Free Response to Motion [Dispositive] - District Court of Federal Claims - federal

Case 1:02-cv-01383-MMS

Document 60-50

Filed 05/02/2007

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Calendar No. 435

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f 07m CONGRESS 2d Session
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SENATE

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TO ELEVATE THE POSITION OF DIRECTOR OF THE INDIAN HEALTH SERVICE WETHIN THE DEPARTMEhT OF HEALTH AND HUMAN SERVICES TO ASSISTANT SECRETARY FOR INDIAN HEALTH. AND FOR OTHER PURESSS

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Mr. INOUYE, from the Committee on Indian AEfairs, submitted the following

REPORT
[To accompany S. 2141
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The Committee on Indian AfTairs, to which was referred the bill ( S . 214) to elevate the position of Director of the Indian Health Service within the Department of Health and Human Services to Assistant Secretary for Indian Health, and for other purposes, having considered the same, reports favorably thereon with out amendment and recommends that the bill do pass.
PURPOSE

The purpose of S. 214 is to elevate the position of the Director of the Indian Health Service to the status of an Assistant Secretary within the Department of Health and Human Services. The bill establishes the Office of Assistant Secretary for Indian Health in order to further the unique government-go-governmentrelationship between Indian tribes and the United States, facilitate advocacy for the development of Indian health policy, and promote consultation on matters related to Indian health. In exchange for ceding millions of acres of Land to which Indian tribes held aboriginal title, the United States entered into treaties with the Indian nations. Many of the treaties provide that health care services would be p r o ~ d e d the citizens of Indian ~ t i o n s . to Some have asserted that these contracts between the United States and Indian governments represent the "first pre-paid health care plan* in America.
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EXHIBIT 47
In Support o Plaintiffs Opposition to f Motion to Dismiss on TPA & I S H Samish v. U.S., No. 02-13831.

Case 1:02-cv-01383-MMS

Document 60-50

Filed 05/02/2007

Page 2 of 2

The Federal obligation for the provision of health care services to Indians also arises out of the special trust relationship between the United States and Indim tribes, which reflects the authority found in Article I, Section 8, Clause 3 of the U.S. Constitution, and which has been given form and substance by numerous treaties, Federal statutes, Supreme Court decisions, and Executive Orders. The first Federal statute authorizing the appropriation of federal funds to carry out the United States7responsibilities, including the provision of health care, to Indian people was the Synder Act of 1921(25 U.S.C. 13). The Snyder Act served as the authorization for provision of h d t h care services to American Indians and Alaska Natives until 1976, when the Indian Health Care Improvement Act (26 U.S.C. 1,501 et sq.) C'IT,CTAn)b e m e IsF. %e IflCEA wss the? . first comprehensive statute specifically addressing the provision of health care to Indians and the Federal administration of health care. a. Evolution of the Indian Health Service Prior to 1954, the Bureau of Indian Affairs within the U.S. Department of the Interior was charged with carrying out the United States' responsibility for the provision of health care to Federallyrecognized tribes and tribal members. However, in 1954, in response to increasing pressure from the public health community that Indian health care responsibility should be transferred to his authority, the Surgeon General, acting through the Public Health Senrice ("PHsn), established the Division of Indian Health ("DIH") to administer the Indian health program. In 1968, the Division became the Indian Health Service ("IHS") and operated as a subagency of other agencies within the Public Health Service including the Health Resources and Services Administration. In 1988, the Indian Health Service was established as a separate agency within the Public Health Service. On October 1, 1995, the Department of Health and Human Services ("DHHS") reorganized its internal administrative structure and the Indian Health Service, along with the other agencies of the Public Health Service, became a separate operating division of the Department. Presently, the Director of the Indian Health Service i appointed by the President and is subject to Senate confirmation s pursuant to 25 U.S.C. 1661ta). Under current law, the IHS Director reports to the DHHS Secretary through the Assistant Secretary for Health. l Since the 1995 reorganization, a l agencies, operating divisions, and programs within the Department, including those previously part of the Public Health Service and under the direction of the Assistant Secretary for Elealth, have been required to report directly to the Secretary. Under the DHHS restructuring, the position of Assistant Secretary for Health was combined with the position of Surgeon General and the Office of Public HeaIth and Science ("OPHS) was established. The Assistant Secretary for Health directs the OPHS, serves as the Secretary's senior advisor for public health and science, and provides lezdership and coordination across the Department on public health and science issues. A key component to the IHS health care system is the Public Health Service's Commissioned Corps. The Corps was established by the Congress in 1889 as part of the Marine Hospital Service,