant to this
Ing the health needs of Indians under this
of the clauses (1) through (5) of subsection
subsection shall not be counted in determin-
Act and such laws, which increases are
(c) for research in each of the areas of In-
ing the fulfillment of the service obligation
caused by inflation.
dian health care for which such funds are
incurred as & condition of the scholarship
(b) The Secretary. acting through the
authorized to be appropriated.
grant.
Service, is authorized to employ persons to
(e) For fiscal year 1978, the Secretary 13
(b) Any Individual enrolled In a school of
implement the provisions of this section
authorized to apportion not to exceed a total
medicine, osteopathy. dentistry, veterinary
during the seven-fiscal-year period in ac-
of $10,025,000 and 425 positions for the pro-
medicine, optometry. podiatry, pharmacy,
cordance with the schedule provided in sub-
grams enumerated In clauses (c) (1) through
public health. nursing. or allied health pro-
section (c). Such positions suthorized each
(4) and (c) (6) of this section.
fessions may be employed by the Service dur-
fiscal year pursuant to this section shall not
TITLE III-HEALTH FACILITIES
ing any nonacademic period of the year.
be considered as offsetting or limiting the
CONSTRUCTION AND RENOVATION OF SERVICE
Any such employment shall not exceed one
personnel required by the Service to serve
FACILITIES
hundred and twenty days during any calen-
the health needs of Indians during and sub-
dar year.
sequent to such seven-tiscal-year period but
Sec. 301. (a) The Secretary. acting through
shall be in addition to the positions author-
the Service, is authorized to expend over the
(c) Any employment pursuant to this sec-
ized in the previous fiscal year.
seven-Ascal-year period beginning after the
tion shall be made without regard to any
(c) The following amounts and positions
date of the enactment of this Act the sums
competitive personnel system or agency per-
are authorized. in accordance with the pro-
authorized by subsection (b) for the con-
sonnel limitation and to a position which
will enable the individual so employed to
visions of subsections (a) and (b), for the
struction and renovation of hospitals. health
specific purposes noted:
centers, health stations, and other facilities
receive practical experience in the health
profession in which he or she is engaged in
(1) Patlent care (direct and indirect):
of the Service.
sums and positions as provided in subsection
(b) The following amounts are authorized
study. Any Individual so employed shall re-
celve payment for bis or her services com-
(e) for Ascal year 1978. $8,500,000 and two
to be appropriated for purposes of subsection
parable to the salary he or she would receive
hundred and twenty-nve positions for fiscal
(a)
If he or she were employed in the competi-
year 1979. and $16,200,000 and three hun-
(1) Hospitals: $67,180,000 for fiscal year
dred positions for fiscal year 1980.
1978, $73,256,000 for fiscal year 1979. and
tive system. Any Individual so employed
(2) Field health. excluding dental care
$49,742.000 for fiscal year 1980. For fiscal years
shall not be counted against any employ-
1981. 1982. 1983. and 1984. there are a'l-
meat celling affecting the Service or the De-
(direct and indirect) sums and positions as
thorized to be approprinted for hospitals
partment of Health. Education, and Wel-
provided in sub ection (c) for ilscal year
fare.
1978. $3,350,000 and eighty-five positions for
such sums as may be specifically authorized
by an Act enacted after this Act.
(d) There are authorized to be appropri-
fiscal year 1979. and $5,550,000 and one hun-
(2) Health centers and health stations:
ated for the purpose of this section: $000,000
dred and thirteen positions for Inscal year
1980.
$6,960,000 for fiscal year 1078. $6,226,000 for
for Ascal year 1978. $800,000 for fiscal year
fiscal year 1979, and $3,720.000 for fiscal year
1979. and $1,000,000 for fiscal year 1980. For
(3) Dental care (direct and Indirect) sums
1980. For fiscal years 1931. 1982, 1983. and
fiscal years 1981. 1983, 1983, and 1981 there
and positions as provided in subsection (c)
1984, there are authorized to be appropriate
are authorized to be appropriated for the
for fiscal year 1978. $1,500,000 and eighty post-
for health centers and health stations such
11-0 of this section such sums as may be
tions for .cal year 1979. and $1,500,000 Rnd
sums as may be specifically authorized by an
incally authorized by an Act enacted
lifty positions for fiscal year 1980.
Act enacted after this Act.
after this ACC.
(1) Mental health: (A) Community mental
(3) Staff housing: "$1,242,000 for nical
yenr 1978. $21,725,000 for fiscal year 1979, and
facilities constructed or renovated in whole
tions and requirements of this title and of
000 for fiscal year 1980. For fiscal years
or In part by funds made available pursuant
the progress being made by such hospit
'1. 1982. 1983, and 1984, there are au-
to this title are not less than the prevailing
and facilities (under plans submitted under
local wage rates for similar work as deter-
subsection (b) and otherwise) toward the
slird to be appropriated for staff housing
mined in accordance with the Act of March
achievement of such compliance.".
such 5111115 as may be specifically authorized
by an Act enacted after this Act.
3. 1931 (40 U.S.C. 276a-276a-5. known as the
(c) Any payments received for services
(c) Prior to the expenditure of, or the
Davis-Bacon Act).
provided to beneficiaries hereunder shall
be considered In determining appropriations
making of any firm commitment to expend,
SOBOBA SANITATION FACILITIES
for health care and services to Indians.
any funds authorized In subsection (a). the
SEC. 304. The Act of December 17. 1970 (84
Secretary. acting through the Service. shall-
(d) Nothing herein authorizes the
Stat. 1465). is hereby amended by adding the
(1) consult with an Indian tribe to be
tary to provide services to an Indian bet.-
following new section 9 at the end thereof:
eficiary with coverage under title XVIII
siguideantly affected by any such expendi-
SEC. 9. Nothing in this Act shall preciude
the Social Security Act, as amended. in pref-
ture for the purpose of determining and.
the Soboba Band of Mission Indians and the
erence to an Indian benedciary without such
wherever practicable. honoring tribal prefer-
Soboba Indian Reservation from being pro-
ences concerning the size, location, type. and
coverage.
vided with sanitation facilities and services
other characteristics of any facility on which
under the authority of section 7 of the Act
SERVICE PROVIDED TO MEDICAID ELIGIBLE INDIANS
such expenditure is to be made: and
of August 5. 1954 (68 Stat. 674). as amended
SEC. 402. (a) Title XIX of the Social Secu-
(2) be assured that. wherever practicable,
by the Act of July 31, 1959 (73 Stat. 267)
rity Act Is amended by adding at the end
such facility, not later than one year after
TITLE IV-ACCESS TO HEALTH
thereof the following new section:
Its construction or renovation. shall meet
SERVICES
"INDIAN HEALTH SERVICE FACILITIES
the standards of the Joint Committee on
ELIGIBILITY OF INDIAN HEALTH SERVICE
"SEC. 1911. (a) A facility of the Indian
Accreditation of Hospitals.
FACILITIES UNDER MEDICARE PROGRAM
Health Service (including a hospital.
CONSTRUCTION OF SAFE WATER AND SANITARY
mediate care facility, or skilled mursing
WASTE DISPOSAL FACILITIES
SEC. 401. (A) Sections 1814(c) and 1835(d)
of the Social Security Act are each amended
cility). whether operated by such Service
SEC. 302. (a) During. the seven-fiscal-year
by striking out "No payment" and inserting
by an Indian tribe or tribal organization
period beginning after the date of the enact-
in lieu thereof "Subject to section 1880, no
those terms are defined In section 4 of
ment of this Act, the Secretary is authorized
Indian Health Care Improvement Act).
to expend under section 7 of the Act of Au-
payment".
(b) Part C of title XVIII of such Act is
be eligible for reimbursement for med
gust 5. 1954 (42 U.S.C. 2004a). the sums au-
amended by adding at the end thereof the
assistance provided under a State plan if
thorteed under subsection (b) to supply un-
following new section:
for so long as it meets all of the condition
met needs for safe water and sanitary waste
and requirements which are applicable
disposal facilities in existing and new Indian
"INDIAN HEALTH SERVICE FACILITIES
eralty to such facilities under this title.
homes and communities.
"SEC. 1880. (a) A hospital or skilled nursing
"(b) Notwithstanding subsection (a).
(b) For expenditures of the Secretary au-
facility of the Indian Health Service, whether
facility of the Indian Health Service
thorized by subsection (a) for facilities in e.x-
operated by such Service or by an Indian
cluding a hospital, intermediate care fact:-
isting Indian homes and communities there
tribe or tribal organization (as those terms
ity, or skilled nursing facility) which
are authorized to be appropriated $43,000.-
are defined in section 4 of the Indian Health
not meet all of the conditions and require-
000 for fiscal year 1978, $30,000,000 for fiscal
Care Improvement Act). shall be eligible for
ments of this title which are applicable gen-
year 1979, and $30,000,000 for fiscal year
payments under this title. notwithstanding
erally to such facility, but which submit
1980. For expenditures of the Secretary all-
sections 1314(c) and 1835(d). If and for so
to the Secretary within six months after in
thoreaed by subsection (a) for facilities in
long as it meets all of the conditions and
date of the enactment of this section
new Indian homes and communities there
requirements for such payments which are
ceptable plan for achieving compliance
"e authorized to be appropriated such sums
applicable generally to hospitals or skilled
such conditions and requirements.
may be necessary for fiscal years 1978,
nursing facilities (as the case may be) under
deemed to meet such conditions and
.079. and 1980. For fiscal years 1981, 1982,
this title.
ments (and to be eligible for reimbur.
1983. and 1984 for expenditures authorized
"(b) Notwithstanding subsection (3). a
under this title), without regard to the
by subsection (a) there are authorized to
hospital or skilled nursing facility of the In-
tent of Its actual compliance with such
be appropriated such sums as may be spe-
dian Health Service which does not meet all
ditions and requirements, during the
cifically authorized in an Act enacted after
of the conditions and requirements of this
twelve months after the month in
this Act.
title which are applicable generally to hos-
such plan Is submitted.".
(c) Former and currently federally recog-
pitals or skilled nursing facilities (as the case
(b) The Secretary is authorized to
nized Indian tribes in the State of New York
may be). but which submits to the Secretary
into agreements with the appropriate
shall be eligible for assistance under this
within six months after the date of the en-
agency for the purpose of reimbursing
section.
actment of this section an acceptable plan
agency for health care and services provided
for achieving compliance with such condi-
in Service facilities to Indians who are ell
PREFERENCE TO INDIANS AND INDIAN FIRMS
tions and requirements, shall be deemed to
gible for medical assistance under title
SEC. 303. (a) The Secretary, acting through
meet such conditions and requirements (and
of the Social Security Act, as amended.
the Service. may utilize the negotiating au-
to be eligible for payments under this title).
(c) Notwithstanding any other provision
thority of the Act of June 25. 1910 (25 U.S.C.
without regard to the extent of Its actual
of law, payments to which any facility of
47). to give preference to any Indian or to
compliance with such conditions and re-
Indian Health Service (including a hos:
any enterprise, partnership. corporation. or
quirements. during the first 12 months after
Intermediate care facility, or skilled nur.
other types of business organization owned
the month in which such plan Is submitted.
facility) Is entitled under a State plan
and controlled by an Indian or Indians in-
cluding former or currently federally rec-
"(c) Notwithstanding any other provision
proved under title XIX of the Social Section
of this title. payments to which any hospital
Act by reason of section 1911 of such
ognized Indian tribes in the State of New
or skilled nursing facility of the Indian
shall be placed in a special fund to be
York (hereinafter referred to as an "Indian
Health Service is entitled by reason of this
by the Secretary and used by him (to
firm") In the construction and renovation of
section shall be placed in a special fund to
extent or In such amounts as are provide
Service facilities pursuant to section 301 and
in the construction of safe water and sant-
be held by the Secretary and used by him (to
in appropriation Acts) exclusively for
such extent or In such amounts as are pro-
purpose of making any improvements in
tury waste disposal facilities pursuant to sec-
tion 302. Such preference may be accorded
vided In appropriation Acts) exclusively for
facilities of such Service which may be
by the Secretary unless he finds, pursuant
the purpose of making any improvements in
essary to achieve compliance with the
to rules and regulations promulgated by him,
the hospitals and skilled nursing facilities of
cable conditions and requirements of
such Service which may be necessary to
title. The preceding sentence shall
that the project or function to be contracted
for will not be satisfactory or such project
achieve compliance with the applicable con-
apply when the Secretary determines
or function cannot be properly completed
ditions and requirements of this title. The
certifies that substantially all of the
or naintained under the proposed contract.
preceding sentence shall cease to apply when
facilities of such Service in the United
the Secretary determines and certifies that
are In compliance with such conditions
The Secretary. in arriving at his finding, shall
substantially all of the hospitals and skilled
requirements.
whether the Indian or Indian firm
will be deficient with respect to (1) owner-
nursing facilities of such Service in the
(d) Any payments received for
ship unial control by Indians. (2) equipment,
United States are in compliance with such
provided recipients hereunder shall not
(3) wkkeeping and accounting procedures.
conditions and requirements.
considered in determining appropriation
(4) BIRL tantive knowledge of the project or
"(d) The annual report of the Secretary
the provision of health care and service
function io be contracted for, (5) adequately
which is required by section 701 of the In-
Indians.
ratued personnel, or (6) other necessary
dian Health Care Improvement Act shall in-
(e) Section 1905(b) of the Social
components of contract performance.
clude (along with the matters specified in
ity Act is amended by Inserting at
(b) jut the purpose of Implementing the
section 403 of such Act) a detailed statement
thereof the following: "Notwithstand/a
provi- was of this title. the Secretary shall
of the status of the hospitals and skilled
first sentence of this section. the I
name that the rates of pay for personnel
nursing facilities of the Service In terms of
medical assistance percentago shall
1:1 the construction or renovation of
their compliance with the applicable coudt-
per centum with respect to amounts
pended as medical assistance for services
tiveness of the activities set forth in subsec-
for any further legislative efforts he deema
which are received through an Indian
tion (a) in such urban center:
necessary to meet the purpose of this title
Health Service facility whether operated by
(6) the existence of an urban Indian or-
RURAL HEALTH PROJECTS
1Ko Indian Health Service or by an Indian
ganization capable of performing the activl-
SEC 508. Not to exceed 1 per centum of the
, or tribal organization (ins defined in
ties set forth in subsection (a) and of en-
amounts authorized by section 506 shall
on 4 of the Indian Health Care Im-
tering into B contract with the Secretary pur-
available for not to exceed two pilot project
provement Act)."
suant to this title; and
providing outreach services to eligible In-
REPORT
(7) the extent of existing or likely future
dians residing in rural communities near
Stc. 403. The Secretary shall Include in
participation in the activities set forth in
Indian reservations.
his annual report required by section 701 an
subsection (a) by approprate health and
TITLE VI-AMERICAN INDIAN SCHOOL OF
accounting on the amount and use of funds
health-related Federal, State. local. and other
MEDICINE; FEASIBILITY STUDY
made available to the Service pursuant to
resource agencies.
FEASIBILITY STUDY
this title as A result of reimbursements
OTHER CONTRACT REQUIREMENTS
through title XVIII and XIX of the Social
SEC. 504. (a) Contracts with urban Indian
SEC. 601. The Secretary. in consultation
Security Act. ss nunended.
organizations pursuant to this Litle shall be
with Indian tribes and appropriate Indian
in accordance with all Federal contracting
organizations, shall conduct a study to deter-
TITLE V-HEALTH SERVICES FOR URBAN
INDIANS
laws and regulations except that, in the dis-
mine the need for, and the feasibility of.
cretion of the Secretary, such contracts may
establishing a school of medicine to train
PURPOSE.
be negotiated without advertising and need
Indians to provide health services for I: -
SEC. 501. The purpose of this title is to
not conform to the provisions of the Act of
dians. Within one year of the date of the
encourage the estabilshment of programs in
August 24, 1935 (48 Stat 793), as amended.
enactment of this Act the Secretary shall
urban areas to make health services more
(b) Payments under any contracts pursu-
complete such study and shall report to quin
accessible to the urban Indian population.
ant to this title may be made in advance or
Congress findings and recommendations
CONTRACTS WITH URBAN INDIAN ORGANIZATIONS
by way of reimbursement and in such in-
based on such study.
SEC. 502. The Secretary. acting through the
stallments and on such conditions as the Sec-
TITLE VII-MISCELLANEOUS
Service, shall enter into contracts with urban
retary deems necessary to carry out the pur-
REPORTS
Indian organizations to assist such orga-
poses of this title.
SEC. 701. The Secretary shall report an-
ntastions to establish and administer, in the
(c) Notwithstanding any provision of law
nually to the President and the Congress on
urban centers in which such organizations
to the contrary, the Secretary may, at the re-
progress made in effecting the purposes of
are situated, programs which meet the re-
quest or consent of an urban Indian organi-
this Act. Within three months after the
quirements set forth in sections 503 and 504.
zation, revise or amend any contract made
end of fiscal year 1979, the Secretary shall
CONTRACT ELIGIBILITY
by him with such organization pursuant to
review expenditures and progress made under
this title as necessary to carry out the pur-
Src. 503. (a) The Secretary, acting through
this Act and make recomumendations to
poses of this title: Provided, however, That
the Service, shall place such conditions as
Congress concerning any additional author-
whenever an urban Indian organization re-
no deems necessary to effect the purpose of
izations for fiscal years 1981 through 1934
quests retrocession of the Secretary for any
this title in any contract which he makes
contract entered into pursuant to this title,
programs authorized under this Act which be
with any urban Indian organization pursu-
deems appropriate. In the event the Congres
such retrocession shall become effective upon
ant to this title. Such conditions shall in-
enacts legislation authorizing approprin-
a date specified by the Secretary not more
clude. but are not limited to, requirements
tions for programs under this Act for fiscal
than one hundred and twenty days from the
that the organization successfully undertake
date of the request by the organization or at
years 1981 through 1984, within three months
the following activities:
after the end of fiscal year 1983, the Scere-
such later date as may be mutually agreed
(1) determine the population of urban
tary shall review programs established
Indians which are or could be recipients of
to by the Secretary and the organization.
assisted pursuant to this Act and shall
health referral or care services;
(d) In connection with any contract made
mit to the Congress his assessment and
") identify all public and private health
pursuant to this title. the Secretary may
ommendations of additional programs
.co resources within the urban center in
permit an urban Indian organization to
additional assistance necessary to. at a
wich the organization is situated which are
utilize. in carrying out such contract, exist-
mum, provide health services to Indians.
or may be available to urban Indians;
ing facilities owned by the Federal Govern-
Insure 8 health status for Indians, which
(3) assist such resources in providing serv-
ment within his jurisdiction under such
at S parity with the health services available
100 to such urban Indians:
terms and conditions as may be agreed upon
to, and the health status, of the general pop
(*) assist such urban Indians in becom-
for their use and maintenance.
ulation.
1116 familiar with and utilizing such re-
(e) Contracts with urban Indian organiza-
REGULATIONS
sources;
tions and regulations adopted pursuant to
Sec. 703. (a) (1) Within six months from
(5) provide basic health education to such
this title shall include provisions to assure
the date of cnactment of this Act, the Secre
urban Indians:
the fair and uniform provision to urban
(6) establish and implement manpower
Indians of services and assistance under such
tary shall, to the extent practicable, consult
with national and regional Indian organiza-
training programs to accomplish the referral
contracts by such organizations.
tions to consider and formulate appropriate
And education tasks set forth in clauses (3)
REPORTS AND RECORDS
rules and regulations to implement
through (5) of this subsection:
SEC. 505. For each fiscal year during which
provisions of this Act.
(7) identify gaps between unmet health
an urban Indian organization receives or
(2) Within eight months from the date "
needs of urban Indians and the resources
expends funds pursuant to a contract under
enactment of this Act. the Secretary
available to meet such needs;
this title. such organization shall submit to
publish proposed rules and regulations in
(8) make recommendations to the Secre-
the Secretary a report including information
Federal Register for the purpose of receiving
tury and Federal, State, local, and other re-
gathered pursuant to section 503(a) (7) and
comments from interested parties.
source agencies on methods or improving
18), information on activities conducted by
(3) Within ten months from the date of
health service programs to meet the needs
the organization pursuant to the contract,
enactment of this Act, the Secretary shill
of urban Indians; and
an accounting of the amounts and purposes
promulgate rules and regulations to imple-
(ii) where necessary. provide or contract for
for which Federal funds were expended, and
ment the provisions of this Act.
health care services to urban Indians.
such other information as the Secretary may
(b) The Secretary. acting through the Serv-
(b) The Secretary Is authorized to reviso
request. The reports and records of the
lee. shall by regulation prescribe the criteria
and amend any rules or regulations promot-
urban Indian organization with respect to
sur selecting urban Indian organizations with
gated pursuant to this Act: Provided, That
such contract shall be subject to audit by the
which to contract pursuant to this title. Such
prior to any revision of or amendment
Secretary and the Comptroller General of
criteria shall. among other factors, take into
such rules or regulations, the Secretary shall,
the United States.
consideration:
to the extent practicable, consult with appro-
(1) the extent of the unmet health care
AUTHORIZATIONS
priate national or regional Indian organin-
needs of urban Indians In the urban center
Sec. 506. There are authorized to be appro-
tions and shall publish any proposed rev:-
Involved:
priated for the purpose of this title: $5000.-
sion or amendment in the Federal Register
(2) the size of the urban Indian population
000 for fiscal year 1978: $10,000,000 for fiscal
not less than sixty days pilor to the effective
which is to receive assistance:
year 1979; and $15,000,000 for fiscal year 1980.
date of such revision or amendment in
(3) the relative accessibility which such
REVIEW or PROGRAM
to provide adequate notice to, and receive
comments from, other interested parties.
population has to health care services In such
SEC. 507. Within six months after the end
urban center:
PLAN OF IMPLEMENTATION
of fiscal year 1979, the Secretary. acting
(4) the extent, 1: any. to which the activi-
through the Service and with the assistance
SEC. 703. Within two hundred and forty
set forth In subsection (a) would dupli-
of the urban Indian organizations which
days after enactment of this Act. A plan will
any previous or current public or prlvate
have entered Into contracts pursuant to this
be prepared by the Secretary and will
ith services project funded by another
title, shall review the program established
submitted to the Congress. The plan will
Mource in such orban center:
under this title and submit to the Congress
plain the manner and schedule (Including
(3) the appropriateness and likely effec-
his assessment the. cot and recommendations
schedule of appropriation requests). of
and section. by which the Secretary will Im-
amendment to the House amendment to
plement the provisions of this Act.
S. 522.
LEASES WITH INDIAN TRIBES
The SPEAKER. Is there objection to
Src. 704. Notwithstanding any other pro-
the request of the gentleman from
vision of law, the Secretary Is authorized, In
Washington?
carrying out the purposes of this Act, to enter
There was no objection.
into leases with Indian tribes for periods not
in excess of twenty years.
AVAILABILITY or FUNDS
SEC. 705. The funds appropriated pursuant
to this Act shall remain available until
expended.
Mr. MEEDS (during the reading). Mr.
Speaker, I ask unanimous consent that
the Senate amendment to the House
amendment be considered as read and
printed in the RECORD.
The SPEAKER. Is there objection to
the request of the gentleman from Wash-
ington?
There was no objection.
Mr. MEEDS. Mr. Speaker, on July 30.
the full House, by a vote of 310 to 9,
passed the Indian Health Care Improve-
ment Act. The purpose of that bill is to
bring the health status of Indians up to
par with the rest of our Nation's popu-
lation. The bill attempts to achieve this
by providing: Broadened scholarship
assistance to those interested in serving
in the Indian Health Service with pri-
ority to Indian applicants; funds for nd-
FORD
ditional health services and for con-
struction of new health facilities; funds
for urban Indian health centers; a feasi-
bility study for an American Indian
GERALD
LIBRARY
School of Medicine, and by allowing In-
dian citizens to take full advantage of
their medicare and medicaid eligibility.
The total cost of the House bill WAS
around $470 million over 3 fiscal years.
The Senate had passed a much more
liberal bill calling for the expenditure of
$1.8 billion over 7 fiscal years. By 3 vote
of 78 to 0, the Senate has decided to nc-
cept the House amendments, with 19 fur-
ther amendments. Sixteen of those
amendments are purely technical and or
clarifying. Three of the amendments are
more substantive. The first amendment
amends the definition of Indian tribe as
it relates to Alaska Natives so that the
definition will be in line with that used
in the Indian Self-Determination and
Educational Assistance Act of 1974. The
second major amendment makes certain
that osteopaths and veterinarian stu-
dents are included in the scholarship pro-
vision of the bill. The third amendment
increases the funding level for programs
in title II to $10 million for fiscal 1978.
rather than the $5 million limitation CS-
tablished by the House bill.
All of these amendments have been
cleared with the three House committees
which worked on this bill, and I know of
no congressional opposition to their
adoption.
The SPEAKER. Is there objection to
the request of the gentleman from Wash-
ington?
There was no objection.
A motion to reconsider was laid on the
table.
GENERAL LEAVE
Mr. MEEDS. Mr. Speaker. I ask unani-
mous consent that all Members may have
5 legislative days in which to revise and
extend their remarks on the Senate
HEALTH
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
PUBLIC HEALTH SERVICE
USA
HEALTH SERVICES ADMINISTRATION
ROCKVILLE, MARYLAND 20852
INDIAN HEALTH SERVICE
October 13, 1976
Indian Health Service Progress Report and Some Planned Activities
Indian Health Care Improvement Act, P.L. 94-437
On September 30, 1976, President Ford signed S., 522, the Indian Health
Care Improvement Act, into Law. A copy of his signing message is
enclosed along with a copy of the Congressional Record of September 16,
which includes S. 522 as passed by Congress and presented to the
President for signature. The Government Printing Office has advised us
that copies of P.L. 94-437 will be available in two-four weeks. A
large distribution of copies will be made from the Indian Health Service
at that time.
On October 1, 1976, the Director, Indian Health Service, designated
Dr. Robert C. Birch, Deputy Chief, Dental Services Branch, IHS, as
Project Manager, P.L. 94-437, to serve as the coordinator of the IHS's
preparations to implement P.L. 94-437. Dr. Birch, with the approval of
the Director, Indian Health Service, has selected members of the IHS
Headquarters staff to serve, under his leadership, as the IHS Core
Team for P.L. 94-437. The objective of the Core Team is:
"To assist the Director, Indian Health Service, in preparing
for the Indian Health Service to implement the provisions of
this Act in an orderly, timely, and complete manner. "
The Core Team consists of a Title Manager for each title of the Act who
is responsible for developing all aspects of the title, and any other
parts of the Act which affect the title, required for IHS to implement
the Act. The Title Manager will be working with American Indian and
Alaska Native people and other IHS and non-IIIS personnel. The Core
Team members are:
Title
Title Manager
Phone No.
(Area Code 301)
I.
Indian Health Manpower
Mr. Pierre Colombel
443-4680
II.
Health Services
Mr. Gene Lewis
443-4725
III. Health Facilities
Mr. Jimny Neifert
443-4700
IV.
Access to Health
Services
Ms. Joe Graber
443-4680
V.
Health Services for
Urban Indians
Mr. Wes Halsey
443-6840
Page 2 - Progress Report, P.L. 94-437
Title
Title Manager
Phone No.
(Area Code 301)
VI.
Amer. Ind. Sch. of Med.
(Feasibility Study)
Mr. Hal Thompson
443-3024
Staff Support
Mr. Hampton Anderson
443-4243/4/5/6
Project Manager
Dr. Robert Birch
443-1107
Every effort is being made to provide clear and correct information about
P.L. 94-437 initiated from one IHS source--the Core Team. Each IHS Area
and Program Office Director is identifying a person as the P.L. 94-437
Coordinator to serve as the communicator with the Core Team. Please
direct all P.L. 94-437 communications (phone calls, letters, etc.) to
the P.L. 94-437 Coordinator at your nearest IHS Area or Program Office.
This should result in the best possible transfer of information.
Immediate Planned Activities
Oct. 1-15
- IIIS organizing P.L. 94-437 activities including select-
ing and orienting Core Team and Area and Program Office
Coordinators, selecting Title Teams, developing work
plans, and establishing methods for communicating with
American Indian and Alaska Native people through IHS
Area and Program Offices and National Indian Organiza-
tions.
Oct. 14
- Presentation on P.L. 94-437 to the National Tribal
Chairmen's Association by the Director, Indian Health
Service. Distribution of written briefing materials
describing P.L. 94-437 to National Indian Organiza-
tions and to IHS Area and Program Offices for their
distribution to American Indian and Alaska Native
groups.
Oct. 19
- Briefing on P.L. 94-437 to IHS Council of Area Directors
by the Core Team.
- Briefing on P.L. 94-437 to IHS Headquarters Staff by
the Core Team.
Oct. 21
- Presentation on P.L. 94-437 to the National Congress
of American Indians Annual Meeting by the Director,
Indian Health Service, plus participation including
the Core Team in a Workshop Session at NCAI to discuss
P.L. 94-437.
Page 3 - Progress Report, P.L. 94-437
Oct. 25-Nov. 3 - Briefings on P.L. 94-437 by Core Team and other IHS
staff at Area and Program Offices and to groups of
American Indian and Alaska Native people at meetings
organized by IHS Area and Program Offices.
These activities during October are intended to:
1. Provide basic information about P.L. 94-437 to as many American
Indian and Alaska Native people as possible.
2. Provide an opportunity, through personal communication, for many
American Indian and Alaska Native people to identify issues of their
concern about P.L. 94-437 as a first step in making the eventual
implementation of P.L. 94-437 as successful as possible.
Planned Activities in Near Future:
1. Presentation on P.L. 94-437 to the National Indian Health Board.
2. Formation of P.L. 94-437 Policy Council including representatives of
several National Indian Organizations and the Core Team.
3. Implementation of activities to make sure Indian and Alaska Native
people have the opportunity to participate fully in identifying issues,
making recommendations about policy and rules and regulations, and
being involved in other planning activities at the facility, Service
Unit, Area, and Headquarters levels of IHS. The method used will be
based on a plan developed by personnel at the IHS Office of Research
and Development in Tueson, Arizona, for ensuring maximum participa-
tion of American Indian and Alaska Native people in the planning and
implementation of P.L. 94-437.
Much hard work remains ahead before P.L. 94-437 can be implemented.
However, if we all work together in a spirit of understanding and cooper-
ation, the result should be one of which we 11 all be proud.
Robert C. Birch, D.D.S.
Project Manager, P.L. 94-437
Approved:
(
Emery A. Johnson, M.D.
Assistant Surgeon General
Director, Indian Health Service
THE WHITE HOUSE
WASHINGTON
October 1, 1976
Dear Mr. nul Tonasket:
In response to your expression of
interest in the Indian Health Care
Improvement Act (S. 522), I am very
pleased to tell you that the Presi-
dent has just signed this significant
piece of legislation.
I enclose a copy of the President's
Signing Statement and with it goes
the President's appreciation to you
for your own support on this important
matter.
Cordially
Bead
FORD
Bradley H. Patterson, Jr.
Mr. Mel Tonasket
Vice Chairman
Colville Business Council
Post Office Box 150
Nespelem, Washington 99155
Enclosure
310 SUFFRIDGE BUILDING
Paso
NATURAL GAS
1775 K STREET N.W.
COMPANY
WASHINGTON, D.C. 20006
PHONE: 202-872-8133
October 21, 1976
Dear Brad:
When Ted Marrs was still on board at the White House, he was
kind enough to obtain a facsimile signature of President Ford on
a copy of Public Law 93-638, the Indian Self-Determination and
Educational Assistance Act. If you could arrange for a similar
signature on a copy of Public Law 94-437, the Indian Health Care
Improvement Act, I would greatly appreciate it. I am enclosing a copy
of the Act which you could have signed on page 15, just below the date
indicating approval.
Sincerely
Rick C. Lavis
pluse
Mr. Brad Patterson
The White House
Washington, D. C. 20500
Suit
1682 LIBRAR &
Colville Confederated Tribes
P.O. Box 150 - Nespelem, Wash. 99155
(509) 634-4591
October 26, 1976
Mr. Brad Patterson
Special Assistant to the President
The White House
Washington, D.C.
20500
Dear Brad;
The Colville Tribe would like to take this time to
express our appreciation to you for your valuable
support and assistance in getting the Indian Health
Care Improvement Act signed by the President.
Would you please thank President Ford for our Tribe.
Not only for signing the bill but also for the very
fine statement that the President made at the sign-
ing.
Cordially;
Lucy Lucy Colville F. Covington, Business Ron
Chairperson
Council
Mel Tonaslat
Mel Tonasket, Vice-Chairman
Colville Business Council
FORD
FCNL
FRIENDS COMMITTEE ON NATIONAL LEGISLATION
245 Second Street, N.E.
Washington, D.C. 20002
October 28, 1976
(202) 547-4343
Bradley H. Patterson, Jr.
The White House
Washington, D. C. 20500
GERAID FORD LIBRARY
Dear Bradley Patterson:
Thank you for your letter of October sixth regarding comments on the
Ford Administration's policies regarding American Indians in the
FCNL August-September Newsletter. I hope this response will indicate
to you the basis of our assessment.
Our Newsletter analysis of President Ford's position on Indians
focussed on the two years he has been in office, since there have
been few Congressional votes on Indian issues. Moreover, as you
will note on other issues, we took events during President Ford's
administration, not President Nixon's administration, whenever possible.
I note that a number of the items on the information sheet you enclosed
on "Protecting Indian Land and Water Rights" pertain to the Nixon
presidency.
Among the major factors influencing our assessment was the Indian
Health Care Improvement Act. As you know, we spent considerable time
urging passage of a strong bill. When the bill was before both the
Senate and the House, the Administration, through HEW, impeded
passage of such a bill. Even after Congress agreed on a less com-
prehensive, severely weakened form of the bill, I understand you
told a former member of our staff that the President might still veto
the bill. When our Newsletter went to press, that was all the
information we had. We are pleased that the President has signed the
much needed Indian health bill and hope that this will be the first
step to assuring improved health care and conditions for the first
Americans. We plan to note his signing in our next Newsletter.
The establishment of a special division within the Justice Department
for protection of Indian resources has not provided a guarantee that
Indian land and water will be safe from corporate, state, and private
interests. It does offer more opportunity for Indian conflict cases
Ralph Rudd
Ch'n, General Committee
to have legal representation but does not deal with legislative proposals.
Marian D. Fuson
Ch'n, Executive Committee
During the Ford Administration, legislation which would have assured some
E. Raymond Wilson
Executive Sec. Emeritus
protection or preservation of land and/or water has had a very low
Edward F. Snyder
priority, in our opinion. The most obvious example was the veto
Executive Secretary
Frances E. Neely
of strip mine reclamation and control legislation. In its weakest
Legislative Secretary
version it still called for regulations stronger than currently
George I. Bliss
exist on Indian land.
Field Secretary
P. Nick Block
Administrative Secretary
Alice Stout
Administrative Assistant
Evelyn W. Bradshaw
Administrative Assistant
Bradley H. Patterson, Jr. - 2
October 28, 1976
Attempts to assure a fair amount of water for tribes in Central Arizona
and in Northwest New Mexico in the wake of reclamation projects have
also met with opposition from the Administration. Administration support
for the Synthetic Fuels bill, which included funds for gasification,
can be seen as an approval for destruction of more Navajo land in
building six proposed gasification plants. Both strip mining and the
gasification process would require large quantities of Indian water.
The Administration also supported, I believe, Sec. 15 of S. 1824, which
would have freed oil companies from paying damages to those Alaskan
natives whose land had been trespassed upon by illegal exploration and
drillings prior to 1971. Fortunately this section died in Committee.
We also feel that the BIA policy of supporting Richard Wilson from
Pine Ridge (who sold tribal land without approval from the tribe)
can be seen as opposition to Indian efforts to protect land and
water resources. I would include timber and fishing in those
valuable resources, also.
The small amount of space available in our Newsletter has meant we
have not carried letters to the editor. Our voting record newsletter
(copy enclosed) was in the final production stage when your letter
arrived and the next issue will be mailed in early November. I hope
the inclusion in the November Newsletter of reference to the President's
signing the Indian Health Care Improvement Act will meet your purposes.
Sincerely yours,
Edward 7 funder
Edward F. Snyder
EFS/ewb
Enclosure
FRIENDS COMMITTEE ON NATIONAL LEGISLATION
WASHINGTON NEWSLETTER
"It is the place of Christian (and other)
citizens, whether in legislatures or in
FCNL
municipal bodies, to try to appeal to the
best in all persons, to the best in their
colleagues, not only in their own party,
but in other parties, and in that way they
may sometimes be able to bring about an
agreement which would otherwise
never have been achieved."
- From T. Edmund Harvey, 1937. (REV.)
No. 385
Telephone (202) 547-4343
October 1976
1976 Congressional Voting Record
This Newsletter shows how your two
mile extension had won handily in the
"IT HELPS THE BALANCE OF PAYMENTS
Senators and Representative stood on
House in October, 1975, by a vote of
fifteen important issues since publica-
208-101. Sens. Alan Cranston CA and
tion of our 1975 voting record. Two
Robert Griffin MI attempted to prevent
caveats: One, we have attempted to
unilateral extension while maintaining
pick votes where the issue was clearly
stringent conservation efforts, but an
defined, but some members may have
amendment by Sen. Edmund Muskie ME to
specialized reasons for their particular
ADVANCED WEAPONS
keep the language intact was adopted
votes. Write them directly, or us, if you
NON-ADVANCED COUNTRIES
58-37 (S. Vote 5). Both houses agreed to
need clarification. Two, voting is only
delay implementation of the extension until
one of a member's responsibilities. Look
March, 1977, and thus allow the Law of
elsewhere for information on other im-
the Sea Conference to deal with the matter
portant factors such as leadership roles
on a multilateral and legal basis.
in committees, on the floor and with
VIETNAM EMBARGO
constituents.
A major citizen effort helped the House
For more information, check the Con-
International Relations Cmte. add a provi-
gressional Record or Congressional Quar-
ARMS
sion to the military aid bill lifting the U.S.
terly in your local library.
trade embargo on Vietnam at least tem-
The following information attempts to
porarily. An effort to delete this provision
on the House floor was defeated 185-223
put these votes in an overall context.
(H. Vote 5). Unfortunately Pres. Ford
GLOBAL DEVELOPMENT
vetoed the bill containing this provision, in
In 1976 Congress beat back several
part because of this section. It was not in-
passed the Senate by voice vote.
efforts to put severe restrictions on U.S.
cluded in the revised bill, to avoid another
Authorization for the Asian Development
commitments to international organiza-
veto; hence the Administration's embargo
Fund passed the Senate by a vote of 52-32
tions.
is still in effect.
(S. Vote 2), but the House failed to act.
COLONIALISM REVISITED
In the Senate, Virginia Sen. Harry Byrd's
Paid-in capital for all three of these regional
amendment to the FY76 foreign aid ap-
financial institutions would go largely to
In August, 1975, Harrop Freeman sub-
propriations bill would have deleted $64
provide loans on favorable terms to
mitted written testimony for FCNL stating,
million from voluntary funds for interna-
developing countries.
"I consider that the attempt by the United
States to make the northern Marianas a
tional organizations. Much of the bite
Congress voted in May to provide $200
Commonwealth of the United States and to
would have been felt by the UN Develop-
million in start-up funding for the Interna-
use its territories for the United States mili-
ment Program. In opposing the amendment
tional Fund for Agricultural Development
tary defense policies is contrary to interna-
Sen. Dick Clark IA stated, "We argue
(IFAD), which had been recommended by
tional law, the United Nations Charter, the
vociferously here over whether we will con-
the World Food Conference in November,
United States Constitution, and the Trust
tribute $190 million or $125 million and
1974, and authorized by Congress last
Territory Agreement." In February the
yet two weeks ago we heard the Secretary
autumn. The Fund will receive about half of
Senate sustained earlier House action in
of Defense say we are going to build Tri-
its capital from the U.S. and other in-
dents [submarines] which will cost us $1.5
voting to make the northern Marianas a
dustrialized nations and half from the
U.S. Commonwealth. The crucial vote
billion and no one on this floor raised the
Organization of Petroleum Exporting Coun-
came on the amendment by Sens.
slightest objection." The Senate rejected
tries (OPEC). Agricultural research and
Claiborne Pell RI and Byrd VA which would
Byrd's amendment by a vote of 37-50 (S.
development efforts aimed at reaching
have effectively killed the proposal; it lost
Vote 1). Similarly, the House rejected an
those most in need would be carried out
25-63 (S. Vote 4).
amendment by Rep. Jack Edwards AL that
under the auspices of IFAD, using existing
TAX REFORM
would have cut $85.5 million from the UN
international channels such as the UN's
Development Program (H. Vote 1).
affiliated agencies and the various regional
A modest tax reform package passed the
House in Dec. 1975. In the summer of
Authorizations for $720 million for the
development banks.
1976 the Senate substantially watered
three-year replenishment of the Inter-
DIVIDING UP THE SEAS
down the House's version. Tax reformers
American Development Bank and $25
Congress this year joined the global rush
generally failed to tighten tax loopholes;
million as the initial U.S. contribution to the
to gain economic control of the seas by
tax expenditures cost the federal govern-
African Development Fund passed the
voting to extend unilaterally the U.S. fishing
ment $105 billion in potential revenues for
House by 249-166 (H. Vote 2), and
zone from 12 miles to 200 miles. The 200-
FY77 (S. Vote 14; H. Vote 14).
(text continued on Page 5)
Page 2
FCNL Washington Newsletter, October 1976
Washington Newsletter, October 1976
Page 3
SOME KEY SENATE VOTES
SOME KEY HOUSE VOTES
8. Nuclear Weapons. Abzug amendment to delete $1.2 billion in the
Energy Research and Development Administration (ERDA) authoriza-
9. Intelligence. Tower-Stennis amendment to deny new Senate In-
telligence Cmte. legislative jurisdiction over intelligence activities of
1. International Organizations. Edwards AL amendment to the FY77
tion for nuclear weapons development, testing, and production. Re-
1. International Organizations. Byrd VA amendment to cut $64 million
from $189.5 million to international organizations. Rejected 37-50,
Dept. of Defense and its agencies. Rejected 31-63, May 19. FCNL
Foreign Aid Appropriations to delete $85.5 million from funds for the
jected 97-286, May 20. FCNL for.
March 23. FCNL against.
against.
UN Development Program. Rejected 179-208, March 4. FCNL against.
9. Intelligence Report. House vote to block release of Intelligence Com-
mittee report. Adopted 246-124, Jan. 29. FCNL against.
2. Multilateral Financial Institutions. Authorization for $50 million as
10. Angola. Tunney amendment to Defense Appropriations Conference
2. Multilateral Financial Institutions. Final passage of bill authorizing
10. Human Rights. Passage of joint resolution to amend the U.S. Constitu-
U.S. contribution to the Asian Development Fund. Passed 52-32, May
Report FY76 limiting U.S. activities to intelligence gathering. Adopted
$720 million for the replenishment of the Inter-American Development
tion to provide for voting representation for the District of Columbia in
6. FCNL for.
54-22, Dec. 19, 1975. FCNL for.
Bank and $25 million for the African Development Fund. Adopted
Congress. Rejected 229-181, March 23. (2/3 required) FCNL for.
249-166, Dec. 9, 1975. FCNL for.
3. Human Rights. Chile. Kennedy amendment to prohibit govemment
11. Food Stamps. Allen motion to table and thus kill the Dole-McGovem
11. Food Stamps. Rousselot amendment to cut $794 million from the pro-
cash sales or commercial sales of arms and military equipment to Chile.
substitute food stamp reform bill providing for decreased purchase
3. Human Rights/Security. Derwinski amendment to delete ceiling on
gram. Rejected 184-222, June 16. FCNL against.
Adopted 48-39, Feb. 18. FCNL for.
price, deduction for working families, and a pilot project on eliminating
military aid to S. Korea. Adopted 241-159, June 12. FCNL against.
12. Jobs, Full Employment. Sarasin amendment to First Budget Resolu-
the purchase requirement. Rejected 31-58, April 8. FCNL against.
tion to eliminate $50 million in startup funds for full employment. Re-
4. Northern Marianas Status. Pell-Byrd VA substitute amendment to
4. Troop Levels. Dellums amendment to reduce the number of U.S.
jected 177-206, April 29. FCNL against.
delete language making the Islands a commonwealth of the U.S. Re-
troops overseas by 47,000. Rejected 88-275, April 9. FCNL for.
12. Jobs. Kennedy motion to First Budget Resolution for $3.2 billion in-
jected 25-63, Feb. 24. FCNL for.
13. Uranium Enrichment. Bingham amendment to delete from the bill (H.R.
crease for jobs and health care programs. Rejected 27-58, April 12.
5. Vietnam Trade Embargo. Bauman amendment to delete provision lift-
8401) those sections authorizing ERDA to contract with private indus-
5. 200-Mile Fishing Extension. Muskie amendment to weaken the
FCNL for.
ing embargo. Rejected 185-223, March 3. FCNL against.
try for development of nuclear fuel enrichment plants. Rejected
Cranston-Griffin amendment striking language that would have
13. Energy Conservation. Final passage of bill setting federal minimum
192-193, Aug. 4. FCNL for.
6. Military Spending. Holtzman amendment to cut $7.5 billion in budget
prohibited a unilateral extension. Adopted 58-37, Jan. 28. FCNL
standards for energy conservation in new commercial and residential
authority and $2.5 billion in outlays from the military, transferring all of
14. Tax Reform. Mikva amendment to reduce real estate tax shelters for
against.
buildings and providing $55 million a year in grants to states and com-
the outlay cut and $2.8 billion in budget authority to domestic pro-
wealthy individuals. Rejected 192-226, Dec. 4, 1975. FCNL for.
6. Military Spending. Bayh amendment to First Budget Resolution to cut
munity action agencies to insulate low-income dwellings. Adopted
grams. Rejected 85-317, April 29. FCNL for.
15. Revenue Sharing. Fountain amendment deleting provisions of com-
$2.6 billion in budget authority and $500 million in outlays from mili-
52-35, March 9. FCNL for.
mittee bill which would have channeled more money to big cities and
7. B-1. Addabbo amendment to delay until Feb. 1977 production funds
tary. Rejected 27-58, April 12. FCNL for.
poor rural areas and strengthened anti-discrimination provisions.
14. Tax Reform. Long motion to table and thus kill the Nelson amendment
for B-1 bomber. Rejected 186-207, June 17. FCNL for.
Adopted 233-172, June 10. FCNL against.
7. B-1. McGovern amendment to cut $948 million which would begin
which would have reduced tax shelters for the wealthy. Passed 46-33,
production of three B-1 bombers. Rejected 33-48, May 20. FCNL for.
June 17. FCNL against.
12 3456 7 89101112131415
12 34567 89101112131415
12 3 456 7 8 9101112131415
15. Day Care. H.R. 9803. Attempt to pass over President's veto a bill to
8. Foreign Arms Sales. Tower amendment to delete provision requiring
provide $125 million for states to meet health and safety standards for
ALABAMA
COLORADO
16 Anderson
NYYNNNYNYYNYNYY
public reports of arms transactions. Rejected 36-44, Feb. 17. FCNL
day care centers. Rejected 60-34, May 5. (2/3 required) FCNL for.
1 Edwards
YYYNYNNN2NYYNNY
Schroeder
NYNYNNYYNYNNYYN
17 O'Brien
2YYNYNNNYNYYNNY
against.
2 Dickinson
YNYNYNNNYNYYNNY
Wirth
NYNNNN2YYYNNYYN
18 Michel
2YYNYNNNYNYYNNY
Nichols
YNONY7N7YNY7NNY
Evans
NYNNNNYNNYNNYYY
19 Railsback
NYYNNNNNYNYYYYY
Bevill
YYYNY2NNYNY7NYY
4 Johnson
YNNYNNYNNYYYNN?
20 Findley
NYYNNNYNYYY77NY
1 2 34567 89101112131415
12 3456789101112131415
12 345 6 7 8 9101112131415
5 Jones
2Y7NNNNNYNN7NYY
5 Armstrong
YNYNYNNN2NYYNNY
21 Madigan
YYY7YNNN2YYYNNY
6 Buchanan
NYPNYNYPYYYYNNY
CONNECTICUT
22 Shipley
N
ALABAMA
LOUISIANA
NORTH DAKOTA
7 Flowers
YNY7Y7NNONY7NNY
Cotter
YNPNNNYNYYNNNNN
23 Price
NYYNNNNNNYNNNYN
Sparkman
NYYNYN2NYNYNYYX
Long
YNNNYNYYYNNNNYY
Young
YNPNYN77YNYN27N
ALASKA
Dodd
NNXNXNYYPYNNY YN
24 Simon
NYNNN2YYNYN7YYN
Allen
YNNYYNNYYYYNNYN
Johnston
NNNN2N7YY7YNNYY
Burdick
NNYNYYNNNYNNNYY
AL Young
YN77YNX7YNYYNNY
3 Giaimo
PY7YNNN2NYNNNY?
INDIANA
ARIZONA
NYY7N2YNNYN7YYN
ALASKA
MAINE
OHIO
4 McKinney
NONYNYYYYYYYNPY
Madden
Rhodes
NYY7YNNXONYYNNY
5 Sarasin
YYNNNNYNYYYYNNY
2 Fithian
YNNNYNYNYYYYYYY
Stevens
NYNNY70YYYN7YYN
Muskie
N2Y2YNYNNYNNYNY
Taft
NYNNYNOYYYNNY*N
2 Udall
6 Moffett
NYNYNYYYNYNNYYN
3 Brademas
Gravel
Hathaway
NYYNYYYNNYNYYNY
Glenn
NYNNNNNYNYNNY?Y
3 Steiger
7NY7YNX7YNOYXN7
DELAWARE
Roush
ARIZONA
MARYLAND
OKLAHOMA
4 Conlan
7N77ONNNYNYOXNY
AL Pont
NYYPNNYNYY7YYY
Hillis
2YYNYNNN2NYYNNY
Fannin
YNNNNNNYY7YNNYN
Mathias
NYYNY2Y7N7N7YNY
Bellmon
NYNNYNNYYNYNN7N
ARKANSAS
FLORIDA
6 Evans
Goldwater
Y7NNNNNYYOYNN7N
Beall
NYYNYNNYNNYNNYY
Bartlett
YNNNNNNYYNYNNYN
Alexander
NYYNYNNNYNNY2NN
Sikes
7NYN77N7YNNONNY
7 Myers
ARKANSAS
OREGON
2 Mills
MASSACHUSETTS
NNYNYN77YYYYXNY
2 Fuqua
YNYNNNNNYNY7NNY
8 Hayes
7YN7N2YNNON77YY
3
McCiellan
YNN2Y7NYYN27N7N
NYYYYYYNNYNY7NY
Hatfield
NYYNYYONNYNYYYY
3 Bennett
YNNNYNNNYYYYNYY
9 Hamilton
NYNNNNYNYYNYYYY
Kennedy
Ham'schmidt
NNYNYNNNYNYYNNY
Bumpers
YNYNYNNNNYNNOYY
Chappell
YNYNYNNNYNYYNNY
10 Sharp
NYNNNNYNYYNYYYN
Brooke
NYYNYNY2NYNYYNY
Packwood
NYNYYNYNNYNNYYN
4 Thornton
NNYPYNY2YNNYNNN
Kelly
11 Jacobs
NNNONNYYNYNYYYN
CALIFORNIA
MICHIGAN
PENNSYLVANIA
CALIFORNIA
6 Young
YNYNYNNNYNYYNNY
IOWA
Cranston
NYYNNYNNNYNYYYY
Hart
N777YY277YNYYNY
Scott
YNNNNNNYNNNYYY
1 Johnson
NYYNNNNN2YNNNYN
Gibbons
2NNNNNYNONYYYYN
Mezvinsky
NYNYNYYYNYNNYYN
Tunney
N7YXN7XNNY772YY
Griffin
NYNNNNNYNNYNN?N
Schweiker
NYYNYYYNNYNNYNY
2 Clausen
PYYNYNNNYNYYNNY
8 Haley
YNYNYNNNYNYYNNY
2 Blouin
NYNYNYYYNYNNYYN
COLORADO
MINNESOTA
RHODE ISLAND
3 Moss
NYNYNYY7XYNNYYN
Frey
YNYNYNNNYNYYNNY
3 Grassley
YNYNYNYNYNYYNYY
N
Haskell
NYYYNYY2NYNYYNY
Mondale
NYYNYYYNNY@YYNY
Pastore
NY*YYNONN*#YYYY
4 Leggett
NYPYNYYYNYNNYYN
10 Befalis
YNYNYNNNYNYYNNY
Smith
NYPYNYYPNYNNYNY
5 Burton, J.
Hart
Humphrey
Pell
NYYYYYYNNYNYYNY
11 Rogers
YNNNYNYNYNNYYNN
5 Harkin
NYNYNYYYNYNNYYN
6 Burton,
NYNYNYYYNYNNYYN
12 Burke
YXYNNNYNYNYYN?Y
6 Bedell
NNNYNYYYYYNYYYY
CONNECTICUT
MISSISSIPPI
SOUTH CAROLINA
7 Miller
PNNYNYYYNYNNYYN
13 Lehman
PYYYNNYYNYNNYYN
KANSAS
Ribicoff
Y7YYYNYNNYNYYN
Eastland
YNNYYNNYY7YN7YN
Thurmond NNNNNNYYNYNNYN
8 Dellums
NYNYNYYYNYNNY Y N
14 Pepper
NYYXN7NNXONXYYN
Sebelius
YNYNYNNN2NYYXNY
Weicker
NYYNYYNNNYNYYY
Stennis
YNNOYNNYYNYNYYN
Hollings
NYNNYNNYN2NNYNY
9 Stark
NYNYNYYYNYNNYYN
15 Fascell
NYNNNNYYPYNNYYN
2 Keys
NYNYNYYYNYNNYYY
DELAWARE
MISSOURI
SOUTH DAKOTA
10 Edwards
NYNONYOYNYNNYYN
GEORGIA
Winn
NYYNYNNN7YYYNNO
Roth
Y2NNYN7N0Y7NNYN
Symington
YNYOPNNNNYNNN7Y
McGovern
YYYYYYNNYNYYNY
11 Ryan
NYNYNYYNNNNNYYY
Ginn
YYYNYNNNYYYYNNY
4 Shriver
NYYNYNNN2YYYNNY
Biden
NYYYYYYNNYNY7NY
12 McCloskey
NYYYNNYNYYY7NYN
Eagleton
YNYNY7NNN7N7NNY
Abourezk
NYYYY2YNNYN2Y2Y
2 Mathis
YNYNYNNNOYYYNNO
5 Skubitz
YNYNY7NN7NY7YNY
13 Mineta
NYYYNYYYNYNNYYN
FLORIDA
MONTANA
TENNESSEE
3 Brinkley
YNYNYNNNYYYY7NY
KENTUCKY
14 McFall
NYYNNNNNNYNNNYN
4 Levitas
YNYNYNYNYYYNYNY
1 Hubbard
YNYNYNNNYNYYYYY
Chiles
NYYNNNNNN7NNNY7
Mansfield
NYYYYNYNNYNN2NY
Baker
NYNN2N2YXNYNYYN
15 Sisk
5 Young
NYNONYYNYNXYYN
2 Natcher
YNYNYNYNYYNNYNY
Stone
Y7YNNNNNN*NNNNY
Metcalf
NYY2YYNNNYNYYNY
Brock
PNNNNN2YY2YNNYN
16 Telcott
YNY2YN7N2NYYNNY
Flynt
YNYXYNN2YNYY7NY
3 Mazzoli
GEORGIA
NEBRASKA
TEXAS
17 Krebs
YNNYYNYYNYNNYYY
7 McDonald
YNYNYNNNYNYYNNY
Snyder
YNYNYNNNYNYYNNY
Talmadge
YNNYYNNYY7NNNYN
Hruska
YNNNNNNYYNNN7N
Tower
NNNNNNNYYNYNNYN
18 Ketchum
7NYNY7NN7NY7NNY
8 Stuckey
YYY7YNXNY7OYXNN
5 Carter
YNY2YNN2YNNNNNY
Nunn
PYNNNNNYYNYNNYN
Curtis
YNNN7NN2YNYNNYN
Bentsen
YYNNYN2YN2YN77Y
19 Lagomarsino
9 Landrum
PNYNYNNNYNYYNNY
6 Breckinridge
NYYNYNNNYYNYYNY
HAWAII
NEVADA
UTAH
20 Goldwater
YYYNYNNNYNYONN7
10 Stephens
YY77YNNNONON7NY
7 Perkins
YYYNNNYNYYNNNNN
21 Corman
Fong
NYPNN7N7Y7Y7NYN
NYNNNYYYNYNNOYN
Cannon
YNYNYNNYY7NNNYY
Moss
NYYNYN2NNYNN27Y
HAWAII
LOUISIANA
22 Moorhead
YNYNYNNNYNYYN7Y
Inouye
NPYNY7NNNYN72YY
Laxalt
YN7NYNN2Y2YNNYN
Garn
Y77NNNNYYYYNNYN
Matsunaga
NYXNNN2YYYNNYNN
Hebert
YXYNN7NXONOONXY
23 Rees
NYYONNY2NYNNYYN
Mink
NYNNNN2YNYXNYYN
2 Boggs
NYNNONNNYYNNXNY
IDAHO
NEW HAMPSHIRE
VERMONT
24 Waxman
NYNNNN2YNYXNYYN
IDAHO
3 Treen
YXYNYNNNYNYYNNY
Church
7777N7*7N*N7Y7Y
Mclntyre
YYPYYNNNNYNNYNY
Stafford
YNNNNNNNYNYYNY
25 Roybal
NYNYNYYYNYNNYYN
Symms
7N77ONNNYNYYNNY
4 Waggonner
McClure
YNNNNON?YNYONYN
Durkin
N7YYYYYNNYNYYN?
Leahy
PYYNYYYNNYNNYNY
26 Rousselot
YNYNYNNNYNYYNN7
2 Hansen
YN77YNNNYNYYXNY
5 Passman
NNYNYNNNYNYY7NO
ILLINOIS
NEW JERSEY
VIRGINIA
27 Bell
ILLINOIS
6 Moore
YNYNYNNNYNYYNNY
Percy
NYNNNN2YNYNNYYY
Case
PYYNYYYNNYNYYNY
Byrd (I)
YNNYYNNNYNYNNYN
28 Burke
NYNYNYYYNYNNYYN
Metcalfe
7YNOXY7YXYNNYYN
7 Breaux
YNONNNNNYNYYNNY
Stevenson
NYP7NYY7N7NNY7Y
YNNYYNNYYYYNNYN
29 Hawkins
NYNYNYXNNONNYYN
Williams
NYYNYYYNYNYYNY
Scott
2 Murphy
NYYNNNNNNYNNNNN
8 Long
30 Danielson
NYYNNNNNNNNNYYN
INDIANA
3 Russo
NNNNYNYYYYNNYNY
MAINE
NEW MEXICO
WASHINGTON
31 Wilson
NYYNYNNNNYNXNYN
4 Derwinski
77Y7N7YN7777YM0
NYYNYNNNYNYYNNY
Emery
YNNNYNYNYYYYNYY
Hartke
Montoya
YNYNYN7YN77NYYY
Magnuson
YNYNYNNNNYNNYNY
32 Anderson
5 Fary
NYYNNNNNYYNNNYN
2 Cohen
Bayh
2Y777YY7N7NYY7Y
Domenici
YNNNNNN2NNYNNYN
Jackson
**XYNN@NX#Y*NY
33 Clawson
YNONYNN7YNYYNN?
Hyde
YYYNYNNNYNYYNNY
IOWA
NEW YORK
WEST VIRGINIA
34 Hannaford
NYNYNNNNNNNNYYY
7 Collins
MARYLAND
Clark
NYYYNYYNNYNY YNY
Javits
N7YNNYYNNYNYY77
Randolph
YNYYYYNYNYNYYYY
35 Lloyd
6 Rostenk's
Bauman
YN7NYNNNYNYYNNY
Culver
PYYYNYYNY7YYNY
Buckley (C) YNNNNNXYYNYNN7N
YNNYYNYNNYNNYYY
36 Brown
Byrd
NYNYN2NNNYNNYYN
9 Yates
NYYNNNYYNYNNYYN
2 Long
NYNNNNYYNNNNYYY
KANSAS
37 Pettis
YNYNYNN7YXYYNNY
NORTH CAROLINA
10 Mikva
NYNOENYNNYNNYYN
3 Sarbanes
NYN7N?Y2NYN7YYN
WISCONSIN
38 Patterson
Pearson
7YYNYNNNNYNNY7Y
YNYYNYYNNYYNYNY
PYNNNNNYXYYNYYX
11 Annunzio
NYYNNNNNNYYNNNN
4 Holt
YNYNYNNNYNYYNNY
Helms
YNYNNNNYOYYNNYN
Proxmire
39 Wiggins
PYYNYNNN2NYYNNY
12 Crane
PNYNYNNNYNYYNNY
N
5 Spellman
Dole
YYNNYNNYN7NNNYN
Morgan
NYNNNONYNNYOXYN
Nelson
NY2YYYY2NYNYYNY
40 Hinshaw
13 McClory
2YY7NNY7YNYYNNY
6 Byron
YNNNYNNNYNYYYNY
KENTUCKY
WYOMING
41 Wilson
NYYNYN2NYN7YNNY
14 Erlenborn
7YYN7NN7YNYYNNY
Z
7 Mitchell
NYNYNYYYNYNNYON
Huddleston
NYNYNY2NYNNYNY
McGee
7YNNN77N20N7YYY
42 Van Deerlin
NYNYNNNNYYNNYYY
15 Hall. T.
NNYNNNYNYYNNNYN
8 Gude
N
N
Ford
NYYYY7YYNYN777Y
Hansen
Y7NNNNNYYNYNNYN
43 Burgener
YNYNYNNNYNYYNNY
Y = voted in favor; N = voted in opposition; O or = paired for; X = paired against; * or = announced for; or . = announced against; 7 absent or not announced; P = Present.
On Mar. 8, Stanley Lundine NY replaced James Hastings, who resigned Jan. 20. On Apr. 7, Ron Paul TX replaced Bob Casey, who resigned Jan 22. Sam Hall TX replaced the late
Wright Patman on June 28. William Barrett PA died Apr. 12, Torbert Macdonald MA died May 21, and Jerry Litton MO died Aug. 3; no replacements have been named.
Bold type indicates positions preferred by FCNL i.e., as expressed in the Statement of Legislative Policy, testimony, etc.
Roman type = Democrats; Italics = Republicans; (C) = elected as Conservative; (I) = elected as Independent; AL = At Large. Source of votes: Congressional Quarterly Service
Page 4
FCNL Washington Newsletter, October 1976
12 3456 78 9101112131415
12 3456789101112131415
12 3456789101112131415
MASSACHUSETTS
11 Scheuer
NNNNNYYYNYNNYYN
20 Gaydos
Y2NNNYYNYYNNY2Y
1 Conte
NYYYNNYNYYNNYNN
12 Chisholm
NYNYNY2YNYXNYYN
21 Dent
NNYXYNNNYYNNYNN
2 Boland
DYNNNNYNNYNNYYN
13 Solarz
NYNNNYYYNYNNYYN
22 Morgan
NYYNNNNN2YNNYYN
3 Early
YNYYYYYNYNNYYN
14 Richmond
NYNYNYYYNYNNYYN
23 Johnson
YYYPYNNNYNYYNNY
4 Drinan
NYNYNYYYNYNNYYN
15 Zeferetti
YNYNYNYNYNNNYNN
24 Vigorito
NYNNNNYNYYNNYNN
5 Tsongas
NYNNNNY2NYNNYYN
16 Holtzman
NNNYNYYYNYNNYYN
25 Myers
NYYNNNNYYNYYNYY
6 Harrington
YYNYNYYYNYNNYYN
17 Murphy
NYYNYNN22YNXYNN
RHODE ISLAND
7 Macdonald YY7X77NX7Y
18 Koch
NNNNNYYYNYNNYYN
1 St Germain PYNXNYYONYNNYYN
8 O'Neill
NYYNNNYNNYNNNYN
19 Rangel
NYNYNYYYNYNNYYN
2 Beard
NYNNNYYYNYNNYYN
9 Moakley
WYNYNNYYNYNNYYN
20 Abzug
NYNYNYYYNYNXYYN
SOUTH CAROLINA
10 Heckler
WYNNNNYYYYNNNYN
21 Badillo
YNYNYYYNYNN0YN
1 Davis
Y2YNYNNNNYYNYNY
11 Burke
NYYXYNYNYYNNNYN
22 Bingham
NYNYNYYYNYNNYY N
2 Spence
YNYNYNNNYNYYNNY
12 Studds
NYNYNY*YNYNNYYN
23 Peyser
YYY7NN7777NNYNY
3 Derrick
NYYNYNNNYYNYYYY
MICHIGAN
24 Ottinger
NYNNNYYYNYNNYYN
4 Mann
YYYNNNNNYNYYYNY
1 Conyers
NYNYXYYYNYNNOYN
25 Fish
NNYNYNNNYYYNYNY
5 Holland
NYNNNNXYYNYYY
2 Esch
NYYYY7NNYY777NY
26 Gilman
YNYNNNNNYYYNYNY
6 Jenrette
YNYNNNNNYYNYYNY
3 Brown
NYYNYNN?YNNYNNY
27 McHugh
2YNNNYY2NYNNYYY
SOUTH DAKOTA
4 Hutchinson YNYNYNNNYNYYNNY
2B Stratton
YYYNYNNNYXYNNYY
1 Pressler
YNNYYNYNYNYYNNY
5 Vander Veen NYNNNYYNNYNN0YY
29 Pattison
NYNYNYYYNYNNYYN
2 Abdnor
YXYNYNNNYNYYNNY
6 Carr
NYNYNYYYNYNNYYN
30 McEwen
YYYNNNNNONYYNNY
TENNESSEE
7 Riegle
NONYN?70X0X77YN
31 Mitchell
YYYNYNNNYYYYNNY
1 Quillen
YYY7YNNNYNYYNNY
8 Traxler
YNNNNNYN2YNNYYY
32 Hanley
NYYNNNYNOYNNYYN
2 Duncan
YNYNYNNNYNYYNNY
9 Vander Jagt NYYPYNNNYNYYNNY
33 Walsh
YNYNNNNNYYYYNNY
3 Lloyd
YNYNYNNNYNYYNNY
10 Cederberg
NYY7NNNNYNYYNNY
34 Horton
WYYNYNYNYYNNNNY
4 Evins
YNYNONNNYNONONY
11 Ruppe
NNN7YNNN2N27NNY
35 Conable
YYYNYNNNYYYYNNY
5 Allen
YYNNNNYYYYNNYYY
12 O'Hara
NYNNNNONYNXN7YN
38 LaFalce
MYNNNNYN2YNNYYY
6 Beard
YNYNNNNNYNYYNNY
13 Diggs
NYNNNYYYXYNN0YN
37 Nowak
NYNNNYYYYYNNYYN
7 Jones
YNNNYNNNYNYY7NY
14 Nedzi
NYN2NNYNYNNNYYN
38 Kemp
YNYNYNNNYNYYNNY
8 Ford
YYNYNYYYNYNNOYN
15 Ford
NYXNNNY7NNNN2YN
39 Lundine*
NY Y Y N YNNY Y
TEXAS
18 Dingell
YY2NNNYNNNNNYYN
NORTH CAROLINA
1 Hall*
N
17 Brodhead
WYNYNYYYNYNNYYN
1 Jones
YNYNY7N7YNYO7NY
2 Wilson
N7Y7777NYNY2NNY
18 Blanchard
NYYNNNYNYYNNYYN
2 Fountain
YNYNONNNYNYYXNY
3 Collins
YNYNYNNNYXYYNNY
19 Broomfield
YYYNYNNNYNYYNNY
3 Henderson 2NY7Y2NNYNYYNNY
4 Roberts
YNY7Y7XNYNY7NNN
MINNESOTA
4 Andrews
XYNYNYNYYYYYNY
5 Steelman
YYYYN7NYNYY7NY
1 Quie
NYYNYNNN2NYYNNY
5 Neal
NN2NNNYNYYYYYYY
6 Teague
YXYXYNNNYNYONNY
2 Hagedorn
YNYNYNNNYNYYXNY
6 Preyer
NYYNNNNNYNNYONY
7 Archer
YNYNYNNNYNYONNY
3 Frenzel
NYNYNNYNYNYONNO
7 Rose
YYYNNNN?OYNYNNY
8 Eckhardt
NYNY2NYY2YNNYYN
4 Karth
NN77NN77XN7NYY7
8 Hefner
YNYNYNNNYNYYONY
9 Brooks
YYYXYN7N7NNNYNN
5 Fraser
NYNYNYYYPYNNYYN
9 Martin
YYYNYNN2YNYYNNY
10 Pickle
YYYYNNNNYNYNNNN
6 Nolan
NYNYNYYYNYNNYYN
10 Broyhill
YYYNYNNNYNYYNNY
11 Poage
YNYNYNNNYNYYNNY
7 Bergland
NYNNNNYYNYNNYYY
11 Taylor
YNYNYNNNYNYYNNY
12 Wright
8 Oberstar
NYNYNYYYNYNNYYN
NORTH DAKOTA
13 Hightower YNYNNNNNYNYYNNY
MISSISSIPPI
AL Andrews
NNYNYNNN2NNYNNY
14 Young
YYY7YNNNYNNNNNN
1 Whitten
YNYNYNNNYNNNYNY
OHIO
15 de la Garza
YNY7Y7NNYYN2NNY
2 Bowen
YPYNNNNNYNNYNNY
1 Gradison
NYYNY2NNYYY2YNY
16 White
YNYXY2NNY@NONNY
3 Montgomery YNYNNNNNYNYYNNY
2 Clancy
YNYNYNNNYNYYNNY
17 Burleson
YNYNYNNNYNYYNNY
4 Cochran
YNYNNNNNYNYYNNY
3 Whalen
NYNYNNYNYYNNYNY
18 Jordan
NYNYNNYYNYNNYYN
5 Lott
YNYNYNNNYNYYNNY
4 Guyer
7YYNONNNO7YYNNY
19 Mahon
YNYNYNNNYNYYNNN
MISSOURI
5 Latta
YNYNYNNNYNYYNNY
20 Gonzalez
YYYNNNNNYNNNNYN
1 Clay
DYNYNY0YXYNNoYN
6 Harsha
NYNYPNNYNYNNN7
21 Krueger
YYYNYNNNYYYYNNY
2 Symington NYNNNNYNYONN7Y7
7 Brown
YYNYNNNYYYYNNY
22 Paul
NYN YYY Y
3 Sullivan
NNYNYNYN2NNN2NN
8 Kindness
PYYNYNNNYNYYNNY
23 Kazen
YNYNYNNNYNNNNNY
4 Randall
2NYN7NNN2NNN7NN
9 Ashley
NYNPNNYNYNNNYYN
24 Milford
YNYNNN2XYNOYN77
5 Bolling
PYNN7NY2NYNN2YN
10 Miller
YNYYYNNNYNYYNNY
UTAH
8 Litton*
YNNNNY2YY272Y
11 Stanton,
1 McKay
NYYNYNNNNNN2YNN
7 Taylor
YNYNYNNNYNYYNNY
J.W.
NYYNYNNNYYNYNNY
2 Howe
PYNNNN7NNY7X7YN
8 Ichord
YNYNYNNNONYYNNY
12 Devine
YNYNYNNNYNYYNNY
VERMONT
9 Hungate
YNNXY7YNNYYNY?Y
13 Mosher
NYNONNY2YYNYYYY
AL Jeffords
NYNNNNYYYYNYYYY
10 Burlison
NNNNNNNNYNNNXYN
14 Seiberling
NYNYNYYYNYNNYYN
VIRGINIA
MONTANA
15 Wylie
YNYNYNNN2NYYNNY
1 Downing
PN2NYNNNYNY7NNY
1 Baucus
NYNNNNYYNYNYY Y N
16 Regula
YYYNYNNNYNYYNNY
2 Whitehurst YNYNYNNNYNY7NNY
2 Melcher
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17 Ashbrook
YNYNYNNNYNYYNNY
3 Satterfield YNYNYNNNYNYYNNY
NEBRASKA
18 Hays
2YY7NN7NYN7NYY7
4 Daniel, R.
YNYNYNNNYNYYNNY
1 Thone
YNYNYNNNYNYYNNY
19 Carney
NNOYNYYNNYNNNYN
5
Daniel,
D.
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2 McCollister
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20 Stanton, J.V. NY7PYNY2NYNXNYY
6 Butler
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3 Smith
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21 Stokes
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7 Robinson
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NEVADA
22 Vanik
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8 Harris
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AL Santini
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23 Mottl
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9 Wampler
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NEW HAMPSHIRE
OKLAHOMA
10 Fisher
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1 D'Amours
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1 Jones
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WASHINGTON
2 Cleveland YYYNNNNNYNNYNNY
2 Risenhoover YNYYNNNN2YNNNNY
1 Pritchard
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NEW JERSEY
3 Albert*
NN
2 Meeds
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1 Florio
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4 Steed
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3 Bonker
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2 Hughes
YYNNNNYNYYYYYNY
5 Jarman
YNYNYNNNYNYYNNY
4 McCormack NYYYYNNNYYNNNYY
3 Howard
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6 English
YNYNYNNNYNYYNNN
5 Foley
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4 Thompson
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OREGON
6 Hicks
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5 Fenwick
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1 AuCoin
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7 Adams
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6 Forsythe
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2 Ullman
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VEST VIRGINIA
7
Maguire
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3 Duncan
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1 Mollohan
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8 Roe
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4 Weaver
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2 Staggers NYYXNNNNYYNNYYN
9 Helstoski
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3 Slack
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10 Rodino
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? X
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3 Green
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13 Meyner
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4 Eilberg
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2 Kastenmeier NYNYNYYYNYNNYYN
14 Daniels
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5 Schulze
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3 Baldus
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15 Patten
NYYNNNNYYYNNYNN
6 Yatron
YNYNYNYYYYYNNNY
4 Zablocki
NYYNYNNNYYNNYYN
NEW MEXICO
7 Edgar
NYNNNYYNYYNNYYN
5 Reuss
NYNYNYYYNYNNYYN
1 Lujan
YY7NN2NNYNY7NNY
8 Biester
NYNNNNYNY7NNYY7
6 Steiger
NYYNYNNNY2YYNNY
2 Runnels
7NYNXNX7ONY7NNY
9 Shuster
YNYNYNNNYNYYNNY
7 Obey
NYNNNYYNNYNNYYN
NEW YORK
10 McDade
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8 Cornell
NYNNNYYYNYNNYYN
1 Pike
NYNNNNYNNNNNYYN
11 Flood
NYONNNNNYYNNNNY
9 Kasten
YNYNNNNNYYYYNNY
2 Downey
NNNNNNYYNYNNYYN
12 Murtha
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WYOMING
3 Ambro
YNYNYNYNNYNNYYY
13 Coughlin
NYYYNNYNYNYYYNY
AL Roncalio
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4 Lent
YYYNYNNNYYYYNNY
14 Moorhead
NYNNNY7NNYNNYYN
5 Wydler
YYYNYN7NYNYYNNY
15 Rooney
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6 Wolff
YNYNYYYYNYNXYNN
18 Eshleman YNN7Y7NNYYYONNY
7 Addabbo NYYYNYYYNYNNYYN
17 Schneebeli 7YYYNNNNYNOYNNY
8 Rosenthal NYNYNYYYNYNNYYN
18 Heinz
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9 Delaney
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19 Goodling
YNYYYNNNYYYYNNY
10 Biaggi
NNYNYNYNYNYNPYN
Andrew Hinshaw CA was convicted Jan. 26 of bribery relating to his former office as county assessor; House rules prohibit convicted felons from voting on the House floor.
Speaker Carl Albert OK ordinarily does not vote. Delegates Walter E. Fauntroy, District of Columbia; Antonio Borja Won Pat, Guam; Ron de Lugo, Virgin Islands; and Resident
Commissioner Jaime Benitez, Puerto Rico, cannot vote on the House floor, but may do so in committee.
Washington Newsletter, October 1976
Page
5
#
FCNL Washington Newsletter,
(continued from Page 5)
JOBS
D.C. REPRESENTATION IN CONGRESS
ARMS RACE
HUMAN RIGHTS
WHOSE RIGHT TO KNOW?
OUT OF CONTROL
those requirements into their building
The First Budget Resolution provided
The House failed to obtain the 2/3 ma-
Congress continued its human rights
Congress and the President carried on a
Efforts to cut military spending failed
codes. The Senate vote stiffened H.R.
both the House and the Senate an oppor-
jority needed to adopt a constitutional
thrust begun last year when the Harkin and
running battle over intelligence data in
repeatedly in 1976, because of election
8650 to force state and local compliance
tunity to place high priority on providing
amendment to give voting representation
McGovern-Abourezk amendment was add-
1976, primarily over the work of the Select
year politics, fear of increased Soviet
with those standards by threatening to cut
jobs for the seven million unemployed per-
to the District of Columbia in both the
ed to the economic aid bill. This year Con-
Cmtes. on Intelligence chaired by Rep. Otis
spending, and inflation. Pres. Ford's revised
off mortgage credit.
sons in the U.S.
House and Senate. This constitutional
Congress strengthened Sec. 502B, the
Pike NY and Sen. Frank Church ID.
request of $113.3 billion in budget
amendment was viewed as a civil rights
human rights provision regarding military
On the nuclear front, the House July 30
The House Budget Committee included
authority for "national defense" received
The issue came to a head in the House
issue (H. Vote 10). As co-sponsor Rep.
aid so much that Pres. Ford vetoed the bill
adopted a controversial amendment by
$50 million in startup funds in the First
only token cuts by the House and Senate
as initially passed, citing this provision as
Jan 29 when the House voted 246-124 to
John Buchanan AL, who is also a minister
Rep. Jonathan Bingham NY to the Nuclear
Budget Resolution for any full employment
Budget, Armed Services, and Appropria-
block the release of the Pike Cmte.'s final
to an inter-racial congregation in the Dis-
one of the several causing his action. A
Fuels Assurance Act (H.R. 8401) by the
legislation which is passed prior to Octo-
tions Committees. On the First Budget
report (H. Vote 9). The Administration con-
trict of Columbia, stated, "One cannot say
revived and somewhat weakened bill was
narrow margin of 170-168. On Aug. 4, the
ber, 1977. A motion by Rep. Ronald
Resolution, Indiana Sen. Birch Bayh's
tended that the report contained classified
that the 750,000 persons who reside in the
passed and signed. It requires the Adminis-
House reversed itself and by a 192-193 roll
Sarasin CT to delete these funds was de-
modest amendment was defeated 27-58
tration to report on the human rights situa-
material which must be sanitized before
District
of
Columbia
fully
participate
in
call (H. Vote 13) rejected Bingham's pro-
feated 177-206 on Apr. 29 (H. Vote 12).
April 12 (S. Vote 6). An amendment by
publication. The House vote and the prior
the rights of American citizenship until they
tion in each country receiving U.S. military
posal. On this vote, a 192-192 tie was
This vote shows that only a narrow ma-
Sens. Thomas Eagleton MO and Mark Hat-
aid and provides a procedure for Congress
leak of the report to the press has left the
are represented in both of the houses of
broken when Speaker Carl Albert voted
jority, one which has not increased since
field OR Aug. 2 to cut $1 billion from the
House in turmoil and killed any hope of
this bicameral body."
to review and to reverse, if it so determines,
against the amendment.
April, was ready at that time to consider
$104 billion Defense Dept. total was de-
an Executive Branch request for military
creating in this Congress a permanent
seriously far-ranging jobs legislation such
DAY CARE STANDARDS
feated 27-63.
aid.
House or joint Congressional Intelligence
As passed, H.R. 8401 would open the
as H.R. 50, the Hawkins-Humphrey bill.
Cmte.
door for private industry to begin produc-
Congress passed a $125 million Day
In the House, NY Rep. Elizabeth Holtz-
tion of enriched uranium, a technology
Sen. Edward Kennedy MA proposed a
Care Standards Act to help day care cen-
man's amendment to cut $7.5 billion in
But when human rights in South Korea
In the Senate, however, the Church
$3.2 billion amendment to the Budget
ters meet the strict staff-children ratios
which the federal government has
budget authority and $2.5 billion in outlays
were pitted against perceived U.S. security
Cmte.'s final report was published, reveal-
monopolized for 30 years, and which
Resolution which would have doubled the
which went into effect February, 1976. The
from the military, transferring all of the out-
interests, human rights lost. The House Intl.
ing a long history of violations of citizens'
Bingham sought to continue. Opponents of
number of public service jobs from 300,-
President vetoed the bill on April 6 because
lay cut and $2.8 in budget authority to
Relations Cmte. on the motion of Rep. Don
rights by government agencies. On May 19
private development feared waste and in-
000 to 600,000 and also would have in-
he believed the new regulations were an
civilian needs, was defeated 85-317 on
Fraser MN, had limited U.S. military aid to
the Senate 72-22 established a permanent
creased dangers of proliferation and en-
creased various health programs. As Sen.
excessive federal interference in local
April 29 (H. Vote 6).
South Korea to the FY75 level, "because of
Senate Intelligence Cmte. But the vote
vironmental hazards.
Alan Cranston CA noted, the Budget
affairs, and he noted also the unfavorable
the gross violations of human rights which
Another attempt by Rep. Ron Dellums
which really determined whether the new
Resolution "fails to deal sufficiently with
budgetary impact of the $125 million price
continue in South Korea." On June 12 the
CA to reduce the number of U.S. troops
committee would exercise authority came
the immediate, desperate need to get
tag. The House overrode the veto 301-101
House deleted the $290 million ceiling on
earlier that day, when the Senate by a vote
FOOD STAMPS
millions of unemployed workers back to
on May 4, but the Senate sustained 60-34
abroad by 47,000 was defeated April 9 by
military aid to South Korea, in effect ac-
88-275 (H. Vote 4).
of 31-63 rejected an amendment which
The Senate passed April 8 a moderate
work," and thus the Senate, "failed its
(S. Vote 15). A compromise bill which
cepting the Administration's request for
would have denied the new committee leg-
food stamp reform bill which limited food
responsibility [of] allocating Federal spend-
would postpone the standards for a year
Sen. McGovern's amendment to cut
$488 million for FY76 and 77 (H. Vote 3).
islative and budgetary jurisdiction over the
stamps to households with less than
ing in accord with an appropriate set of na-
was signed by President Ford on Sept. 7.
$948 million earmarked to begin produc-
However, the Senate on Feb. 18 by a
intelligence activities of the Department of
$8,100 income and set standard deduc-
tional priorities." (S. Vote 12) The amend-
tion of three B-1 bombers was defeated
AMERICAN INDIANS
vote of 48-39 adopted an amendment by
Defense (S. Vote 9).
tions of $100 for all households, plus extra
ment was defeated 27-58.
May 20 in the Senate 33-48 (S. Vote 7). A
Sen. Edward Kennedy MA which
Another relevant Senate vote came Feb.
deductions for the elderly and working poor
Few recorded votes have been taken on
later amendment by Sen. John Culver IA to
REVENUE-SHARING
delay a decision on production until Feb. 1,
broadened a ban on U.S. military grants and
(S. Vote 11).
Indian legislation during the 94th Congress.
17 on the $4 billion FY76 military aid
The House voted 361-35 on June 10 for
The Pueblo Lands bill, repealing an earlier
1977, passed 44-37 but was deleted in
credit sales to Chile to include government
authorization bill (S. 2662), when the
In meetings of the House Agriculture
a 45-month extension of revenue-sharing,
act which gave New Mexico condemnation
conference. The following senators voted
cash or commercial sales of arms and mili-
Senate rejected, 36-44, an amendment
Committee, food stamp supporters and op-
a program of federal financial assistance to
rights over certain pueblos, passed without
for production but then switched to vote
tary equipment as well (S. Vote 3).
which would have deleted language in the
ponents stalemated, reporting out a bill
state and local governments. The program
a recorded vote. The Indian health bill,
for the Culver delay:
bill requiring the President to disclose
Aug. 10 that is satisfactory to few on either
would disburse $6.65 billion each year. The
unanimously passed in the Senate (May,
Bumpers AR, Nunn GA, Inouye HI, Pearson KS,
publicly all military assistance and arms
side. The scaled-down committee bill, H.R.
Eagleton and Symington MO, Metcalf MT, Mcln-
WEAPONS FOR ISRAEL
House-passed bill includes improvements
1975), passed the House with a vote of
sales transactions (S. Vote 8).
13613, is estimated to be within current
tyre NH, Burdick ND, Jackson and Magnuson
in the citizens' participation and anti-dis-
310 to 9. Significant increases and policy
In seeking to reduce U.S. arms ship-
WA, Randolph WV.
INTERVENTION
program costs. This bill is pending on the
crimination provisions of revenue-sharing.
mandates regarding Indian programs came
ments to Israel, Rep. David Obey WI
There was no vote in the House to stop
House floor. (Write for G-52.) The House
Sec. of State Kissinger's Dec. 9, 1975,
A substitute containing more improve-
through Appropriations Committees,
stated, "I deeply believe that if we do
B-1 production. OH Rep. John Seiberling's
previously rejected efforts to cut back food
ments of the revenue-sharing program was
showing a greater sensitivity by the 94th
not show that we are willing to trim at
acknowledgement that the U.S. was
amendment to the military authorization bill
stamp appropriations. (H. Vote 11)
defeated 172-233 (H. Vote 15).
Congress to Indian needs.
least some amount from this bill, we
covertly supplying arms and aid to anti-
to delay production until Feb. 1 was de-
diminish the possibilities for peace in
Soviet factions in the Angolan civil war
THE FRIENDS COMMITTEE ON NATIONAL
feated 177-210 on Apr. 8. A later attempt
brought sharp reactions from Congress.
LEGISLATION includes Friends appointed
the Middle East and increase the likeli-
by Rep. Joseph Addabbo NY to amend the
FCNL CONTRIBUTORS NEWSLETTER SERVICE
by 22 Friends Yearly Meetings and by 10
hood that any further war will be at a
After two secret sessions, the Senate on
$105 billion Dept. of Defense appropria-
SUPPORT FCNL's Washington lobbying efforts with a contribution
other Friends organizations in the United
much higher violence level than we
Dec. 19, 1975, adopted 54-22 an amend-
States. Expressions of views in the FCNL
tions bill to include the Feb. 1 delay also
of $10.00.or more ($5.00 for those on limited incomes) and receive
WASHINGTON NEWSLETTER are guided
have had in the past." Obey's amend-
ment offered by Sen. John Tunney CA
failed 186-207 on June 17 (H. Vote 7).
eleven issues of the FCNL Washington Newsletter annually. It
by the Statement of Policy prepared and
ment to FY76 foreign aid appropria-
which limited U.S. activities in Angola to in-
an
includes Federal Budget Analysis State Congressional Delegations
approved by the Committee. Seeking to
The Senate again added the Feb. 1 delay to
tions would have cut a modest $200
telligence gathering (S. Vote 10).
with Committee Assignments Record of Key Votes.
follow the leadings of the Spirit, the FCNL
the appropriations bill and in conference it
speaks for itself and for like-minded
million from the $1.5 billion for military
On Jan. 27, 1976, the House, on a mo-
CONTRIBUTORS may receive FCNL's Congressional testimony,
Friends. No organization can speak offi-
was accepted with $87 million a month
credits and grants to Israel. It lost
participate in the FCNL District Contact Program and receive special
cially for the Religious Society of Friends.
slated to keep production lines open for
tion from Robert Giaimo CT, approved the
action mailings. Additionally, upon request, they may obtain single
FCNL WASHINGTON NEWSLETTER.
32-342 on March 4, 1976. The
Tunney amendment 323-99.
following voted for the cut:
copies without charge of FCNL Policy Statements, staff studies and
Contributors to this Newsletter, other than
four months.
Ashbrook OH, Baucus MT, Bergland MN,
ENERGY
Burlison MO, Conyers MI, Evans CO, Evans
FCNI
other materials announced for distribution in the newsletter.
the Members of Congress, without whom
NY Rep. Bella Abzug's attempt to delete
we could not have presented the material at
all, include: Volunteers Chris Moore, Mat-
$1.2 billion for nuclear weapons develop-
The Senate March 9 adopted H.R. 8650
Complete and mail with your contribution to:
IN, Evins TN, Findley IL, Frenzel MN,
thew Stadler, Steve Patrica, Nancy
ment, testing, and production was defeated
(S. Vote 13) which, like the House version
FRIENDS COMMITTEE ON NATIONAL LEGISLATION
FRIENDS COMMITTEE ON NATIONAL LEGISLATION
Hamilton IN, Hansen ID, Hungate MO,
Schauffler, Nancy Yinger Interns Sylvia
May 20 by 97-286 (H. Vote 8). In the
Ichord MO, Jacobs IN, Johnson CO, Karth
adopted in 1975, directed the Dept. of
245 Second Street, N.E., Washington, D.C. 20002
Bronner, Larry Newlin, Ruth Anderson,
William Guthe, Steve McNeil. Legislative
Senate a similar amendment offered by
MN, Kastenmeier WI, Keys KS, McDonald
Housing and Urban Development to draw
Name
Assistants Steve W Angell, Tim Atwater,
Mike Gravel AK lost June 25 by 5-77. Join-
GA, Moffett CT, Montgomery MS, Mosher
up energy-efficiency standards for new
(Please Print)
and Diana Payne. Regular FCNL Staff Ed-
OH, Mottl OH, Myers PA, Nolan MN, Obey
ing Gravel were Sens. Abourezk,
homes and commercial buildings and to
Address
ward Snyder, Frances Neely, Nick Block,
WI, Roush IN, Shuster PA, Skubitz KS,
Jean Conway, Sharon Martin, Evelyn
McGovern, William Proxmire WI, and
Wylie OH, and Zablocki WI.
help state and local governments work
City
State
Zip
Bradshaw. 245 Second St., N.E., Washing-
William Hathaway ME.
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