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Senate Begins Debating Indian Health Care Bill

On January 22, the Senate began considering a bill (S. 1200) to reauthorize the Indian Health Care Improvement Act (P.L. 94-437). The Senate Finance Committee approved the bill on September 12 (see The Source 9/14/07); the Senate Indian Affairs Committee approved it on May 10 (see The Source, 5/11/07).

Sen. Lisa Murkowski (R-AK) said, “Back in September of 2007, the Committee on Indian Affairs held an oversight hearing on the prevalence of violence against Indian women [see The Source, 9/28/07]. We had several witnesses, very compelling witnesses, at that hearing, one of whom was from Alaska, a woman by the name of Tammy Young, and she represented the Alaska Native Women’s Coalition Against Domestic Violence and Sexual Assault. She testified about the intensity of such prevalence and the need for remedies to properly address the problem…In Alaska, an Alaska Native woman has a likelihood of rape that is four times higher than a nonnative woman in the state…But we know it is not only in Alaska that there is this danger of violence that faces our Native women. Statistics show that Native women around the country are two to three times more likely to be raped than women from other populations in the United States…But even if this fact were not as disturbing as it is, it gets even worse because so many of these women who have had this violence upon them also face the prospect that the rapist may not be brought to justice.”

Sen. Murkowski continued, “At the hearing we had a witness indicate that the health services within the Native communities simply lacked the proper infrastructure, the proper resources, to even conduct the forensic exams and therefore assist in the prosecution of the perpetrators…In addition, it is the training. We simply do not have enough [people] who are trained in the proper collection of the evidence. Back in 2005, we in Congress passed aggressive programs and services for the reauthorization of the Violence Against Women Act [P.L. 109-162], or VAWA. The witnesses who were there at the hearing back in September advocated that we build on the foundation of VAWA. That is what this legislation does…It includes programs to address domestic and sexual violence that are critical to shoring up this health infrastructure, that are necessary to support a successful prosecution, whether it is providing for rape kits at the Indian clinics and hospitals or the training for the health professionals to become the sexual assault examiners…In addition, the legislation will also require the secretary of HHS [Health and Human Services] to establish protocols and procedures for health services to victims of violence, as well as to coordinate with the attorney general in identifying areas for improvement within the health system to support these prosecutions. I believe this aspect of the legislation is extremely important for so many. Again, our statistics in this area are devastating, unacceptable. There is more we can do about it, and this is one small step.”

Sen. Amy Klobuchar (D-MN) said, “Today, the health disparities between our tribal communities and the rest of the country are shocking. According to the Indian Health Service, the average life expectancy for Native Americans is almost two and [one] half years below any other group in the country. The incidence of sudden infant death syndrome among tribal communities is more than three times the rate of nontribal infants…The suicide rate among Native American youth is the highest of any racial group in the nation. In fact, suicide is the third leading cause of death among Native American youth. One of the country’s most recent victims is a 12-year-old Red Lake boy who hanged himself last October…This calamity serves as a tragic reminder of the importance of increasing efforts to effectively address mental health issues in Indian country and elsewhere…We know the negative impact mental health issues have on our communities, but we also know [that] access to modern mental health care resources can make a difference. That is why it is so critical to reauthorize the Indian Health Care Improvement Act. Reauthorizing this bill will provide tribal communities with the tools needed to build comprehensive behavioral health prevention and treatment programs programs that emphasize collaboration among alcohol and substance abuse, social services, and mental health programs, and programs that will help communities such as Red Lake prevent further tragedies. The federal government has a trust responsibility to provide health care for our tribal communities. I cosponsored the Indian Health Care Improvement Act because we made a commitment to our tribal communities. We must ensure our tribal communities have access to convenient, preventive, and modern health care. I urge my colleagues to join me and support reauthorizing this important bill.”

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