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Ms. CARPENTER. At this moment we have 28 people with the health project.

Senator DECONCINI. Where did your funding come from?
Ms. CARPENTER. From IHS.
Senator DECONCINI. All of it?
Ms. CARPENTER. Yes.
Senator DECONCINI. Except for CETA?

Ms. CARPENTER. Yes, we have $184,000 under Public Law 437 and $143,000 for title V moneys. Last year we asked for $15 million, which was granted to us for our people across the Nation, and President Carter cut it. And I feel like if we can get this back to the original $15 million or even add this amount of money into the budget, it would be a tremendous help.

Senator DECONCINI. You say the President cut it? And did Congress appropriate it?

Ms. CARPENTER. Yes, Congress appropriated it and then the President cut it.

Senator DECONCINI. I have no questions. Thank you very much. Ms. CARPENTER. Thank you for your time and consideration. [The statement follows:)

STATEMENT OF RITA CARPENTER

Mr. Chairman, members of the Subcommittee, I thank you for this opportunity to speak before you today. My name is Rita Carpenter and my Indian heritage is Cheroker. I am requesting $1,127,236.00 from this committee to expand services and the development and expansion of the health program of the Dallas Inter-tribal Center's Clinic. My reytist is submitted because some simple truths and actual facts support the needs of our people to survive in the only country they have ever known. The way of liír which is called "American belongs to the frontier. At all times, and even now, the first associations with the frontier are with the Indians. However, the days of the frontier belong to history. The Indians now live in peace and more and more we will live as do our white neighbors, but it will be a long time before the Indians are absorbed into the white population and lose our community background and tribal traditions. Yet the Indians of the past occupied the United States thousands of years before other ancestors knew there was such a country, acquired a store of knowledge as to the kind of life necessary to live in this country, domesticated the most promising of its wild plants, and thus, by experience, knowledge and achievement laid an economic foundation good enough for the building of thesc United States, so it cannot be denied that the Indian has an important place in American History,

There is a Cherokce prayer that says, "Oh, Great Spirit, help me always to reinember that when my brother does not keep step with me, perhaps he steps to the beat of a different drummer."

The urban American Indian travels to the boat of a different drum. a ruin brat that often spells out strife in pounding rhythms. overty in muslied rolls, success in infrcquent syncopation and health in resounding beats.

He has wandered from the rural and reservation cnvironment to sample the hopes of city life - education, a better job, more comfortable housing and higher pay. But he often finds that the bait is imbedded with a painful hook that sangs him helplessly to a world he has no comprehension of among people who have no understanding of him.

He has closed the door on the attendant miscries of rural and reservation: ind infant mortality rate three times the national average, and average lifespan of 44 mcager years due to disease and malnutrition, a suicide rate 10 times the white man's and i school drop-out rate of twice the national average only to open the door to culture shock, loneliness, loss of identity and total displacement in a sprawling metropolis. He still moves to the drummer of the rural and reservation in a society that demands he listen and adhere to a more rigid, faster tempo.

Approximately one-half of the Indians in the United States have chosen to risk the odds of city life to the almost certain poverty of the rural and reservation and about 20,000 of them, representing more than 100 tribes have chosen thc Dallas/Ft. Worth metroplex as a home. Up to 2,000 migrate here annually from areas primarily in California, Arizona, New Mexico, Oklahoma, Mississippi and the Dakotas. The profile of the Dallas iFi. Worth red man is a profile of courage and endurance, but a profile hardened and scarred with poverty and alienation. Until a few years ago, this profile was accepted as the unalterable fate of people who could not cope with urbanism.

But then a swell of comradeship rippled in the Dallas Indian community and a wave of cultural pride and a tide of desire to improve their living standards and restore the dignity of their race arose in the shadow of Dallas on the south side of town, the Dallas Inter-tribal Center opened its doors in 1971, with no money, one volunteer doctor, one nurse and borrowed drugs, to minister to Indians with health as their main concorn. Since then the clinic has received over 13,000 office visits because the realization that bealth an affect one's personality, ambition and way of life. Preventive health is achininistereel if the clinic and referrals are made to larger hospitals for serious illnesses. Upper respiratory infections plague 40% of the clinic's patient and other common illnesses are malnutrition, allergies and anemia and sadly, statistics show that 75% of Invian women's pregnancies do not receive prenatal care.

Realizing that 45% of the Dallas Indians have never receivei dental care the Dallas Inter-tribal Center is working conjunctively with the Dallas City Dental Ilealth Programs to initiate these services. With supportive funds the goals and objectives will be: 1) To instill appreciation of good dental health and motivation for preventing dental disease among the population served by Dallas Inter-tribal Center. 2) To restore to oral bealth as many as possible of patients served by Dallas Inter-tribal Center. 3) To provide dental services in a manner culturally acceptable to Native Americans. 4) Tr motivate Nattive Americans to pursue careers in dentistry. 5) To train Native Anericans on site .15 dental assistants.

With the significant increase in the demand for outpatient services, the Center was obligated to seek out necessary hcalth manpower which was available through the National Health Service Corps. Upon application and eventual designation as a medically underserved area, the Center was notificed that a physician, a physician extender, a dentist and a dental hygienist would be appointed upon availability.

While attending the Indians medical needs, their other problems came to the forefront. In 1978, an informal survey was conducted by the Dallas Inter-tribal Center to assess, in

a very general way, the mental health resources available to Dallas Indians. Agencies
contacted (21) had no Indians enrolled in their programs, nor any past data. Agencies
referring clients for mental health care felt it was difficult to arrange referral to major
providers of mental health care for a variety of reasons, especially when dealing with
Indians.

Some of the major reasons cited were: (1) Indians were not utilizing mental health
services; (2) Indians were not sure of the need for referral; (3) Indians felt that providers
f mental health care were not awarc nor able to identify with their problems; and (4) Indians
had negatives experiences with other health care delivery systems and had little notivation
to subject themselves to more.

Altitudes regarding mental health services vary, but most urban Indians are wary and even highly suspicious of these programs, even when the need for services appear to be obvious. It is the general view of mental health and its definition which must be carefully delt with by those providing the care.

The Dallas Inter-tribal Center lends a helping hand in legal aid, employment assistance, housing, transportation, welfare, drug awareness and crisis situations and offers recreations in bowling leagues, softballs, and basketball tournaments.

The Dallas Inter-tribal Center works on the assumption that the urban Indan is poor,
uneducated, undernourished and maladjusted to city life and statistics prove us right.
In 1969 the Department of Commerce reported that 40% of American Indians were living
below the poverty level as opposed to 13.7% of the total U.S. population. For every
$100 dollars other Americans brought home, the Indians made $61.00. Even the National
Institute on Alcohol and Alcohol Abuse reported the alarming disclosure that alcoholism is
at cpidemic proportions among Indians, at least twice the national average of 08.

Through the Dallas Inter-tribal Center and individual efforts the Indian in the Dallas/
Ft. Worth Metroplex is over coming some of the overwhelming orlds that accompany his
moved from rural and rescrvation with up until now minim. hd from Federal programs.
With your needed and grateful help in allocating this money the determination of Wallas /
Fi. Worth Indians to prevail over the pitialls of urbanizalon sind simulaneously keep
our culture viable, will overrule the threat of culture extinction,

The Indian's peace of mind, genuine sener of humor, sympathy for the unfortunate,
racial unity unbiased by social rank or cconomic status and the unalterable love for humanity
and nature are often misinterpreted as laziness, indifference, ignorance, poverty and lack
of motivation. But the native American does not ask his evaluator for his education, his
wealth or his acceptance, but only to hear the prayer again; we step to the beat of a
disscrent drummer. The days of the wild, wandering Texas Indian are over and frustratingly
few details of the Indian's everyday life-styles were recorded and preserved. But the
startling facts remain that the Native American population has long bocn described as the most
isolated and deprived minority in the U.S. based on any measure of income, health, education
and employment. The key behind the Dallas Inter-tribal Center's proven ability to provide
effective services to the American Indian population is an emphasis on delivering quality
health care rather than merely making it available.

Quite obviously quality health care for Urban American Indians inust immediately
and substantially be improved. With adequate funding the Dallas Inter-tribal Center's
Clinic can continue to enlarge and deliver efficient high quality primary health care so
long neglected of identifying unmet health needs of Urban Indians in the Dallas/Ft. Worth
Metroplex. The demand for quality health care delivery can only become totally offective
when an organization is permitted solvency through sufficient funds.

SUBCOMMITTEE RECESS

Senator DECONCINI. We will stand in recess now until 1 o'clock this afternoon.

[Whereupon, at 11:58 a.m., the hearing was recessed, to reconvene at 1 p.m. the same day.]

(AFTERNOON SESSION, 1:20 P.M., THURSDAY, MARCH 8, 1979)

NONDEPARTMENTAL WITNESSES

OPENING REMARKS
Senator STEVENS (presiding). My apologies for the delay.

The Subcommittee on the Department of the Interior and related agencies will now resume hearings for nongovernmental witnesses who wish to testify in connection with appropriations for the Department of the Interior and related agencies, including the Forest Service, Department of Energy, and Indian health and education programs under the Department of Health, Education, and Welfare.

In all, we have 4 days scheduled for outside witnesses and we still have a full schedule. I would again ask that witnesses keep their summary remarks within the time allowed so that the large number of witnesses, many of whom traveled long distances, can be heard. We must insist, again, on the 5-minute time limit, or be forced to adjourn without hearing all of the scheduled witnesses.

Let me remind the witnesses that their prepared statements will be printed in the record. We would prefer that you not read your full statement, but simply cover the main points and highlight any area that you feel needs special attention.

This will make for a much better hearing, and will allow all who have come to be heard. When your name is called, would you please present copies of your statement to our staff and take a seat at the witness table, and proceed.

Our first witness is Governor Alexander Lewis, Sr., from the Gila River Indian Community in south central Arizona.

GILA RIVER INDIAN COMMUNITY

STATEMENT OF ALEXANDER LEWIS, SR., GOVERNOR
ACCOMPANIED BY VELMA ALLISON, MEMBER, TRIBAL COUNCIL

Governor LEWIS. Thank you.

Mr. Chairman, members of the committee. I am Alexander Lewis Sr., Governor of the Gila River Indian Community. With me I have Ms. Velma Allison, member of the tribal council.

We are here again this year to testify to the need for a new hospital to replace the old one that has been in existence for a number of years, and it shows that it is beginning to deteriorate, or has been that way for a number of years. The services that they try to perform are limited because of limited staff and limited equipment. I have prepared some pictures which are with the statement. One of these pictures shows it looks like it is a trailer park.

We further explain that situation there. That is, because the present facility, the actual building, has become deteriorated and space has become limited. And therefore, they have pulled in a number of trailer houses in order to provide services to the people, and also to have a place to file records, and so forth. At a number of times and places within the structure, they have knocked holes through the wall in order to pull in a trailer house to make more room available.

We feel at the present time that it does need a new hospital so that better services can be performed. We are located 35 miles south of Phoenix. In Phoenix there is the Phoenix Indian Medical Center, but the local hospital, because of limited services, a lot of the people that have transportation cannot afford to make the trip into Phoenix Indian Medical Center to get services. And by the same token, even though they do get services there, also probably it limits services to other tribes in the State of Arizona.

We feel, if a new hospital is provided and funded, that the services there would be made available to local people, so that maybe more other tribes can be given services at the Phoenix Indian Medical Center. In the particular area, the population has increased and the facility we have there is just not the type that would provide services needed for our people of the Gila River Indian Community.

Senator STEVENS. I think we are all familiar with these facilities, and we would certainly like to upgrade them as quickly as we can, Mr. Lewis.

Governor LEWIS. Yes.

Senator STEVENS. There are some budgetary constraints, but we will do our best and will confer with the Senators from your State before we make our decision.

Governor LEWIS. We thank you very much, Mr. Chairman.
Senator STEVENS. Thank you.
[The statement follows:)

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