[Senate Report 108-165]
[From the U.S. Government Publishing Office]
Calendar No. 308
108th Congress Report
SENATE
1st Session 108-165
======================================================================
IMPLEMENTING THE RECOMMENDATIONS OF THE GARRISON UNIT JOINT TRIBAL
ADVISORY COMMITTEE BY PROVIDING AUTHORIZATION FOR THE CONSTRUCTIONS OF
A RURAL HEALTH CARE FACILITY ON THE FORT BERTHOLD INDIAN RESERVATION,
NORTH DAKOTA
_______
October 15, 2003.--Ordered to be printed
_______
Mr. Campbell, from the Committee on Indian Affairs, submitted the
following
R E P O R T
[To accompany S. 1146]
The Committee on Indian Affairs, to which was referred the
bill (S. 1146) to implement the recommendations of the Garrison
Unit Joint Tribal Advisory Committee by providing authorization
for the construction of a rural Health Care facility on the
Fort Berthold Indian Reservation, North Dakota having
considered the same, reports favorably thereon with an
amendment and recommends that the bill (as amended) do pass.
Purpose
The purpose of S. 1146 is to implement certain
recommendations of the JTAC relating to the replacement by the
Federal government of a health care facility on the Fort
Berthold Indian Reservation, North Dakota, which was destroyed
as a consequence of the construction of the Garrison Dam and
Reservoir (the Garrison Dam). The bill authorizes $20 million
for the construction of a health care facility and such sums as
are necessary for related facility expenses.
Background
The Committee Report for Title XXXV of Pub. L. 102-575, the
Three Affiliated Tribes and Standing Rock Sioux Tribe Equitable
Compensation Act (the Equitable Compensation Act), S. Rep. No.
102-250, contains an extensive history of the development and
impacts of the Garrison Dam, the relevant portions of which are
summarized herein.
The Flood Control Act of 1944 (the Flood Control Act), also
known as the Pick-Sloan Project, was a water development
program comprised of multi-purpose dams and reservoirs designed
by the U.S. Army Corps of Engineers and the U.S. Bureau of
Reclamation.
The Flood Control Act resulted in substantial flood
control, navigation, recreation and power benefits throughout
the Missouri River Basin but also generated significant impacts
to the states and Indian tribes in the upper Missouri River
Basin.
The Garrison Dam, constructed under the Flood Control Act,
resulted in the loss of over 150,000 acres on the Fort Berthold
Indian Reservation. Although existing treaty rights provided
that this land could not be ``taken'' without the consent of
the Three Affiliated Tribes of the Fort Berthold Indian
Reservation (the tribe), the tribe was not consulted prior to
enactment of the Flood Control Act. The Bureau of Indian
Affairs had prior notice of the probable harm the tribe would
suffer, yet registered no objection to the plan while it was
being debated in Congress in 1944.
In 1949, 325 families of the tribe, representing 80 percent
of the tribal membership, were forced to relocate due to the
construction of the Garrison Dam. One quarter of the tribe's
reservation land base was flooded and vital infrastructure,
including the Elbowoods facility, a U.S. Public Health Service
hospital, was destroyed.
Thirty years after completion of the Garrison Dam, the
Secretary of the Interior (the Secretary) appointed the
Garrison Diversion Unit Commission (the ``GDUC'') to review the
initial stages of the Garrison Diversion Unit.
In its Final Report of December 20, 1984, the GDUC
recommended that the Secretary establish a committee ``to find
ways to resolve inequities'' borne by the tribe in the
implementation of the Flood Control Act. S. Rep. No. 102-250,
at 3. Compensation provided the tribe for the lands flooded by
the Garrison Dam was determined by the GDUC to be inequitable
relative to the losses experienced by the tribe.
On May 10, 1985, the Secretary established the JTAC to more
closely examine the effects of the construction of the Garrison
Dam on the tribe and make recommendations regarding
compensation. In its Final Report of May 23, 1986, the JTAC
concluded that the tribe was entitled to the replacement of
lost infrastructure, including the health facility which the
JTAC found to be an ``urgent and critical need''. S. Rep. No.
102-250, at 6.
C. Emerson Murry, former Chairman of the JTAC, testified
before the Committee in 1991 that ``many assurances were given
expressly or by implication by various federal officials that
the problems anticipated by the Indians would be remedied,''
yet many of the promises were never fulfilled.
Since that time, Congress has acted on several, but not
all, of the recommendations contained in the JTAC report. The
Equitable Compensation Act authorized a recovery fund to return
to the tribe the Four Bears area of the reservation, among
other things. However, no funding or authorization was provided
to replace lost infrastructure. Accordingly, recommendations
relating to the replacement or reconstruction of
infrastructure, particularly the health facility, remain
unfulfilled.
A. THE HEALTH FACILITY
S. 1146 would implement the JTAC's recommendations that the
tribe is entitled to replacement of the Elbowoods facility. S.
Rep. No. 102-250, at 6. The bill would amend the Equitable
Compensation Act to authorize $20 million for the construction
of a health facility. The bill also authorizes ``such sums as
are necessary'' for expenses related to the facility. These
expenses include the costs associated with staffing, equipping,
operating and maintaining the facility.
The Committee wishes to make clear that the facility
authorized under this bill is not intended to be a full service
hospital. The Committee agrees that a full service inpatient
hospital is not feasible and recognizes that such a facility
would duplicate services already provided by existing
facilities near the tribe's reservation.
The health care facility authorized under this bill is
intended to provide extended hours of care to meet the
emergency medical needs on the tribe' reservation in the
evenings and on weekends on an outpatient basis. The facility
will also provide such services as cancer screening and care,
testing for cardiovascular diseases, expanded dialysis
services, and tele-health capabilities not currently available
at the existing Indian Health Service clinic.
The Committee has urged previous administrations to provide
the resources to replace the health facility destroyed by the
Garrison Dam. The Committee believes that with this
authorization, every effort should be made by the
administration and Congress to provide the federal funding for
this health facility as expeditiously as possible.
The Committee also recognizes that funding for construction
of Indian Health Service facilities is currently limited to
only those facilities already on the construction priority
list. The facility authorized by this legislation is not on
this priority list.
The Committee does not wish to bypass the priority list,
given that some of the projects on that list have been waiting
a decade or more to be funded. However, the Committee does
recognize the unique federal responsibility of replacing the
facility on the Fort Berthold Indian Reservation and urges the
Administration to give this project full and fair
consideration.
Legislative History
S. 1146 was introduced on May 23, 2003, by Senator Conrad
for himself, and for Senator Dorgan. The bill was referred to
the Committee on Indian Affairs. Senator Campbell was added as
a cosponsor on June 11, 2003.
The Committee held a hearing on S. 1146 on June 11, 2003.
The Committee received testimony from the Three Affiliated
Tribes and the Mandan, Hidatsa and Arikara Elders Organization.
During the hearing, tribal representatives expressed their
support for the bill and the need for the federal government to
fulfill the longstanding commitment made during the
implementation of Flood Control Act.
Section-by-Section Analysis
Sec. 1. Short title
This Act may be cited as the ``Three Affiliated Tribes
Health Facility Compensation Act''.
Sec. 2. Findings
This section sets forth the findings of Congress regarding
the effects of the Garrison Dam and Reservoir upon the Fort
Berthold Indian Reservation. Congress found that the Garrison
Dam and Reservoir flooded over 150,000 acres of the reservation
and destroyed tribal infrastructure including a hospital.
Congress further found that after examination by the Garrison
Unit Joint Tribal Advisory Committee, established by the
Secretary of the Interior, the Three Affiliated Tribes of the
Fort Berthhold Indian Reservation were entitled to reparations,
much of which have yet to be fulfilled.
Sec. 3. Rural health care facility, Fort Berthold Indian Reservation,
North Dakota
This section amends Title XXXV of Pub. L. 102-575, the
Three Affiliated Tribes and Standing Rock Sioux Tribe Equitable
Compensation Act, to authorize $20,000,000 for the construction
of a health care facility on the Fort Berthold Indian
Reservation and such additional sums which are necessary for
other expenses related to the health care facility.
Committee Recommendation and Tabulation of Vote
On July 16, 2003, the Committee, in an open business
session, considered S. 1146 and an amendment recommended by
Senator Conrad. The Committee voted unanimously to favorably
report S. 1146, as amended, to the full Senate with a
recommendation that the bill, as amended, do pass.
Cost and Budgetary Considerations
The cost estimate for S. 1146 as calculated by the
Congressional Budget Office, is set forth below:
U.S. Congress,
Congressional Budget Office,
Washington, DC, September 22, 2003.
Hon. Ben Nighthorse Campbell,
Chairman, Committee on Indian Affairs,
U.S. Senate, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for S. 1146, the Three
Affiliated Tribes Health Facility Compensation Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Eric Rollins.
Sincerely,
Douglas Holtz-Eakin,
Director.
Enclosure.
S. 1146--Three Affiliated Tribes Health Facility Compensation Act
Summary: S. 1146 would authorize the appropriation of $20
million for the construction of a new hospital on the Fort
Berthold Indian Reservation in North Dakota. The bill also
would authorize the appropriation of such sums as necessary for
other expenses--such as operating costs--associated with the
new facility.
CBO estimates that implementing S. 1146 would cost $2
million in 2004 and $57 million over the 2004-2008 period,
assuming appropriation of the necessary funds. These costs
would be borne by the Indian Health Service (IHS), which would
construct and operate the new hospital. The bill would have no
effect on direct spending or revenues.
S. 1146 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA)
and would not affect the budgets of state, local, or tribal
governments.
Estimated cost to the Federal Government: The estimated
budgetary impact of S. 1146 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------
2003 2004 2005 2006 2007 2008
------------------------------------------------------------------------
SPENDING SUBJECT TO APPROPRIATION
Construction of new hospital:
Estimated authorization 0 1 1 12 6 0
level....................
Estimated outlays......... 0 1 1 12 6 0
Construction of staff
quarters:
Estimated authorization 0 1 1 12 5 0
level......................
Estimated outlays......... 0 1 1 12 5 0
Equipment and furnishings:
Estimated authorization 0 0 0 0 3 0
level....................
Estimated outlays......... 0 0 0 0 3 0
Operating costs:
Estimated authorization 0 0 0 0 5 10
level....................
Estimated outlays......... 0 0 0 0 5 10
Total spending under S. 1146:
Estimated authorization 0 2 2 24 19 10
level....................
Estimated outlays......... 0 2 2 24 19 10
------------------------------------------------------------------------
Basis of estimate: CBO estimates that implementing S. 1146
would cost a total of $57 million over the 2004-2008 period,
assuming appropriation of the necessary funds. Construction of
the new hospital would cost $20 million over that period, while
related costs would total $37 million.
Construction of new hospital
S. 1146 would authorize the appropriation of $20 million
for a new hospital on the Fort Berthold Indian Reservation in
North Dakota. Based on the Indian Health Service's experience
in building other hospitals, CBO assumes that planning and
design for the new hospital would take place during 2004 and
2005, and that construction would begin in 2006 and be
completed in 2007. CBO estimates that costs for these
activities would be $1 million in both 2004 and 2005, $12
million in 2006, and $6 million in 2007.
Construction of staff quarters
In addition to the hospital itself, IHS would also have to
build living quarters for hospital staff. Based on information
from IHS, CBO estimates that the cost of these quarters would
total about $19 million. CBO assumes that these quarters would
be built at the same time as the hospital, with costs of $1
million in both 2004 and 2005, $12 million in 2006, and $5
million in 2007.
Equipment and furnishings
Based on information from IHS, CBO estimates that the
purchase of medical equipment and furnishing for the new
hospital would cost $3 million in 2007.
Operating costs
Based on information from IHS, CBO estimates that staffing
and maintenance costs for the new hospital would total $5
million in 2007 and $10 million in 2008. Costs in 2007 would be
lower because CBO assumes that the new hospital would be open
for only part of the year.
Intergovernmental and private-sector impact: S. 1146
contains no intergovernmental or private-sector mandates as
defined in UMRA and would not affect the budgets of state,
local, or tribal governments.
Estimate prepared by: Federal Costs: Eric Rollins. Impact
on State, Local, and Tribal Governments: Leo Lex. Impact on the
Private Sector: Cecil McPherson.
Estimate approved by: Peter H. Fontaine, Deputy Assistant
Director for Budget Analysis.
Regulatory and Paperwork Impact Statement
Paragraph 11(b) of rule XXVI of the Standing Rules of the
Senate requires that each report accompanying a bill to
evaluate the regulatory and paperwork impact that would be
incurred in carrying out the bill. The Committee has concluded
that S. 1146 will not require the promulgation of regulations
so the regulatory and paperwork impact should be minimal.
Executive Communications
There have been no executive communications received on
this legislation.
Changes in Existing Law
In compliance with subsection 12 of rule XXVI of the
Standing Rules of the Senate, changes in existing law made by
the bill S. 1146, as ordered reported, are shown as follows
(existing law proposed to be omitted is enclosed in black
brackets, new matter is printed in italic, existing law in
which no change is proposed is shown in roman):
RECLAMATION PROJECTS AUTHORIZATION AND ADJUSTMENT ACT OF 1992
Public Law 102-575
AN ACT To authorize additional appropriations for the construction of
the Buffalo Bill Dam and Reservoir, Shoshone Project, Pick-Sloan
Missouri Basin Program, Wyoming
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
* * * * * * *
TITLE XXXV. THREE AFFILIATED TRIBES AND STANDING ROCK SIOUX TRIBE
EQUITABLE COMPENSATION PROGRAM, NORTH DAKOTA
* * * * * * *
SEC. 3504. FUNDS.
* * * * * * *
Authorization of Appropriations.--There are authorized to
be appropriated such sums as are necessary to carry out this
section.
[SEC. 3511. AUTHORIZATION.
[There are authorized to be appropriated such sums as may
be necessary to carry out the provisions of section 3504 of
this title.]
SEC. 3511. RURAL HEALTH CARE FACILITY, FORT BERTHOLD INDIAN
RESERVATION, NORTH DAKOTA.
There are authorized to be appropriated to the Secretary of
Health and Human Services $20,000,000 for the construction of,
and such sums as are necessary for other expenses relating to,
a rural health care facility on the Fort Berthold Indian
Reservation of the Three Affiliated Tribes, North Dakota.