STATEMENT OF GORDON KITTO Mr. Chairman, I would like to thank you and the members of the committee for this opportunity to appear before you on the school construction issue. I am Gordon Kitto, Superintendent at Crow Creek Reservation High School, which is on the Crow Creek Sioux Reservation in Central South Dakota. I am asking for school construction appropriations for the construction of an elementary and secondary school building, to be built on the Crow Creek Sioux Reservation. This appropriation will provide a K through 12th grade educational system including classrooms, administration support, community involvement area, needed housing for the isolated area and opportunity for involvement of state physical education program. In an isolated area such as the Crow Creek Reservation, all human endeavors are basic to all concerned people. The prime focus, other than the necessities of life, is education. Education has long been the tool by which competent, successful members of society are molded. With this premise in mind, in conjunction with the Self-Determination Act of 1965, we Indian people firmly believe that we too can fulfill the premise that in our schools we can and could train competent, successful Indians who can compete in this multi-cultured, technological society. Among the major points of the basic philosophy by which we foresee our major respousibilities to our students both now and in the future, are: The main question then becomes a major point. Although we have facilities that have been handed down through the Church and a building which was constructed by the government in 1955, which, at the time, was inadequate to house all students of our reservation. The BIA educators decided that the high school students would attend public schools in the area. The students had to travel 35 miles one way, at the minimum. The success ratio of our students graduating from these schools has been most dismal. We believe, therefore, that what has been promised by the Big Bend adequately. The elementary school is over twenty years old and while it is safe construction wise, it has large cracks in almost every room and the maintenance of the old bathroom facilities and heating system is costly. There are at least four classes being held in temporary classroom buildings and due to the lack of space, the kindergarten classes are held in half-day sessions to accommodate the number of students. 1. 2. 3. ELEMENTARY SCHOOL & HIGH SCHOOL TO BE BUILT AT FT. THOMPSON A Tribal Resolution for a new school was passed on 39,978 sq. ft. elementary building has been applied Renovation funds for 3 million dollars have been re- Attendance at the present time: 250 students attend schools in area The projected enrollment shows an increase of 25%, due to the population on the Reservation. The average age on the Reservation is 17, implying that the young people are either remaining or returning to the Reservation. The younger adults will have more children to educate. NEVADA URBAN INDIANS, INC., HEALTH PROJECT STATEMENT OF DIANE TIBBILS, DIRECTOR Senator MCCLURE. The next witness is Diane Tibbils, Nevada Urban Indians, Inc. Ms. TIBBILS. I direct the Nevada urban Indians health project. Its headquarters are in Reno, Nev. We serve four cities in Nevada: Carson City, Reno, Sparks, and Winnemucca. This project is fairly new. We were just recently funded through Indian health services, September 1978, serving approximately 3,000 Indians primarily, which are made up of native Nevadan Indians from Nevada. We derive a lot of our Indian people from the fact that the average size of the reservation in Nevada as only about 10 to 20 acres. Therefore the urban area is a primary area for the Indian people to go to. Second, the native Nevadan Indians of Nevada have been traditionally a very migratory people and have moved from what we know now as city to city but area to area. We have been experiencing some very severe problems with our Indian people primarily in dealing with the substandard health care that exists and also coupled with the fact that Reno, which has a majority of the Indian people, over 2,000, residing in there, is experiencing an economic boom that has caused severe inflation in health and housing. These stresses have increased the substandard health problems we are experiencing. The National Chamber of Commerce survey of cities found that Reno had the sixth highest cost of living in the United States, the fourth highest in the Western States. The two areas they cited for this were health and housing. To follow this up, for instance, the national inpatient hospital cost per day is $193. For Nevada, it is $254.32, a difference of $66 a day. In one hospital in Nevada, it rises as much as $350 a day for normal inpatient services, an average. An initial visit to a private physician is $41; followup is $17. Contrasting this to the urban Indian, which is, again, I say, a native Nevadan Indian, native of Nevada, we find urban Indians have an average income of $6,500 and for the non-Indian, it is between $11,000 and $12,000, a difference of 56 percent. The family size of the Indian family that we serve is 70-percent higher. Our unemployment rate is 248 percent higher, almost 21⁄2 times higher than the non-Indian unemployment rate. The mortality rate of Indian people that we serve is 22 percent higher. The birth rate is 60 percent higher. As you see, these problems are very acute. The moneys that we currently receive, $125,000, is simply inadequate for us to get into just basic primary health care. We are requesting that Congress appropriate another $117,000 to Nevada urban Indian health projects so we can get into basic health care, primary health care. I don't think this is an exorbitant amount of money to serve four cities. It averages out to about $65,000 per city, and over 3,000 urban Indians. We further request that the Congress look at the need for increasing Indian health services contract health care dollars to the full State of Nevada. We are requesting that they add an addition al $500,000 so that the native Nevada Indian who is eligible for those services may receive these services right now; although they are eligible, due to the lack of funds, they are often not served at all. Or if they do go for contract care, which is to go to a physician, say, in Reno, they find themselves being constantly billed by the hospital or the physician, because Indian Health Service returns the bills that are due. They do not pay them because they do not have enough money. The closest Indian health hospital, by the way, is really an outpatient clinic. It has never been approved by the joint accreditation. It is 160 miles round trip from Reno. We have a distance of 334 miles round trip between two of our cities that we serve, so in between that there is not much. It is desert. So we appreciate any consideration that we can have in looking at our appropriations. Thank you. Senator MCCLURE. Thank you very much. [The statement follows:] STATEMENT OF DIANE TIBBILS Appropriation Request: Currently, the Nevada Urban Indians, Inc., is contracting with the Indian Health Service for $125,000 under Title V of P.L. 94-437 (Indian Health Care Improvement Act). The catchment area served under this contract covers four cities (Reno, Sparks, Carson Cityand Winnemucca) and services approximately 3000 Urban Indians. The Nevada Urban Indians, Inc., specific appropriation request is twofold: 1) That the fiscal year 1979-80 funding of the Nevada Urban Indians, Inc., Health Department be increased from the base of $125,000 plus 6% to a base level of $250,000. This increase reflects the need for funds to cover health personnel, medical supplies and equipment needed to minimally support primary health clinics for the four cities within the described catchment area. The major clinical operations are planned for the Reno area through & combined clinic with the Reno/Sparks Tribal Council. 2) That Indian Health Service Contract Health Care monies be increased for Nevada by $500,000 to allow the off-reservation (Urban) Native Nevadan Indians the opportunity to fully participate within contract health services. At the present funding level of $3,000,000, there is not sufficient monies to allow these Indian people to completely utilize the much needed health services that they are eligible for as of August 4, 1978 through a Department of Health, Education and Welfare ruling (Federal Register, Vol. 43, No. 151, 8/4/78). Statement of Problem: The Indian population nationally, as well as in Nevada, is young, growing and becoming increasingly more urban. The median age in 1970 was 20.4 contrasted with 28.1 years for the United States as a whole. This urbanization movement has brought a change in lifestyle, occupation and certain attitudes and customs. However, a combination of historic, economic, social and cultural factors has contributed to the depth and persistance of Indian poverty in the urban and rural area. Limited job opportunities, generally low incomes, relatively poor education and unskilled occupations offer little opportunity for rising above the poverty level. More over, discrimination often closes the doors to upward social and economic mobility. For the Nevada Urban Indian, the issue of health care is a major concern. The choice of relocating to an urban are is often hindered by the lack of health care available. Suitable employment may take months to find, if ever, and the insurance provided through any employee plans is usually inadequate or inaccessible due to unaffordable deductibles and premiums. Deductibles of $100 on medical/dental coverage and family premiums running as high as $50 per month are prohibitive when the average Urban Indian family earns only $6500 annually (as compared with $11,500 annually by the rest of the population). Contract care services for off-reservation Native Nevadan Indians are provided, yet reimbursement monies to the contractee is often difficult to receive. When contract care through private practitioners or hospitals (the contractee) is authorized, it is assumed that payment of the incurred bill will soon follow. Unfortunately because of lack of monies from the Indian Health Service for contract care in Nevada, payment of bills may drag on indefinitely. It is the patient who was led to believe his/her health care costs were covered who is hounded for payment, not the IHS contractor. The one consulation is that services were rendered, and the immediate health problem cared for. Out-ofstate Indians have no coverage for illness, cannot be authorized for contract health care, thus being eligible for only the basic primary care services available at the service unit. This factor accentuates the problems faced by out-of-state Indians. If the need arises for secondary or acute medical attention, the out-of-state Indian must either go back to the tribal setting which disrupts his schedule, job and life, or go without health care which could lead to serious illness or death. The figures for morbidity and mortality on Native Americans exceed overall populations figures. In Nevada, the mortality rates are: Native Americans 10.46 per 1000; Entire Population 8.16 per 1000. This shows a 22% higher death rate among Native Americans as compared to the entire population. Morbidity data shows the incidence of illnesses with 1. respiratory 2. accidents 3. mental disorders 4. endocrine, and 5. diseases of the eye heading the list in Nevada. In our catchment area, the problems faced by those migrating to the city are particularly severe. Because of the apparently booming job market, there has been a great influx of both out-of-state Indians and Native Tribal Indians to the urban areas of Nevada. In 1978, the Nevada Department of Employment Security found that during the peak employment period in Reno, Urban Indians still experienced the highest unemployment rate of any significant segment. With an overall unemployment figure of 2.58, Hispanics followed at 4.3%, Blacks at 5.7%, and Indians at a searing 8.7% unemployment rate. These figures were compiled while the city was experiencing a tremendous economic boom due to the expansion of the gaming industry. Indian people drawn to the area by what they thought were unprecedented employment opportunities found low wages, high housing costs and even higher health care costs. The National Chamber of Commerce conducted a survey in 1978 on the cost of living in America's major cities and found Reno has the sixth highest cost of living nationally and the fourth highest of the western states. The following housing costs were figured from September 1978 by the Truckee Meadows Housing Service Center in January 1979: Studio rentals up 8.4% to an average of $244 per month; One bedroom rentals up 10.38 to an average of $287 per month; two bedroom rentals up 15.8% to an average of $336 per month; three bedroom rentals up 7.5% to an average of $419 per month. A vacancy rate of less than 48 remained during the time this survey was compiled with the majority of available rentals accepting adults only. The average Urban Indian family with an income of $6,500 per year has three children which demonstrates their inability to find or afford adequate housing. |