WELFARE REFORM IMPACTS ON TRIBAL SOCIAL SERVICES:

A NATIONAL FORUM

Sponsered by the National Congress of American Indians

Thursday, April 23, 1998

Double Tree Hotel LLoyd Center Portland Oregon        

TAPE TRANSCRIPTION       
 

Welcome - Moderator

Invocation - R. T. Burke

Address - R. Allen
 

HOUSING AND TRANSPORTAION
D. Goff
L. Bingham
D. Burnie
R. McKay
E. WalleR
 

ALCOHOLISM and SUBSTANCE ABUSE:
M. Echohawk
A. Ladamer
 
EMERGENCY ASSISTANCE:
J. Bushman
E. Adams
W. Clarke
B. Greenstein
A. Klane
M.A. O'Neill E. Fox Discussion

CHILD SUPPORT SERVICES:
R. Mills
S. Sodamish
J. Olson

WELFARE OF ELDERS:
D. Baldridge
Y. Jackson
R. Barker
D. Cortora
B. Greenstein
 
 
 
 
  P R O C E E D I N G S

MODERATOR: If I could have your attention, please. And for those of you that would like to find a seat, we can go ahead and get started. We have got a very, very full agenda and hopefully a very exciting one in which we can address what I believe are some very timely and critical issues. In doing so, though, we are going to have to have your cooperation, your attention, as well as strong participation.

We would like to begin by welcoming all of you here. I know that all of you come from different parts of the country with different interests in regards to welfare reform because welfare reform takes in so many different types of programs all the way from social services to employment and training to education and to economic development.

Today we are going to be addressing one of those key components, and that's basically the support services on how we move people from welfare to work.

Before we go any further, however, we would like to get started by having an invocation. We have asked Raymond T. Burke, Mr. Burke, who is from the Confederated Tribes of the Umatilla Indian Reservation. We are very honored to have him here today. And where is he?

MR. BURKE: I am here.

MODERATOR: Oh, yes. We are very honored to have him here today. And as he is coming up, this is a gentleman who has distinguished himself as a veteran in World War II, as a tribal leader serving on tribal council and as tribal chairman, as a volunteer in being of service to the people in working with youth.

He has great spirit about being of service and of helping others. It's this kind of individual that brings honor to us as an elder, and an elder that we can hold, and brings honor to us, as I have indicated, on a daily basis.

We would like to have him do the invocation for us. I should also mention that he is the father of six children and the grandfather of 11 children. That's always critical.

MR. BURKE: I am glad to be here with you people today. I know many of you have done lots of things. I see packed with lots of good things, thoughts.

Today I was coming through the traffic thinking about the old people, thinking, gee, we are going to be late, we have only gotten 25 minutes to go, and we are coming through lots of traffic. Old folks used to have horses them days ago but they never used to have a worry about being late. Always kind of maybe that's where the Indian time come, start on their time when they get there. But it was good anyway even though we waited for our chief here. He just come in in a hurry, but he explain a lot of things just within seconds. Never make us so we won't forget.

But I want to say on greeting people, like he greeted, that we will greet today on Indian words, (inaudible). Greeted your people wherever you come from, the north, south, west, wherever you come from, to greet you at this big meeting. This is the kind of way our people used to do, to greet people. Whether they were white, whether they were different color, it was good to greet them. Somebody would tell them about what they said. So this, again, we are going to learn something today.

I was telling one man here, these things we have on the agenda, I don't know how many times we went through them. Today we are going to try again. Bring these things up. Maybe something that we forget, things that make us people kind of take notice when somebody brings something up to tell you or maybe the president reminds us once in a while.

Maybe the big chiefs of all the nations here, people that are going to have another big council, chiefs also, these people in mind and open heart, open mind, to tell us what we should do. Maybe if they can do it before things ever happen and we will leave and we will have something bigger to say.

This kind of things we got to be ready. It's like the stop sign says "Stop." Might be a man there with a little pole says "Stop." Then "Go." Reminds us so that we won't get in an accident. Lots of rules. Indians always respected. They called it the Tumanuet (phonetic). All the Creator's laws. Respect the ground, even the weather, the sunshine, the wind, all like that. Fresh air, with (inaudible) noses that go up in the air.

This morning everybody cleaned up. We are clean. Also we should have clean hearts when we come. Talk about important things. Indian people, Indian human beings. We do that with open heart, open mind, maybe things will be done. Do things, Indians follow spiritual physicalness.

Indians believed, had faith to survive, our people, especially all the blue mountains, faith to survive. Faith that the Creator would bring them all the fish in the tributary waters, the mountains that the white father left them. Seeded areas. These were important. This is the way the lifestyle of the Indian was, eat, live off of the land, good environment.

We lost that. Not much left. Maybe some of us are just a little speck on the map now. They want everything. No thought of kindness, no thought of other human beings.

Today we are going to listen to all the things in this agenda. Our people, the housing, have hard times. Some adjust it too high. Don't give the other people a chance. White man has the contract. Indians should have the contract so they can adjust to the Indian ways. Even the laws, have court outside. You always get beat but you have your own laws in tribal reservation. These at least give you a chance, your Indian ways, the habits of Indians.

Long time ago they used to never punish, fine them for money. Always a big switch. Maybe five lashes to start with. And they would leave. Not a one ever see you again. Comes back the second time, same offense, double the switching even if he is a big human being, older one.

Maybe it is good to go back about the people that used to go in the buggy days down the road, dusty, good country, forest, roads. I learn to drive a team

-- I hate to say how old I am today. I am 74 years old and seeing some of the old people. Also seeing some of the new things. How many have seen Buck Rogers funny papers.

Seen all of the new things that were to come. Even the white man (inaudible) it all and others that, oh, I can't believe that's ever going to happen. Fastest booming sound plane 3,000 feet per second, going to the moon. I have seen important days. First television, Dick Tracy on these launches that see on the other side.

Important times. We want to improve our people. Domestic violence, alcohol, drug. If I was to ask to raise your hand, you are alcoholic, (inaudible). Violence to each other, violence to your people, other people.

I guess honesty today -- handshake was binding. If we uphold them kind of things maybe we wouldn't have all of this. Today we could be at home taking it easy. Everything is going nice today. Tomorrow, too.

Had something here. Went to a prayer service the other day. Of all people I should see was there was this young negro, Meadowlark. Told the history, story about himself. Even the negroes have problems. White people have problems. Anglo people, I should call them. White human beings, and the dark human beings, and brown human beings.

I think many of us forget -- in our country we talk about the old man upstairs. Used to ride with my grandfather. His Indian name was (inaudible). Tom Ton was his name. Used to ride beside him. I could hear him talking. He said, "Tell the old man I always talk to you but never seem to help me. What do I have to do? Would you give me a good sign."

And I would ask him, "Why are you talking to him?" "Oh, the Great Spirit. He helps us if we ask him." He would (inaudible), human beings, different kind of human beings.

Maybe today when everybody leaves, have to talk to the old man for all of these things on the agenda. Nothing is impossible, they tell us, if we ask these people of the Council to go to work for us, help us.

(Inaudible) the invocation I was remembering the older people, those that come -- think about how you were. Are you honest? Are you going to help your people? Say we have to keep clean to do things. We will be honest. Go back home, tell them what you heard, tell them what you have seen.

This I heard at the prayer service the other day. You probably recognize this prayer. It was done a long time ago in one of the presidents, Lincoln's time when he had hard time, talking about his people. Maybe this fits in with us, too.

We have grown in number, wealth and power as no other nation has ever grown, but we have forgotten God and we have vainly imagined in the deceitfulness of our hearts that all of these blessings were produced by some superior wisdom and virtue of (inaudible) aided with unbroken success. The necessity of all redeeming and preserving grace too proud to pray. And God has made us in the holiest (inaudible) humble ourselves to confess (inaudible) sins and to pray for clemency and forgiveness.

I think this is important, like we always hear, listen to the elders, listen to the ministers, listen to the leaders of the reservation. Be humble, open your heart, take time to listen, voice your good opinion. I think these are important (inaudible) overcome. Open ourselves up. They will open themselves. Humbleness is something that very few have. Let us look at Creator once in a while, man upstairs, talk to him.

I know the war (inaudible) ending. People will say when is it going to end. All the people got together as one, people that went into Indian war was one. Ones that went to the Pacific theater, the Atlantic theater, was one. People that prayed for all the ending, prayed. We should do the same again. Maybe it will work.

I want to thank you again for letting me be here.

MODERATOR: Leyland, what are we going to do about space here? We are definitely overcrowded. Are we going to get it cooled down a little bit?

Make yourselves comfortable a little bit. Take off your coats, if you have coats, and relax just a little bit.

Again, for those of you that have come in late we would like to welcome you. We apologize for the little crowded positions. It's never clear how many we are going to have or not have, but it's clearly an indication of the interest that continues to grow in regards to the welfare of American Indian people and families and children.

As we get prepared for this we have a welcome by an individual who I have known for a number of years. When we look at new legislation, with every new legislation comes opportunities and challenges as well as concerns. But the man that will be introducing or welcoming us here today perhaps represents one of those individuals that is always, and I have to stress always, has been willing to take on a challenge, willing to take a look at what the opportunities are, but not to turn his head away from what the issues are as well, but to take a look at both and then begin to think creatively what can we do, where do we need to go, et cetera.

When I first met this gentleman, I think in Washington, D.C., he always had an answer to things. He carried his briefcase around and every time an issue came up he is reaching in his briefcase saying, "I think I can speak to that." It was obvious to know that when I first met him that he would eventually emerge, not only as a leader for his nation, but a leader across the nation of American Indian people.

It's been a honor to know him, to see his leadership, to see his creative courage and his willingness to step up to the plate and to address some very tough issues as well as to champion issues such as welfare reform.

Ron, we thank you for your support through the National Congress of American Indians and we welcome you here to this meeting to give us a welcome.

MR. ALLEN: Thank you, Eddie. I am honored to be able to be here with you and thank you very much for the introduction and nice compliments.

I welcome everyone here on behalf of NCAI. We are trying to help, take the lead in bringing people together across the nation to deal with the welfare reform legislation. I think that if I was going to try to get a single concept across to you as we engage in the discussion today on the various topics of welfare reform, that is the single concept of focus and perspective.

Last workshop we talked about the TANF programs and all the conditions and considerations that the tribe should look at with regard to TANF programs. We talked about the problems with regard to our economies and jobs, the issues that we have with regard to finding placements for our people in order to implement the Act, the deficiencies of the thinking of the Act.

We talked about the need for development of our programs for our children and for our families. We talked about the need to strengthen and enhance the overall government-to-government capacities and relationships and cooperation between the tribes and the local governments and the state governments in implementing this program and making sure that the Federal Government is owning up to their responsibilities to Indian country who is often thought of, dealt with, I should say, in an afterthought policy with regard to Indian issues.

And last but not least, last workshop, we talked about the need for data, the need for data to understand exactly what's going on in our communities and a way to measure are we making progress, are we getting further behind, are we fighting the odds against the frustrating conditions imposed on our communities.

We have a long history, a long history of survival. That's what Indian country has always been about. That survival has been passed down to us. You could hear in the spirit of Elder Burke from Umatilla Nations that we are taught to know and understand about what our mission is as leaders and as implementers of our program to serve our people.

So today you have a next set of issues that we need to discuss and think through. As we think about all the challenges we have in Indian country they are overwhelming. They are just flat out overwhelming. You deal with threats against our sovereignty, our fundamental foundation of who we are. You see threats against -- imposition of taxations against the tribes, undermining our ability to become self-sufficient.

You see threats against the tribes in new kinds of conditions that are unreasonable as we reacquire our homelands for the purposes of economic development, for the purposes of homes, the development of places for homes for our community, and so forth.

You see threats in the forms about our ability to manage our natural resources.

Last but not least, you see threats against our ability to conduct our religious, cultural and traditional affairs the way we have always done them. All of a sudden roads going through traditional and religious areas are more important to society than respect for religious practices and areas that are sacred to the Indian communities who have sacrificed so much for this nation. All those kinds of issues. And I am only naming a few.

You got ISTEA out there and the NASDHAA issues out there and so forth. There is a lot on our plate. Now you are focusing on just one of them, welfare reform. And in welfare reform there is a lot of issues. I name but a few.

What are we going to talk about today? We've got housing and transportation, we have the need to deal with the alcohol and drug abuse problems in our communities, we have the need to be able to figure out how we are going to provide better services for our children so that they can be able to be served.

We have the problems and needs of strengthening our communities and our relationship with our elders and so forth. There is going to be a lot of issues. And we've got some great panel members here who are going to talk about these topics, talk about the complexities of each of these issues, and how we are going to deal with them.

So I go back to the point of focus and perspective. We need to methodically go through these issues. Now, each of us have our own techniques. Some of us are more linear. We just deal with it from A to Z and move on to the next one.

Some of us have a more random approach on how to deal with each of these issues. We will bounce back and forth. Neither is right or wrong. It is the style that we use in order to learn and understand the issues that we are challenged with. That's what we are going to deal with today. You are going to have a list of issues.

I want to keep this brief because I know we have a lot of discussions, but there is a little phrase that says, either meet or work. You can't do both. So the issue is you are meeting in order to exchange ideas and thoughts. But after you are done we have to go to work to get the job done. That's the bottom line.

So the issue is are we going to be committed to do that and are we going to be committed to make a difference and continue to survive and make it work. We have a lot to do, we have a lot of people to educate. Ninety-nine percent of America does not understand who we are and what our story is all about and yet we have to continue to plug on and continue to make a difference and survive for the benefit of our people.

The spirit of Elder Burke clearly is what drives us. But we have to think about our children to make them stronger so that they become viable people within our communities and provide opportunities for their parents who are still looking for jobs in order to be able to deal with what their needs are so they can have a way of life that is only right for America Indian and Alaska native people.

I thank you for being here very much. I look forward to the dialogue that is going to take place today and the solutions you have coming up in terms of how we are going to improve the welfare reform legislation and its impact on our communities. Thank you. (Applause).

MODERATOR: You know, Ron, President Allen just went over a number of issues and challenges that face us. And we have to ask ourselves why is social services, family and children so important. And why is it so important that we have support services in the community to help families and children. And I think it all comes down to the fact that it is stated that you cannot have a strong tribe or a nation unless you have strong communities.

You cannot have strong communities unless you have strong families. And you cannot have strong families unless those children and parents are working together and have the kind of support and security that they need each day to wake up, to go to school, to go to work, to be consistent, and to have those kind of services that literally each day gives someone hope when they wake up in the morning that through some work and through some planning that their children will have the opportunity of a quality education, that as parents they will have the opportunity to be able to raise their children in an environment which supports the kind of values that they have held as well as their ancestors have held.

So what we do here to me is some of the most important work that we will ever do in strengthening tribal governments, in strengthening tribal nations, and in strengthening tribal families.

We often talk about how important economic development is, and it certainly is important; and how important all of the other kinds of day-to-day life things. But unless we have people who are together, unless we have parents who are teaching, unless we have children who are listening and growing, we lose the battle on the other fronts.

So today we are delighted because if you look we are talking about temporary services and safety net programs critical to Indian people. It talks about a synopsis of welfare issues, but we are going to add something to that. We are going to talk about a synopsis of welfare reform initiatives and issues. Initiatives in that we know that there are a lot of very interesting things going on out there from our last summit.

We know that there are tribes that had not been just sitting still, that most of the tribes have been looking, thinking, doing very critical thinking of how do we make this work. Do we want to take -- the question is to TANF or not to TANF. And the idea is what can we do.

Now, the majority of tribes have not been, as I have said, just sitting there thinking, oh, what's going to happen to us. Many of the tribes have been taking on and taking different directions, meeting with state, meeting with their internal organizations as well discussing that.

Federal Government has been at work taking a look at how they can coordinate and understand what resources are out there and how the communication and coordination can improve.

So today we want to address all of that. Now, let me lay out some ground rules for this. If you look at the agenda you will probably ask yourselves how are they going to accomplish that. I asked the same question. So we have got a major task on our hands here today.

Let me set some ground rules then. They are very similar to what we did at the last summit, that is, each of the panelists here will have only three to four minutes to state their initiative or concern or whatever they feel is most important that they can deliver to the audience. And I will be very strict on that, and I would ask that you -- myself and Leyland will be out in the audience, that if we give you the cut-off sign, that that's what that means.

The only reason why is because we have a number of people here that come with a lot of questions and concerns and we want to get those questions and concerns addressed. And the only way we are going to do that is to a very strict kind of time frame.

We would also ask that as we look at housing, transportation, alcohol and substance abuse, suicide prevention and on and on through the program, that any one of those topics are so broad we could spend five days on one of those topics.

So we are asking your questions as well as the comments from the panelists to be focused on what that has to do with welfare reform, such as on housing, how does housing impact moving people from welfare to work.

Transportation. How is that impacting welfare reform and moving people from welfare to work. So we want to be very specific and specialized on this topic.

Any questions on that? We will have microphones out there so that when the panelists finish their presentations if you raise your hand we will make a microphone available to you.

We would like for you to be very specific in your response, if you have a question, to direct your question. If you have a comment. We are certainly looking for comments and ideas as well. But if you could keep that as specific as possible we would certainly appreciate that as well.

Our first panelist -- we are going to try to cover two sections. One, if you look at housing and transportation. Do we have everyone up here? Who are we missing? Is Bernie -- got to come up here. Can't talk from the back of the room.

Because there are two separate areas here we are going to address, first, housing. And I would like -- for housing we have Mr. Dan Goff (phonetic), who is director of housing for this region. And we have also Mr. Leroy Bingham. Could you please raise your hand, Leroy. Bingham who is president of Tribal Planning Services.

Now, to get started here, one of the things on housing: We often hear that up to 25 percent of American Indians live in undeveloped housing with no running water, electricity, whatever, compared to like 5 percent for the rest of the nation. Now, that's unheard of.

When we start talking about welfare reform we are saying how important is it that individuals, particularly single parent mothers with children, have decent places to live if they are in fact going to move from a welfare situation to a work situation. We don't want individuals having to worry about heating or the roof leaking or not having a roof over their head so that they are able to make sure that their children are safe and that they are able each morning to get up and go to work.

I am interested to see what's happening in the world of housing, addressing that, and what are the concerns that, maybe, are not being addressed.

So let's first begin with Mr. Dan Goff.

MR. GOFF: Good morning. Your program says that Jackie Johnson was supposed to be here this morning. Well, obviously, I am not Jackie. But I am Dan Goff. A little about myself. I am a (inaudible) Quapaw. My family is from Miami-Oklahoma area.

Currently I am the director of housing in the northwest office of Native American programs. I have been at that job for about 20 years. Prior to that I was the executive director of the Umatilla Reservation Housing Authority.

A PARTICIPANT: Stand up.

MR. GOFF: Pardon me?

A PARTICIPANT: Go ahead and stand up.

MR. GOFF: Oh, I am sorry, please.

A PARTICIPANT: We can't hear you.

MR. GOFF: Beg your pardon?

MODERATOR: Go ahead and use the microphone as well. Here, this one at the podium is fine.

MR. GOFF: In response to the question that was raised, what's available to assist in the scenario that was set up, we have recently enacted new legislation known as NASDHAA, the Native American Self Determination and Housing Assistance Act, which provides much, much greater flexibility to tribal governments.

First of all, it gives control of the housing program on the reservations to the tribes rather than the housing authorities unless the tribe decides that they want to continue that relationship with the Housing Authority. But it does give the options to tribal leaders on how the money is to be spent.

Now, the scenario that was raised about leaking roofs, about running water, that sort of thing, those are all things that can be addressed using the NASDHAA grants. Previously it was always new construction, modernization on HUD constructed homes, and it was pretty limited.

Now, it's a much broader kind of an opportunity where existing housing can be renovated, improvements can be made. But these are decisions that the local governments have to make. They have to set the priorities as to where they think their housing dollars are best spent. NASDHAA is an entitlement grant. So essentially everybody who provides HUD with an Indian housing plan will be eligible for a grant that's put together on a formula basis. You may want to talk about that when you get into it.

There are other grants that are available through HUD, Indian Community Development block grants, that can very definitely be used in the area of economic development which is something I know that you are all very much interested in. There are TOPS grants, (inaudible) Opportunity Programs; there are drug elimination grants. I am trying to think of -- this is kind of out of my area. I have got some notes here if I can refer to them.

At any rate there is a number of grants that are available to Indian tribes that are all geared toward employment opportunities, training, helping families transition between poverty and being a working family. So I would hope that this morning we can talk about some innovations that might work for you.

Recently we had a program called Family Self- Sufficiency -- that was under Secretary Kemp -- which was not a bad idea. I think now under NASDHAA, with the flexibility you have, it might be something to definitely look at. The basis of that program was that the housing entity or the tribe entered into a contract with a family that said they would provide these services, they would provide these educational opportunities, and the family would agree that they would pay their rent, they would be responsible, they would do all of the things that they were expected to do to make this transition.

And as a reward the rent that was paid by the family was escrowed during this period. And if they successfully lived up to their contract at the end of that they were given that money as kind of a start-up to either get them a place of their own or get them started in business or whatever they needed the money for. So that was one idea. But you have got the flexibility to be able to do those things.

MODERATOR: Thank you.

MR. GOFF: Okay.

MR. BINGHAM: Good morning everyone. My name is Leroy Bingham. I am from Montana originally. I am a member of the Blackfeet Indian tribe. My background, I am not a housing person. I was one of the tribal folks who sat on the NASDHAA Negotiated Rulemaking Committee, and I came to it basically with an employment and training and a tribal planning background. So if you ask specific housing questions, and it doesn't look like this is a housing crowd, so that's good. Anybody with that stuff can talk to this guy.

But NASDHAA is a real earth-shaking event in Indian country. We can talk about it in the kind of clinical generic terms, we have this new act and it does these things, but it really is a fundamental

C-change (phonetic) in terms of how Indian housing is part of the tools that we need to bring about change in our communities.

I was listening to the words that Mr. Burke spoke this morning, and he said something that really touched on what I was hoping to get across here. And he talked about when there was a war, and all the people came together, and that's how we won the war, and that war continues in Indian country.

Well, it has struck me over the years that we have been given a number of different tools but we have never been able to bring them together as one. We have never been able to create one arm. We were sent out and given all of these programs that kept us working out of little boxes.

And so the housing people never talked to the employment and training people, never talked to the social services folks. And nobody was paying attention to what the health care workers were doing, and everybody operated in their own little boxes in their own little world.

And we have spent a number of years now -- my friend, Leo Cummings from Fort Berthel (phonetic) is here. Leo and I have been leading the charge the last few years in consolidating our employment and training programs together and finding smarter ways to work. We are not getting anymore money in Indian country for the most part, so we have got to find ways to work smarter with what we have had.

We have been involved in something called 477 that's made that happen on the employment and training side. Now, housing, with NASDHAA we finally have a program that, as Mr. Goff suggested, comes under tribal control. For years and years, in fact forever, Indian housing was separate and apart from what the tribes were doing.

The HUD people, the housing people, the folks at the Indian Housing authorities, they worked with HUD almost exclusively, and it was a competitive environment. I would write a grant, this gentleman would write a grant, this gentleman would write a grant, and we would go compete against each other, and we would beat each other's brains out because only one of us was going to get money this year. Yet all three of our communities had these terrific housing needs as Dr. Brown pointed out.

I grew up on the Blackfeet Reservation in one of those houses that Eddie was talking about, that you could have put about five of them in this room that we are in right now. And that's where three adults and four children were raised, along with my grandparents. That's why I got into the business that I got into. And it's one of the things that this gentleman spoke about in terms of one army.

We didn't come here to be grant managers. That's one of the things I realized after I got into the business. I was a CETA director and a JTPA director. And it occurred to me over a period of time that what we were doing was working out of these little boxes, and everybody was sort of doing their own thing, and we were never able to pull it together in terms of one comprehensive strategy.

NASDHAA finally allows us to do that. It gives the tribes the ability to take control and to bring housing finally under some sort of tribal direction. And it's a block grant now. That's a very critical piece. We are not competing and beating each other's brains out for funding.

They used to talk about doing Indian housing plans. It was a joke in the old days because you never knew. Every year you rolled the dice and maybe you got money and maybe you didn't. We are all pretty much familiar with that grant game. And it was kind of who you knew in HUD and what kind of a good grant writer you had and all of those kinds of things to determine whether you were able to get the dollars to do the job that you needed in your community.

Now it's a block grant. Every tribe that submits a plan, as he suggested, is going to get money. All you have to do is fill out the forms and get in the documents. So now tribes actually can sit down with some certainty that year after year they are going to see Indian housing money. It is so exciting to me to see that we are finally passed this now you have it now you don't kind of an environment.

We managed to do that with Indian child welfare a few years ago. Now we are doing it with Indian housing. There are $600 million in Indian housing this year. That's up, what, $150 million from the year before. And the tribes have control. They have control. They can either run the programs themselves or they can authorize their existing housing authorities to do it.

But by taking those programs, those housing programs, and talking amongst people like yourselves, the social workers and the folks that are out there working in the communities, the people in employment and training, housing can finally become an integral part of what the tribe strategy is for resolving the issues for these families on welfare.

Welfare reform is the great steam roller. It's coming down on all of us. Everybody is wondering how we are going to break that cycle. And housing has always been one of those pieces that was never able to be there when we needed to do the things that we needed to do.

So NASDHAA really does give us a tremendous opportunity if you use it. We were talking to some folks last night here that there is lots and lots of ways that you can take those HUD dollars and integrate it with the other things that you are doing and really help develop a successful strategy in dealing with welfare reform.

MODERATOR: Thank you.

While we are waiting for some questions from the audience let me ask you how much money is allocated under this new act?

MR. BINGHAM: Six hundred million dollars.

MODERATOR: Six hundred million. Is that sufficient if -- I heard a projection that if we really were truly interested in meeting the need of American Indians it would have to be more like 850 million. Is that correct or?

MR. BINGHAM: I am sure that that's correct, Eddie. We know we always need more money. There is simply no question about that. And with the formula funding it used to be that with going into a competitive environment only, maybe, a third of the tribes in any year were going to see any money. Now everybody gets a piece. So some of the folks who had been wildly successful in generating dollars may see a little bit less money.

We were happy that we were able to get the funds increased from 450 to 600 million. But we would certainly rather see a billion or better. That's certainly probably more appropriate for the job that needs to be done.

MR. MORRISON: My name is Levi Morrison from Umatilla Indian Reservation, and I was on that NASDHAA Committee also, and I know that 600 million is not nearly enough.

But what my question is for the panel is -- I need to make a comment also on Jackie Johnson. It's just (inaudible) that they are not here. I had a lot of questions for them, and I know they have specifics, because Jackie Johnson and Chester were both on the committee with us.

(End Tape 1, Side A.)

MR. CUMMINGS: We have to get people in housing, and how to work welfare reform and to put our people to work. What kind of a ceiling and what is the minimum, we can give our people, our tenants, to get into these houses and not set them up for failure.

A lot of our people right now are getting jobs because of economic development on the reservation, working at casinos and the golf course, stuff like that. Then they are making too much money to keep them into these units. How much flexibility -- the (inaudible) office in Seattle, how are they going to work with our tribes in the northwest? Thank you.

A PARTICIPANT: Well, there's a couple of issues there. The issue of the families that are now making a little bit of money and are becoming closer to middle income, that's a problem because this very specifically is aimed at low income people being defined as 80 percent of median income or below. I wish I had a good answer for you on that one. I don't. It is low income only.

As to the issue of flexibility, you can do virtually anything you want as long as you bear two things in mind, that it's low income housing related and -- and what else? It's low income and it serves low income families, is what I am trying to say, in a housing manner.

So if you can define an economic development opportunity or a training opportunity through construction or use community facilities for transitional job preparation, anything that the Housing Authority, or what used to be the Housing Authority, has generated can be used to help with this transition from welfare.

I am not sure that gets to your question

but --

MODERATOR: Next.

MR. BINGHAM: Can I respond to that question for just a second, Eddie, because I think it raises a really valid issue. And it goes back to this notion that they have had us working in boxes and they have had us working in a poverty environment.

The government declared war on poverty 30 years ago, and we were among the poorest communities in the country so we all signed on. We knew we needed those dollars, we needed those services in our communities.

But it's 30 years later and we are still in this mindset that the Federal Government only comes to help us if we are just desperately poor. And I think the gentleman raises a very valid issue and something that I think our tribal leaders, I know the folks on the committee, were very much aware of, is that NASDHAA is not a finished product by any stretch of the imagination.

And one of the things that we need to do as a people is to fight to make sure that we have the flexibility to raise ourselves out of that poverty and not create incentives basically will only help you if you stay poor, which is kind of where the mindset is. That's not what we need to be doing.

They have had us pitching to all the wrong things in our community and we need to be able to start doing things right. And if we need the flexibility to serve folks who aren't desperately poor because we manage to create an economic environment on our reservations, then we should have the right to do that.

You don't tell your landlord how to spend your rent check. And that's what they have been doing to us for a very long time.

And so I think it's one of those things that we need to keep angling -- we know we have a lot of work with very low income people. But once we start getting at that issue and we start raising that, and our tribal planners and our leaders are developing that economic base, we don't want to get to a point where we can't help our own people because --

MR. MORRISON: Okay, Leroy --

MR. BINGHAM: -- we are not poor.

MR. MORRISON: -- but let me ask you this question: Does that allow the tribe the flexibility to do exactly what you are saying?

MR. BINGHAM: To a degree it does, but there is also a cautionary tale there. And Leo and I know, and Gary Bibb (phonetic) here, some of the folks that have been involved in 477, which is the initiative on the employment and training side, go out there and try to be innovative and creative, and quite often you are going to take the bureaucracy on full tilt.

They do not know about innovative and creative. They talk about linkages for years and years. They want to know -- this guy is smiling. He knows what I am talking about.

They want you to write that when you write your plans. They want to know how you are going to integrate. And when you try to do that in any kind of creative fashion our experience has been they don't understand it. And if it doesn't look and smell like something that they have been doing, if it doesn't look like mutual help, if it doesn't look like low rent, they don't know how to deal with it.

A PARTICIPANT: Okay.

MR. BINGHAM: So as a group we need to find those innovations and then be willing and have the leadership to go out there and fight to get the right to do what we need to be able to do.

MODERATOR: Mr. Cummings, could you please, when each of you ask your question if you could state your name and where you are from, please.

MR. CUMMINGS: Leo Cummings from Three (inaudible) Tribes in North Dakota. My concern is on the other hand. You talked about people earning more. My concern, therefore, is on the other hand of TANF recipients that are being sanctioned that are in housing and therefore do not have the rent monies to pay for that. And yourselves have seen that NASDHAA is making the tribes -- this is their business. Now, if they don't got money to pay for the housing your business is going to go down.

A PARTICIPANT: That's a tough one because you have had the authority for over two years now to basically establish rents or home buyer payments at any level you want. You could transfer a house to an individual for no consideration, and that would all be perfectly legal. But what you are doing is killing any cash flow that your housing program has and virtually marking it for ultimate destruction or end.

I think that the key to this whole thing is to really -- Leroy said get out of the box, start thinking out of the box, forget what's gone on in the past, start trying to devise and come up with means on your reservation that work there, that fit, that best utilize housing dollars for the clientele you have.

MODERATOR: Okay, please.

MR. AMIL: My name is Wesley Amil (phonetic). I am a MSW, and I work as an independent contractor. I work in North Nevada currently. I am out of Boisie, Idaho.

My concern is at a national level, regional, state and reservation level I think, and as was in the opening remarks by one of the elders here, I think that is very much and very consistent to the vision.

I think the mission we need to really think about is we need to find some consistent values, and our policies need to be value based, and they need to be consistently based across all the spectrum because what I think we have seen in the past, like you have talked about, has been a conflict of values, really, we have run into.

So working with mainly juvenile offenders what I see when you go into a poor community, like we know that most reservations are -- in 1934 when we adopted a democratic form of government the thing we forgot to do, and the thing that I think today is very much inconsistent is the fact that we don't have that capitalism that drives the nation. I mean, we lack that on reservations.

So I think that we need to really focus on having a consistent value base in our policies across the spectrum. Not only that, we also -- you know, because when you bring in young Indian men into a program there is going to be his sense of coherence and that of a middle class white person. They are going to have a lot more resources to access than that young man and that family. So how are we going to develop strategies to enhance those families.

And also the ability I see in middle class America is they have access to credit. Indian people have access to credit maybe one time. I mean, all these gaming tribes, I think we should pool our resources so that we can develop sustainable businesses. And that's really truly where it's at. We need to create opportunity.

Once we are able to develop resources for families and strengthen families, we will bring families together. So my question would be what type of uniform strategies and value based strategies would you people, as board members here, panel members, develop, and what values would you use.

MR. BINGHAM: I think we are getting to an environment where we finally have the ability to start -- getting to a point where we can think about developing those strategies. In years gone by, with everything being disjointed and functioning out of different boxes, it was almost impossible to do that.

And I would like to go back to what Leo asked just a moment ago. In the flexibility that we find in NASDHAA now, among other things the tribe can lower rents for those families, the people who get sanctioned off of welfare. The tribe does now have the flexibility to basically even deed over the house to that family.

In years gone by there is a thing in the housing world they call TARs. And if you are a housing person you know what that means. That's Tenant Accounts Receivable. And in the old environment where you competed for grants, if you had high TARs you weren't going to get any money. So that was one of the conflicts, the inherent conflicts, that was set up. The only way that you could keep that cash flow that he was talking about was keep hammering on your people for those rent payments because if they don't make their rent we are not going to get any money at the Housing Authority next year. That's gone now. The Housing Authority does not have to worry about that. So that's one gun that's removed from their head.

So if you do have those families that Leo was mentioning that are sanctioned off of welfare that simply cannot pay because they just don't have it, it's not going to hurt the tribe now to maybe give them their house or make something available to them. It's not going to wound them in future years of funding. That's another very fundamental C-change that this new act brings to us --

MODERATOR: Let me ask, then. We have got a number of other questions, however. And this is a very simple question. A lot of the services, support services, that we have been talking about, whether it's child care or housing, or whatever, almost seems to pit the working poor against the people on welfare.

The question I have in housing, if you are committed to move people from welfare to work, and you have people who are qualified and are able to be on TANF, what is the commitment to make sure or to prioritize those individuals for housing to help them move? Is that a flexibility that the tribe has to set that prioritization?

MR. BINGHAM: It's absolutely a tribal decision now. The tribe has the ability to put them -- the other thing that the old HUD program used to do was you had a waiting list. It was a first-come first-served kind of a basis. Tribes now have the ability to create their own policies and procedures for those waiting lists.

So, for example, if it's a tribal decision to move all of the TANF families or welfare families to the top of the list, or move all the elders to the top of the list, they have that ability now to create that policy where they --

MODERATOR: Okay.

MR. BINGHAM: -- simply did not in years gone by.

MODERATOR: Thank you. I want to get to the two last questions, and then we are going to move on to transportation, please. Here.

A PARTICIPANT: My question -- I am with the Tribal Council for the Carvil (phonetic) Confederated Tribes in Washington State. I just have a kind of a comment and maybe a heads up for other tribes.

(Inaudible) Garden has been training our attorney general too, I guess, because they just issued a -- we are just coming into the construction season. One of the things we have been really trying to do is to get our tribal people in the contracts business, to get some of the head monies for the construction, and we have been getting a little bit of success in that in getting our people to work in those areas.

But now the attorney general in Washington State just issued a ruling that they are not going to give our Indian contractors state industrial insurance anymore, for now anyway. So if they can't get their insurance they can't get all the state certifications. And we have all these contract and procedures in place that require state licenses. And we are just stuck. I don't know what we are going to do now.

They are talking about a federal insurance plan, Senator Inouye. I don't know, maybe something like that is needed because we are just scrambling around now. We have got houses to build and people that can't get their certifications. So just kind of a comment and a plea for help, I guess.

MODERATOR: Thank you.

Is there one more question?

MS. SPENCER: I am Helen Spencer and work at the (inaudible) legal services attorney. I just would say on the sanction issue, though, we just recently completed our regions plan with the state. And in the tribal provision we are successful in getting provision to say that no one should be sanctioned by the state, who is a tribal member, without first going back to the tribe and seeing if they can't remedy what the problem is or work with the problem.

A PARTICIPANT: Good for you.

A PARTICIPANT: I would like to speak basically back to the gentleman -- Admil? Okay, Mr. Admil. There is one thing you might look into either through a consortium or a tribal consortium, and that's the CRA loans. People always think of those in terms of real estate loans, but they are also small business loans and that sort of thing that are made available through the Community Reinvestment Act.

MODERATOR: Okay, let's have one last comment because we have got to move quickly over to transportation.

Please, sir.

MR. BURKE: Oh, this is one of those things, maybe it's too far back but I am going to say it anyway. When they had contracts with HUD, on our reservation we had a big sign that says Indian Housing. Now we deal with HUD and no HUD. (Inaudible) housing, Indian housing. Especially when they go to court the tribe wants to evict people, people that come, prosecutors, want to evict them. This happened a long time ago.

But we called for all the people, Housing Authority, we called for HUD. HUD didn't show up. The party don't show up, they win. Housing was mad over that because we didn't do nothing about it. The third party didn't show up.

So this useless, this housing, HUD. Indian should have been the party that contracted it. Then we could have got them in court. These things are important to the Indian people.

Remember a long time ago people, you got to learn them, teach them health, good health. I remember our people, chiefs go to Washington, D.C. Roll the carpet out for them. Give them what they want, get rid of these Indians. Don't want to hear about it.

But now we have to write the whole ledger. What about the treaty time. Come visit us. You are my children. Now we have to write a whole ledger, maybe two or three ledgers, to get to see the HUD or the president. (Inaudible) is important. We must not leave them out. And they will go see the president. I am your children. Help me. I am the chief, you get me a house, free one.

Still waiting for my 20 (inaudible) of gold. That's something else never transported to us. Still waiting. Maybe I should give the sign like the Indians used to, give lots of talk and then -- always broken one place or another. I hope we can help all these people. This is important today. Think about people that's in it, HUD, attorneys. These people, they should give advice too. Not just leave the Indian.

They went to a store one time, was golfing. Told us to open the golf course. So I was wondering, gee, how am I going to hit that ball over the pole way down there. Studied quite a while, pointed it out. This is what I have seen on TV, I was telling myself. Maybe I'll try it that way. And as I aim down there, I swung, I look down and made the round circle and (inaudible). I couldn't see it. "Oh, that's a good shot." I was going to look for the ball. Couldn't see it. Maybe that's the way with some of us today.

Then I went to the store. I am going to learn how to do this -- book store. They had a book. This lady turned it upside down. So I paid for it and walked outside and look at the book. You know what it said? Golf For Dummies.

MODERATOR: Mr. Burke?

MR. BURKE: Yeah.

MODERATOR: Appreciate those comments. We are going to move along. And I think all of those presented, the bottom line here is as Mr. Burke stated, it used to be we went to the Federal Government and said where is our house.

With the devolution of government and putting the responsibility and the money back in the community we no longer go to Washington and say where our house is, but we go to the tribal council, we go to the tribal administration, and we say where our house is.

A PARTICIPANT: Absolutely.

MODERATOR: So the creativity that we are talking about we know we still don't have enough money and the tribe is expected to be very, very creative so that greater pressure is put at the tribal level, the tribal council and tribal leadership of how do we take what money we have and put it to work in the most creative way of providing quality shelter for Indian people. But clearly it goes back to the tribal government.

Gentlemen, I want to thank you. Don't leave there. I want you to continue there. We have got to move on to transportation. Let me set the stage quickly.

Some of our researchers said that transportation was mentioned as one of the main barriers to putting TANF recipients back to work.

Judging from some of the comments of a state worker, it says the biggest problem is that people tend to live far out from the nearest town. There is no public transportation.

People in remote areas are isolated. They need assistance to get to the state office. The tribe owns a bus but there is nothing to help people get to work. Their available transportation is not adequate for maintaining employment.

A TANF recipient stated, "My transportation is definitely not adequate. My truck is always broken down. The further I go with my education and training the harder it is. I am not close enough to town, I am not close enough to stores. My aunt has to take me shopping. I have to go 30 miles for gas."

A tribal social service provider stated, "Our transportation problems are shocking. We are close to the city yet we are still isolated. It's like there is a big wall around our community."

So transportation is critical. They are saying it makes no difference. If you have got a job people are not going to hire you if you live many, many miles away. If you can't get there, there is no reason why you should take a job, et cetera.

Let's first go with talking about some of the initiatives. I want to turn to Doug Burnie (phonetic) who is the Welfare To Work coordinator for the Federal Transit Administration.

MR. BURNIE: Good morning. At the Department of Transportation we agree for the last year and a half to two years we have been working very hard to make sure that as welfare reform moves forward transportation isn't a forgotten issue.

At the Department of Transportation we are saying that transportation is actually the "to" in Welfare to Work because you can't get a job if you can't get to a job. According to the Administration for Children and Family, they have been saying that only about 6 percent of welfare recipients own automobiles, and that the automobiles that they own are worth between six and $700. So that means they are not all that reliable.

So we are going to have to depend on public transportation and some kind of specialized transportation to get people to support services and to jobs if we are going to be successful with welfare reform.

Unfortunately, at the beginning of welfare reform transportation wasn't very high on the agenda. I got a call about a year and a half ago from the Administration of Children and Family saying that they were evaluating the first states that had been granted the waiver prior to the passage of the Welfare Reform Act. And guess what was the major problem. It was transportation.

When I went to that conference call with the states and some of the regional offices I asked them what kind of planning had they done for transportation when they had gotten their waiver. And it was dead silence. So there wasn't much by way of anticipation.

And the TANF plans that have been submitted, very few of them mentioned transportation. But we know we are not going to be able to succeed if we can't get people to jobs.

Now, what we have said the basic problems were in terms of transportation is where the jobs are and where people are. This is both true in the inner city and in the rural areas. Most of the jobs in this country are growing in the suburbs and yet it has some of the poorest connections vis-a-vis public transportation.

Also, the jobs tend to take place, entry level jobs, not necessarily during the nine to five work hours. They are often during shift work. So that means they are going to be late at night or on weekends. And guess what happens to the public transportation we have late at night and on the weekends. It's very difficult.

And also about 90 percent of the people who are on welfare are mothers with children. And so those trips aren't just getting on the bus and going to work. They tend to be very complex trips getting your children to welfare.

Now, this is a very difficult problem and it's easy to get discouraged about it. But one of the things we have been trying to do is get that on the agenda both with the TANF programs and the Department of Labor with their three billion dollar welfare to work program. Because typically people on the human services side, the way they tend to think about the problem is here is a subsidy, here is money for the transportation. But it does you no good to have a subsidy if the transportation isn't there in the first place.

So we work very hard with DOL and HHS to make sure that those TANF dollars and those welfare to work dollars, the $16 billion a year for TANF and the three billion over the next two years for welfare to work can be used not only to support individuals' transportation but actually to create transportation.

In addition to that many of you may have heard that the highway and mass transit programs are being reauthorized right now. It's called ISTEA. The Congress is looking at those programs right now and reauthorizing them. As part of that the administration has proposed a program to put additional dollars out there to help make those connections to connect low income people as well as welfare recipients to jobs and support services. And the Senate has passed that bill, and the House has passed that bill. And each of them have reserved $150 million annually for that.

But it's a good time to be talking to you because we haven't decided exactly how we are going to administer that program, so this is a good opportunity to talk about that.

MODERATOR: Let me just ask quickly. Is it ISTEA money we are calling it?

MR. BURNIE: Yes. It's --

MODERATOR: Okay.

MR. BURNIE: -- access to jobs, and it's part of the ISTEA reauthorization in the Senate and the House --

MODERATOR: And that money is coming down. And how much has been appropriated nationally?

MR. BURNIE: Nothing has been appropriated. The bill is just --

MODERATOR: It's just a request?

MR. BURNIE: -- reauthorized. So we know that the glass is $150 million. The appropriators have put no money into it yet.

MODERATOR: Okay.

MR. BURNIE: They are waiting for the final passage --

MODERATOR: And you are saying that no decision has been made as how that money would be distributed, whether a portion of that would come off the top to tribes?

MR. BURNIE: That's right. It's a competitive program, but the details of how it will be administered are yet to be determined.

MODERATOR: Okay. I think that's important to know. Okay. Thank you, sir.

Next, we have Mr. Robert McKay who is chairman of the CAL Transit Native American Advisory Committee with the State of California, Department of Transportation.

MR. McKAY: Good morning. Like you said, my name is Robert McKay. I am (inaudible) from Northern California.

What I will be addressing today mainly would be dealing specifically with California and the problems that CALTRAN sees in California. I guess all of you kind of heard it before. California consists of about 104 federally recognized tribes. CALTRAN broke up into like 12 different districts.

Within the State of California we have what is called an MPO and RPTAs. Metropolitan Planning Organization and Rural Training -- Rural Planning -- anyway, RPTAs, whatever. Today I am lost for words. But anyway they are the ones -- the RPTAs and the MPOs are the ones that control 75 percent of transportation monies that comes into California.

All the tribal governments within the State of California, if they have a plan or they want to get some type of input on how transportation is going to affect their people getting from point A to point B, point A being where they live, point B being where they want to go to work with this welfare reform, they basically have to get a hold of the MPOs or the RPTAs, whichever one is in their district.

And one of the best ways to do is to find out what district you are in, CALTRAN's district, and who is the administrator of that district, the district director, and find out what MPO do I fall into to go apply for the type of changes and let the MPO know the needs that we are experiencing here in California. And you have to be put on a list.

It's kind of like, yeah, we can help you but get in line. Oh, incidentally, on all the RPTAs and MPOs no tribal government sits on any one of them. So we basically know where they put the emphasis on the input that they are going to get. It comes from non-Indians.

The other thing is that CALTRAN itself is just now in the process of developing a proposal to submit to Department of Labor and probably to Department of Transportation when it comes into reality if they do get any part of that glass of $150 million. We will probably be writing a proposal on how we want to do this.

So what we need also is from the tribes in California to put input into their district directors and into the deputy director which in California is Alan Hendricks. He is in 1120 N Street in Sacramento.

Go ahead. I know you are dying to break me off.

MODERATOR: Let me just ask, because we want to make sure we hear from the last individual before we go into questions. But the fact is does any of tribes receive transportation money directly from the Federal Government, or do most people have to go to the state right now?

MR. McKAY: Within California we have, well, Bureau of Indian Affairs. They do have their transportation monies --

MODERATOR: Which is just highway money.

MR. McKAY: -- which is basically that, right.

Tribes that get other monies like, say, from your MPOs or state transportation dollars, I would say, no, it is non-existent.

MODERATOR: Okay. So right now our major way of getting transportation money or something is working through the state unless we were to approach the ISTEA situation and begin to talk about direct funding.

I want to move quickly to the next individual if you have a closing comment.

MR. McKAY: ISTEA, I don't know how it works in the rest of the states, but in California ISTEA has a certain amount that is line item for the Bureau of Indian Affairs. And then they have the rest of that gone to the Department of Transportation which 75 percent of the monies that come into California through gas taxes or the Department of Transportation goes out to the MPOs and RPTAs. And they control what is going to be used towards -- the department itself only has 25 percent, and that's to run all the state workers, CALTRAN's workers, and different type of programs that they want funded.

The RPTAs and the MPOs do have access to submitting proposals for a portion of that 25 percent that CALTRAN has.

MODERATOR: Now, will the ISTEA legislation change that, or is that still going to continue to work that way?

MR. McKAY: As was said earlier, under ISTEA most of the money goes out either to the states or the metropolitan areas. If it's a metropolitan area it goes to a planning organization that represents the area decision maker. I don't see any apparent reason that a tribe couldn't be part of that area decision making.

That metropolitan planning agency takes those dollars and then allocates the dollars either for highway projects or for mass transit projects. That is still the basic way in which the program will work under the reauthorization as well.

MODERATOR: Okay. Let me move next to the --

A PARTICIPANT: Let me answer a little bit more on that one. The man from Department of Transportation is talking about the money going out to the tribes or out to the MPOs and the MPOs represent the tribes. Nowhere in the United States, that we know of, maybe it does exist, that an Indian tribal government sits on an MPO. And the MPOs are the ones that allocate where the dollars go.

MODERATOR: Okay, thank you.

Let's move on to the next individual, Everett Waller, who is chairman of the Intertribal Transportation Association.

Mr. Waller.

MR. WALLER: I am going to stand up and talk to you. I have got a different approach. I come from a cultural home in Hominy, Oklahoma. I am an Osage Indian. God has graced me with the presidency of the ITA, the Intertribal Transportation Association. I am not going to go into the rhetoric you are hearing now.

All I know is that on this legislation, as far as transportation goes it's never going to be enough. It's never going to be on. They are talking of $150 million. They are going to rob Peter to pay Paul there. That seed money is probably going to come out of your tribal money.

Now, when they come up and talk 450 million, then that will be good because I put a curb on guttering back on the reservation. We identify our monies. ITA, the organization itself, is to help Indian tribes get organized, get your dollars. That's your new bullets, is that dollar. Every one of them you can get, that's a bullet shot off.

We had warriors lawyers speaking this morning. That does us good. When you have an elder we feel like you have arrived. But as far as transportation issues go, we need to get together, you get your monies together, and you will be powerful.

It's an honor to be up here in northwest country. I come off the (inaudible) Reservation. Our money, we never did see it. When I was a council member the only way they found my home is I took $15.4 million of theirs. They were there the next day. You go home and try the same thing.

The least I can say is this -- oh, I had a lot of things I was going to say, but after hearing a lot of this it's hard to do.

As far as representing all tribes as the president, all I know is that they might drag me out here while I am still rambling. But you still go home, you identify your needs, and you collect your dollars, and we get together and we get them.

I work with enough legislative aides. Yeah, I know that split tongue. When they are here with you they tell you what you want. But when they are back here at Blackie's, at that steak house, drinking them highballs, you ain't there, and neither is none of your issues.

So ladies and gentlemen, all I can say on behalf of the ITA, we are trying to get our membership. The commercial will be outside. I am going to save my time for talking to you. Get together with everybody. That eagle can fly with all those feathers. It will never go without any of them being gone. It puts it back so it can go up to God and fly and talk to him. If we pray to him like your elder says, he gets to come home, talk to us.

My culture is my only defense against this world. I don't blend. I can't even get a ride from the guy from the shuttle here, and I represent 557 tribes. A hundred and twenty plus are transportation tribes. Welcome to the third world. That's where they want you. And that's not where I am going to end up, and that's damn sure not where my child is going to end up. So we are going to try our best.

In closing all I got to tell you is this: It's an honor to be here, it's an honor to speak to all of you. And, God willing, our people say when the end of time comes there are going to be two people on it. We believe one of them is going to be Osage. You pray the other one is your tribe. Thank you. (Applause).

MODERATOR: Questions in regard to transportation. Again, we ask you to remember to introduce yourself and keep either your comments or your question specific as possible.

A PARTICIPANT: (Inaudible). I am with the Nez Perce tribe. I have a couple of comments on transportation and I was thinking of what Chief Burke was saying about thinking about the people and their needs.

And I think of a welfare family, a mother of three, who would have to hitchhike to her welfare appointments, hitchhike to her WIK (phonetic) appointments, hitchhike to school to talk to the counselor, as well as hitchhike to tribal court when someone turned her in for neglecting her children, for bringing them on the highway to get to these appointments.

And the concern that I have coming from the Nez Perce tribe, where we are a rural community, our communities are far apart, one of the things we are really lacking in is financing -- and I don't know if that's on the agenda -- financing for the cars that these mothers need to get to these jobs, as well as financing for the homes that they want to house their families in.

When we go to the banks in Lewiston, our closest town, we don't get loans, we don't get the financial, the creditworthiness that they are looking for because we don't have credit experience. We can't go in there and say, yeah, you can check all my credit references. They don't have credit references to check.

And I think if we are looking at housing and transportation we need to think about the people right there on the reservation. Sure it's good to talk about ISTEA and developing roads, but we have people right now who need that creditworthiness, and I don't know if that's on the agenda, to look at financing.

I think you can tell by the turnout here that there is a very strong interest here in the welfare of our people, and it's unfortunate that the room wasn't bigger to accommodate everyone to meet on this.

I had hoped that at this meeting we would be able to talk about some of the northwest issues. We have many issues here to do with land planning, to do with looking for the future, with our housing plan. We have 300 units that we need to build, and we need to find the money to do that. Sitting on the tribal council, how do we find the money to do that? How do we develop that creditworthiness within our own people?

MODERATOR: Thank you.

Let's move on because we have a number of other questions as well.

MS. HILL: Virginia Hill, Southern Indian Health and also Southern California Tribal Chairman's Association.

My question is directed towards Department of Transportation staff member here. And the first one is, can the administration require tribal input on the MPOs, either tribal input or a tribal representative on those MPOs since we are going to be running our own programs?

And the second question is, or just a comment here to tribal members here regarding a Department of Transportation bill that's currently up. We have been lobbying Congressman Filner in our area for direct funding to the tribes so we can provide our own transportation.

We have been meeting with SANDAG, which is the representative in San Diego County, and they basically told us that they were going to exempt tribal people from having to travel if it's beyond one hour, which would mean to them that the time limits would continue but they would not receive the training because of the problems with transportation.

A PARTICIPANT: I think your first question was, is there a specific requirement that the Federal Government can put to the MPOs that they have consultation with Indian tribes or Native Americans.

When ISTEA first passed -- and by the way, ISTEA stands for the Intermodel Transportation Efficiency Act of 1991 -- it had very, very strong -- it took the public involvement process and it stepped it up a notch.

The idea is that there should be no plan, transportation plan, without full community involvement, including Native Americans. The enforcement of that has probably been very uneven. I mean, as every MPO has striven to develop a public participation process, in developing that process they are to be going out within their communities, including the Indian members of that community, and developing that public participation process.

It isn't something they are supposed to do on their own but to do collectively. And periodically they are to revisit that process and try to improve upon that process. So that's one opportunity.

If you find in your area that that's not taking place, that you are not having the kind of input that you should have in developing your transportation plan, then I think the proper step is to come to our organization, the federal organization, the Federal Transit Administration.

And of course we have got regional offices all over the country, including in San Francisco and California, and try to make that case that we can be supportive of you in trying to make sure that that public participation provides for that kind of consultation because ISTEA went to a more participatory process.

It wasn't that the transportation engineer was to march in and say "Here is my plan," and then sell it to you and try to convince you that that's the best transportation option for your community. It was really a public transportation process. MODERATOR: Okay. Thank you.

We have time for one more question. Yes, Mr. Yaza (phonetic).

MR. YAZA: (Inaudible) to everybody from the Navajo Nation. My name is Alex Yaza with the Navajo Nation. I am the TANF coordinator for the nation.

I have got a question to Mr. Burnie from DOT. First of all, I just want to make a comment. It's very interesting that as we sit here today, which just brings up another matter, which just clarifies itself, federal agencies such as DOT, DOL, DHHS, and other programs that are involved in welfare reform, should be all sitting at the table together in regards to these developments because that's what forces us as tribes to talk about these consolidation and integration efforts. Earlier there was a mention to that even with the housing issues. But above and beyond that my question is regarding the ISTEA dollars. You were mentioning that there would be about $150 million for access to jobs in which a bill would be reauthorized. You mentioned that it would be a competitive program.

My question is, those tribes that do have current transportation programs, such as we do, we have a Navajo Transit System in existence, a public transportation system, these programs that already are in existence, would they be able to apply immediately for these funds and access these dollars so that we can provide transportation services for our clients in the TANF programs?

MR. BURNIE: Yes. The new access to jobs program is not to support the services that are already there because those connections are already being made. The intent of the access to jobs program, and of course it's not -- the reauthorization of ISTEA isn't complete yet, and then the appropriations will have to take place, so we will have to find out how much money actually ends up in that pot.

And they are general revenues. They are not coming out of any of the formula allocation, so it will come from no other source.

But in terms of those dollars, as I said, they are meant for new services. But existing transportation systems are probably in a very good position to put a plan together and come in for those dollars. Probably in a much better position for those that don't have any kind of plan.

What we have to do is really figure out how this program is going to work. So I am saying we are at a very good juncture now. We know that the dollars are going to be out there because it's both in the House and the Senate. We can be meeting with you and getting your input and figuring out how this program ought to be administered so it takes into account the concerns that you have.

MODERATOR: Okay. I think that's excellent -- we are going to -- Alex, could you hand the microphone over to this gentleman here.

If you could make it very brief, please, and then we can break for our next panel.

MR. LATHER: I will make it brief.

Mr. Burnie, my name is John Lather. I am the director of Social Services at the Iowa tribe here in Washington. We are negotiating a TANF program. I have heard you say we can do this, we can do that, et cetera. I have not heard the Department of Transportation say we have done this, we are doing that.

What have you done to set up a consultation program so that the tribal input can be delivered to the Department of Transportation?

MR. BURNIE: We haven't set up a consultation program yet on the access to jobs program because it hasn't passed. I just called back to the Department of Transportation this morning and the deputy secretary of transportation, Mortimer Downey, has been over at the Department of Interior and they are working on developing a better process for getting Native American input. But this process, until the law passes we won't set up the process.

I just want to say --

(End Tape 1, Side B.)

MR. BURNIE: -- because when they have their welfare to work grants, the supplementary three billion dollar program, they invited the Department of Transportation to sit at the table along with HUD and HHS to help develop their program. And that's why in that particular program those dollars can be used to develop additional transportation services.

We have set up a technical assistance system that's available to everybody who is going to be struggling with this problem now so that we can take, say, some of those of you who have set up transportation systems that are working very well, and then we have a system that will be able to move you to talk to other tribes who are struggling to do the same kind of thing.

So we are trying to set up a framework to tackle this problem. And part of that framework is going to be just like the Department of Labor did, to bring people together to try to figure out how this program would be implemented including the tribes.

MODERATOR: Thank you.

Let's move here just quickly in summarizing. It appears that we got very few, if any, representatives on the local planning boards. It's ideal that we are going to try to do that.

ISTEA is coming down as far as legislation, hopefully in the next few months. They have planning coordinations that's going to do that. The problem is, as this one lady said in the back, we have got women standing on the side of the road with children right now trying to get to and from offices, to work, et cetera.

What are we as tribal governments -- how are we thinking creatively to address those issues? Some individuals are saying let's identify dollars on our welfare to work that can start a transportation program of maybe used cars. Let's put a car pool together on a reservation where we have people who might be able to actually repair those cars or keep them in good repair. But we have got to begin to think in little more creative ways of how we get people from welfare to work. We are a long ways from that. Let's understand that, we are a long ways from that.

But if we are saying we are going to put people to work, we are not going to do it if the transportation system is not there. So in the next year if we don't have a transportation system in place those individuals that hit their 24 months and must be working at least 20 hours a week in most states, are going to be having a very, very difficult time if they are not having a difficult time now. Major problem.

Gentlemen, 30 seconds, 30 seconds is all you get for a wrap-up statement and then we are going to move on. Please. And I am going to time you.

MR. McKAY: Wrap-up statement. I don't know if you guys are aware that California is a 209 state and it says that no preferential treatment from our -- they voted that in last year. So that eliminates a lot of the different types of programs that we can go for as even American Indians, even though we do have a special relationship with the Federal Government. Thank you.

MODERATOR: Mr. Waller.

MR. WALLER: ITA joined it. We are going to go with the same system. I have got a year and a half in office. I am going to keep saying what I am saying.

Secondly, we are going to work on town hall meetings to come all over the reservation. Twelve area representatives are going to identify your problems. Councilmen here, my (inaudible). Northwest Tribes Symposium, May 5th. Be there. This man will tell you what you need to know because I am not up here for the biggest tribe in the world. I want the smallest one. Bring them out of that damn gutter they have lived in and they can't get out of because they don't know how.

But one thing about it, you do it with your culture. And if you don't have one, you go find one. Or you find Lord Jesus Christ. You end in this world like the way you come in, pure and free. Thank you.

MODERATOR: Thank you.

Next we have Mr. Leroy Bingham.

MR. BINGHAM: That's a hard act to follow, I am sorry. (Laughter). This guy gets me all fired up here.

MODERATOR: Fifteen seconds.

MR. BINGHAM: Fifteen seconds or less. It's time to be creative. I think Eddie just said it. We have to look past the obvious. And I think one of the things we need to do is quit looking for somebody to bring money to help us. And sometimes we need to just roll up our sleeves and get down to it. And I think more than anything else we need to find those creative solutions ourselves. It is part of our tradition. Creativity is part of our tradition.

MODERATOR: Mr. Goff.

MR. GOFF: Continuing on the same theme. The ball is in your court now. You guys, you know what you need. You have the expertise on your reservations to do it. Now you have the flexibility through NASDHAA to use that monies in a way that's going to be more effective for your people.

MODERATOR: Mr. Burnie.

MR. BURNIE: On the theme of do it now and not wait, your TANF dollars and those welfare to work dollars can be used for transportation. And there will be guidance coming out to that effect probably within the next couple of weeks. So you can start to use those dollars.

And when the access to jobs program comes down the line those TANF dollars and those welfare to work dollars can be matched with our dollars so that you can have 100 percent federal funding for those transportation services that you need. And the automobile can be part of that. You can use your TANF and welfare to work dollars to do those things with the automobile as well.

MODERATOR: Thank you. We want to thank our panelists. We are going to take just a short ten-minute break, and we are going to be back to address alcohol and mental health issues. Very critical. Very critical in moving people from welfare to work. Ten minutes.

If I could ask the next panelists to meet me up at the head table, please.

(A brief recess was taken.)

MODERATOR: -- with us today. And again we are going to try to do this in rounds. We were able to cover very briefly housing and transportation this morning. But I think cover some very interesting and relevant points in regards to what don't we have and where we are headed here in the future. And the reality is that we have got to become more creative at the local level. And I think you are going to hear that kind of conclusion throughout the day.

Let me kind of set the stage, if I may, by quoting -- we, doing some research, had a chance at different times to talk with focus groups. Focus groups of TANF clients, focus groups of tribal administrators, and focus groups of state administrators in regards to moving American Indian residents from a welfare to work situation.

And it says: "It would be less stressful" -- excuse me. "Within communities personal or family histories of alcoholism were reported to be barriers to employment. A social service director said `Discrimination is a problem here. Once you are labeled an alcoholic you have a stigma for life. People who know the background of individuals won't hire them. That's the weakness of trying to work within the community.'"

In one of the focus groups a participant said she was having great difficulty finding a job. "It's because of my background is why they are rejecting me, because of my name. People think all my family are alcoholics. My father died of alcoholism."

Another woman had a similar story: "I have been sober for three years but no one will hire me because I used to be an alcoholic. I am trying to get back with the rest of the world but I have been labeled as an alcoholic."

One of the things we are finding that's so critical is that many of our TANF clients come to the TANF office, whether it's state or tribal, and come with multiple problems, and one of those is alcoholism and substance abuse.

If we are challenged to move people to a work situation within 24 months how is that realistic? What is the challenge, and what is the coordination that has to be done in regards to the alcohol programs that are currently existing on reservation, and the welfare to work organization that's being put into place?

Now, in order to address that we have two outstanding individuals. We have Dr. Marlene Echohawk, who is the deputy chief of the Office of Alcohol and Substance Abuse Program, the Indian Health Service, Department of Health and Human Services. So we are going to be interested to see what IHS sees as their role in addressing this and working closely.

We also have Ms. Anna Ladamer (phonetic), who is the executive director of the National Association of Native American Children of Alcoholics.

So, please, Dr. Marlene Echohawk.

DR. ECHOHAWK: Thank you, Dr. Brown.

Good morning. It's been a privilege for me and an honor to have been invited here to talk with you this morning. We were told don't be long-winded. So I am going to pose my presentation in terms of questions, just things for us to think about.

Alcohol and substance abuse, as we are all aware, have been defined as the No. 1 problem within Native American communities. And given that fact, we know that we face a big challenge related to the high correlation of alcohol abuse with violence in our communities. And just to name a few of those behaviors we are talking about child abuse, domestic violence, suicide, homicide, gangs, assaults, et cetera.

How are these problems addressed within Native Americans as they relate to welfare reform? Many of our households, as we heard earlier, are single parents with children who are on welfare. Who cares for the children while the mothers are to receive training or to get into the job market? What is the quality of that care?

After the mother is trained what are her chances for a job, not to mention a well-paying job? Has the problem of alcohol and/or substance abuse been overcome?

What alcohol treatment programs are available for families seeking help? What is the quality of the programs? If the mother has no transportation, how does she get to a training resource center and/or a job? We heard those questions earlier.

Are programs available for adults as well as youth? If there are schoolchildren who participate in their important school activities, and we all know how important that is for children if their parents need to be involved there, how is the mother then to be able to participate if she is either in training or in a job that she is mandated to hold?

Who is there for them after school? What fears are there for the mother and what kind of stress does she undergo, the parents undergo? If there is violence in the communities how safe will the children be?

How do we answer these questions in a manner worthy of us as Native Americans and worthy of our children?

So I didn't time myself on that. Those are questions I have posed for our own programs. We have over 400 programs that are 638. You are all aware of that in this area. All of our alcohol programs are 638.

We have ten youth regional treatment centers. And, again, we heard concerns of funding earlier for other programs that we have. Within the alcohol programs it has been estimated we are funded at 40 percent of our needs. So that means 60 percent of the needs that we have to address a serious problem, that we have called our most serious problem. We need to have that extra funding to be able to provide for those services.

MODERATOR: Thank you.

Let's next hear, then, from the next speaker, please.

MS. LADAMER: Thank you. Good morning. I am Anna Ladamer. My Indian name is Yotahowit (phonetic).

It's good to be here to talk about the impact of welfare reform on our women and our children. It's absolutely imperative that we integrate and look at substance abuse treatment and especially prevention when we are looking at welfare reform.

I grew up on welfare. It took over 20 years to get me into the work force. We have to look at what these time limits are. We have to look at impacting the shame messages that Dr. Brown was talking about in terms of being on welfare. Too many of us here know that feeling of those words that have been said to ourselves or our families about being on welfare.

And the only good thing that I remember is how long that commodity cheese lasted because in our neighborhood we built a fort out of commodity cheese and we were able to play in it for a really long time. (Laughter). It does. It lasts a long time.

In looking at welfare reform there is an overall failure to address the impact of substance abuse on poverty and lack of education and the individual's ability to become self-sufficient. And I want us to look at the words that we use in terms of helping our families because even on welfare we are very self-sufficient.

I remember talking to a welfare worker who said that my parents didn't know how to work. And I watched my mother carrying the water, I watched my father build the fires, I watched him cut the wood, I watched him work out in people's yards, I watched my plant the gardens. I watched my mother go and get the garden can and feed us. Very self-sufficient. And as children we learned how to take care of each other at a very early age because we had to.

We must include plans that provide for alcohol and drug dependent treatment services because you can't work and drink.

When my mother descended into alcohol that impacted how much we could eat, and whether that fire got lit. And, by gosh, for her to go and leave the house and go and work, what would happen to us kids because my father was out there working the jobs up and down the state to try to feed us also.

The requirements, in terms of when we are working with the families, need to be therapeutic, they need to be compassionate and not punitive in nature.

One of the things that we learned in our family was how to lie to that welfare worker when they asked, "Did you make any money while working out in the fields picking strawberries? Did you make any money while baby-sitting?" And we said no. And we were working very hard.

And I am very thankful to the people who helped bring some money into my family by being very creative. I went and worked for the city but they knew that it was going to impact that welfare check, and so the money came to my family indirectly. I don't know how they did that, but I knew that they sat down and told me that they were going to do this different.

And those words about being very creative in terms of working with our family systems, the words that we use with our children are going to be very critical in terms of making this transition.

It is absolutely imperative, necessary, must happen that we support a public policy that will not penalize the women who suffer from addiction and have had little or no real opportunities in the past to empower themselves through education, through work, or other resources including child care, transportation, housing, that we have been talking about in our haste to overhaul the system that has many flaws, and they are obvious.

We should avoid replacing it with a system that's going to reinforce and continue to perpetuate a financial and psychological demoralization, to bring those feelings down about who we are as women and mothers and life givers; that we don't perpetuate that, make it worse on our women and children who are affected by alcohol and drug dependents and domestic violence.

It takes more than just a few months to get us out of a violent relationship. It takes more than a few months to learn how to go out and work and know that our children are going to be taken care of in a loving and caring way when we go out to work.

And we must never forget the importance of prevention because the majority of our families are young people, 18. Fifty percent of them are very young, child-producing age. We have to look at the importance of prevention and helping understand alcohol and the effects of racism and genocide on us as a people.

MODERATOR: Okay, thank you.

You know, Anna and Marlene, I don't think any of us would argue with what you have said. It's very clear. But the reality is how do we make that work? How do we recognize individuals coming to TANF, or coming into the state program or tribal program, who may be at risk, or who may have alcohol and substance abuse, if we don't ask, or if we don't have some type of family assessment in place when the individuals come in and we assume people are going to work and we have no understanding the kind of family problems they are having, the kind of individual problems they are having, et cetera?

Is somebody from Klamath here? Oh, there. I knew you were here. It's a kind of a setup. What do you do on a family assessment? What happens? Because I think it's important when people come to the door you have got to be able to assess that family, that entire family, of what risk they are at and whether or not there is alcohol and drug abuse problems involved.

A PARTICIPANT: Well, we do have a risk -- okay, make me speak into the microphone probably so you can record me and send it back down to my boss.

What we do is when we get a client in -- first of all, we know most of our clients. Our case workers are tribal members and they know a lot of circumstances behind the family being on welfare. Let me state that right up front.

But we ask them. We sit down with them and ask them. We use a risk assessment tool that we developed and we sit down and ask them what are the barriers. Actually we have a whole category. Like, one may be is there a criminal background, and what is that criminal background. Have they had arrests for driving while intoxicated.

Do they have those risk areas, those risk factors in their background, is there domestic violence. We ask them. Basically we ask what's going on and use the information we already have in our risk assessment matrix scale we use to find out.

MODERATOR: What do you do? How do you get them? Let's say that they do. Are you set up or organized that there is a good strong coordination between what you are trying to do and what the alcoholism program in the community is trying to do?

A PARTICIPANT: Yes, we do. We have a very good working relationship both with our tribal health organization, Klamath Tribal Health and Family Services, and with the organization that does the drug and alcohol treatment for Klamath tribal members. That's Klamath Alcohol and Drug Abuse or KADA. We will then make a written referral to them for treatment services.

We also on occasion do pre-drug testing as well. If we feel like the family's issues are such that they are using, and that is one of the main barriers, we do do drug screening. We refer them over to a local agency for urinalysis. The first time they get a urinalysis we don't sanction them. That's our baseline if they come back positive for whatever substance they have been using.

And then at that point in time we do testing after that. Actually, the program that does our drug and alcohol treatment does it for us, and they will do random testing. It is a requirement for them to be in the program to do random testing.

MODERATOR: Thank you. Next question.

MS. HILL: Virginia Hill. My question is to Dr. Echohawk. The Southern California Tribal Chairman's Association require substance abuse testing as part of the application process. And if they are found to be positive the plan also requires them to go into treatment or counselling.

And what we are finding out is that there is no funding available for this. The TANF program can pay for the testing but not for the counselling, not for the treatment. And so we have this plan. And the tribal chairs, the tribal leaders that are part of our consortium plan are very supportive of this because this is the first time that we have ever had any leverage in the community to require them to get counselling or treatment.

And we are running up to a brick wall. We have talked to several agencies and there is nothing there.

DR. ECHOHAWK: You are talking about people at the -- counselors or therapists at the doctoral level? Is that what we are talking about? Or at the masters level?

MS. HILL: No. I am just talking about any kind of treatment money at all for those adults that need the treatment. And also the youth as well.

DR. ECHOHAWK: You are talking about in California specifically.

MS. HILL: No. I am talking on behalf of all the tribes because if they run the TANF programs and the individual is having problems with substance abuse

then they are going to be asking you for additional funding.

DR. ECHOHAWK: Okay. The way it is set up now with funding, all the monies go out to the tribes. We have very, very little discretionary funds to speak of at all. So the money is out there. And, again, this is where we are talking about networking. Possibly the states can -- you will have resources there. But, again, what are the priorities with --

MODERATOR: -- lunch this afternoon. Again, we are trying to stay pretty much on schedule.

I think one of the things this morning we have gotten into some really, I think, some critical as well as heavy challenges that affect all of us either as workers or administrators in one form or another that at times we realize the impact and the demand that's going to be on us.

We didn't necessarily create this law. It's a law that has been given and passed by Congress that now falls on our shoulders of saying just how are we going to ensure whether we take the program over ourselves or whether we leave it to the state. How are we going to assure that families and children are being cared for on reservations and in the communities and are not just dumped to the wayside.

So with that I think it is a very important and a very tough kind of job as well as stress on our minds as well. We thought that after this morning, kind of given how we may have left it, it really talked about the seriousness of the issue.

We thought maybe we could give ourselves some strength by having a special prayer song by Mr. Andrews here if he would take just a few minutes and provide for us a little of maybe the spiritual aspect that is so much needed as well as we attempt to do what is expected of us, and assisting us to renew our spirit and direction, and the things that need to go hand in hand.

I think many of you, that as you return home, it's that you return home with the spirit, that you begin to also share with others, and that can provide hope even despite of despair for not only the clients that we work with but for our fellow workers as well.

This afternoon we have got another very ambitious agenda, and I want to welcome all of you back. I know you had to hurry for lunch and we appreciate your dedication of coming back here and being with us to discuss some very important situations here.

Let me read something to kind of set the stage. We are going to be talking first on emergency assistance. And we have with us in that regard Mr. John Bushman who is the director of the Division of Tribal Services of the Office of Community Services in the Administration for Children and Families.

We also have Ms. Edie Adams, Child Welfare Specialist with the Bureau of Indian Affairs, Department of Interior; Mr. Bill Clarke, who is the deputy executive director of Human Services for the Cherokee Nation. Will be talking on Medicaid in just a bit.

But I think it's important to understand -- emergency assistance. We talked this morning about the tremendous need, particularly when we are talking about single parent mothers with children and the kind of situations and the needs that are out there.

Let me just share with you some of the information that we found in talking with TANF clients that live on reservations. Says most of them reported lacking basic household supplies at the end of each month including fuel, clothing and food. Most participants reported never buying anything for themselves, only for their children, if at all.

One woman said, "I haven't bought clothes for myself in three or four years." Another woman said her parents still bought her clothes. Many reported that their children wear hand-me-downs. In some communities residents still rely on wood fuel for heating their homes. One woman reported, "The money I get from welfare is not enough to cover the rent and butane. My fuel runs out and we have to sit in our house with blankets over us."

This lack of basics also makes it difficult for recipients to care for their families and effectively pursue employment at the same time.

So the question is, as we go through this, what kind of emergency assistance, if in fact people are trying to make an effort, and an individual is trying to care for their family as well as move toward employment, what kind of welfare emergency assistance is out there in addition to maybe the monthly stipend that one receives off of TANF.

Addressing this we have -- and, again, we want to stick to our time frames of -- I will give you the cutoff sign, I would hope that you would respect that. If not, we have two people out there waiting.

So let us begin with Mr. John Bushman, if we may.

John.

MR. BUSHMAN: Good afternoon. I feel like I just passed a major hurdle or major challenge. The last time I went to speak about welfare reform issues I broke my leg. So I made it up here in good shape and I haven't broken anything yet.

I really struggled with this concept of emergency assistance, temporary assistance issues, and what I would talk about -- what we know as emergency assistance under the traditional public assistance program, as of August 22nd 1996 it was gone. When the president signed this welfare legislation it repealed AFDC, emergency assistance and jobs programs for the states.

There is no such thing as emergency assistance anymore, and I could leave it at that and say that there isn't anything left. But with this welfare reform legislation it has given us the opportunity, us in Indian country, to run TANF programs in lieu of the state and design and develop our own kinds of programs which can include a new form of emergency assistance.

Briefly, let me tell you now that 22 states in the country do have now under the guise of TANF something akin to emergency assistance. They call it diversion payments. And what those diversion payments are intended to do, if a family comes in and seeks assistance and they are in danger of going on TANF, but all they need is a helping hand, maybe they need their car repaired, or maybe a mother needs some child care, or she needs some clothes to go for job interviews, these states will provide diversion payments to this family and allow them to get the kinds of services that would divert them away from TANF.

One of the problems with emergency assistance over the long term is under the new TANF rules -- again, states are defining it differently so there is no one set definition. And that goes for tribes as well. But the basic premise is that it's a continual ongoing form of payment.

Then these things called time limits and work participation requirements kick in. So in order to avoid that states are providing this one-time diversion payment, and that way the time limits and the work requirements don't kick in on the families seeking this assistance, and they can move on.

Now, I was listening to the discussion this morning. When I come to meetings like this and hear from other people there are so many creative ideas. But I kept hearing this morning, and I am sure it will be continued to be said this afternoon, that there is a need for a lot of creativity now.

We have to begin thinking outside of the boundaries that we have all been living under. Anyone who is familiar with public assistance programs in the United States knows that for the past 60-plus years states have been administering public assistance programs and tribal people have been having to go to the states for these kinds of services.

Now that the whole public assistance effort in this country has changed, and now tribes can do this, we need to be creative. We can develop emergency assistance programs. We can bring in housing programs, transportation programs.

Those tribes that are running TANF, or will run TANF down the road, can take their TANF dollars and use it for transportation. They can use it for housing. They can bring in all these other programs under this TANF umbrella. What it's going to necessitate, and I leave you with nothing else than this, is to be creative, to think outside of your normal realm because any rule that we have ever known about how public assistance was delivered in the past, there are no rules.

Tribes, like the states, are given the opportunity, the flexibility to design programs that work for their particular communities and their particular service populations.

MODERATOR: John, of the 10 -- is it 10 TANF tribes now?

MR. BUSHMAN: We have 12 now.

MODERATOR: Twelve. Any of those have a diversion program built into their plan?

MR. BUSHMAN: I believe -- I want to say Redcliff in Wisconsin. I left a characteristics chart in back of some of the plans that have been approved and what they are doing. It doesn't specifically identify diversion programs.

MODERATOR: Okay.

MR. BUSHMAN: But tribes are only bound by their imagination, their creativity. And as long as what they are doing is in keeping with the intent of the statute, and that's trying to get people into the work force, they can design any kind of program they want.

MODERATOR: Okay.

MR. BUSHMAN: And we will work with them to get it approved. We have been very successful. We now have five plans pending which will represent about 150 tribes in the country probably by July 1 will be running TANF. So the more --

MODERATOR: Are these consortium tribes that you are talking about?

MR. BUSHMAN: The ones in Alaska. There are two in Alaska that are pending. We have one consortia tribe in southern California that is running TANF.

MODERATOR: So you see on the horizon many more tribes coming in and running their own TANF programs?

MR. BUSHMAN: I think as the tribes learn more about TANF, especially as the time limits in their states are starting to affect their people, I think you are going to see -- we expect to see a lot more tribes coming in to run TANF, yes.

MODERATOR: Okay. Because of time here, emergency assistance, I am saying, well, what the heck, why do we need one. If we need emergency assistance we will go over to the 638 or the BIA program and get the emergency assistance from the Bureau and the Bureau dollars that are funded.

That brings us up to Edie Adams.

Edie, you are going to tell us what's there for us as far as emergency assistance, the Bureau is going to come through for us?

MS. ADAMS: Am I at the wrong meeting? No. I went through the same thing that John went through when we saw the agenda and when our team leader was saying that I am just going to have to come out here and talk about emergency assistance. And I was saying basically, well, we don't have it. What am I going to tell them?

We don't have emergency assistance in the Bureau of Indian Affairs under social services. We do have a line item miscellaneous assistance. And when that breaks down it means a burial assistance that is to follow county guidelines.

But the good news, or bad news, whichever way you want to look at it, is the Bureau of Indian Affairs is in the process of revising the general assistance regulations. They have been in draft for about eight months and going the loops. A lot of you people don't know what the loops are. But they are from the (inaudible) Office to OMB, back to us, back up front, back down and around. And I think we are probably on our, what, our 32nd revision of them with just within.

Debra Malis (phonetic) has made a commitment that their drafts are going to be going out very soon to all the tribes, the area offices. There is going to be one consultation with the tribes at the NCAI meeting in Green Bay.

So I guess the heads up to all the tribes is you need to be aware and keep in touch of when those regulations are coming out because we had worked to make some major changes in them. We are trying to work with the new welfare reform.

But that's not necessarily true of what's going to come out because of all of the different routes that they have to go, I think we are all aware of. And every time we go out we get beat up because BIA social services is a secondary program. The tribes are saying, no, that's your trust responsibility to us.

But we don't write the rules. This is the tribes' golden opportunity to speak out, to be there and to fight for their people in the revision of the regulations. They have not been revised since 19 --

MODERATOR: Eighty-five?

MS. ADAMS: -- 85. And so you know and I know there have been major changes since 1985. And right now I don't think there is any of us in this room that can predict what welfare reform is going to do to each and every one of our reservations and to our people.

MODERATOR: Edie, you said some important things and I hope everybody heard that about amending the regulations for GA, and that there is going to be one consultation meeting, and that's going to be in Green Bay on when? What's the date?

MS. ADAMS: I believe the dates are -- it's at the NCAI meeting. I think it's like April -- I mean June.

MODERATOR: June 14th through the 17th?

MS. ADAMS: Through the 17th.

MODERATOR: And you are going to get out flyers on that information notifying all the tribes and the importance of this? Any major surprises?

MS. ADAMS: We don't know because when we left they had gone. They made the route up to our supervisor, our team leader. And we understand that the assistant secretary has some strong comments in there. So we don't know because we came out here. We will find out when we get back.

MODERATOR: Okay. One question. If I am on TANF and I get sanctioned, state TANF, can I be expected to be covered by the tribal social services program?

MS. ADAMS: Maybe if you go to Russia. Well, the way we have written it when we left was that it will be depending on why you were terminated. If you followed every loophole that they have and then -- also it depends on the tribes because in our new regulations the tribes have the opportunity to revise their program.

They can take over social services, and they can determine their own eligibility, their own dollar amount. And the bottom line of that, which I will warn you of, is that there will be no money increase.

MODERATOR: Now, I thought the law stated that the monthly allowance in welfare reform was tied to the state, that the BIA monthly allowance and the state were tied together and couldn't be separated. I mean, you had to pay the same amount that the state was paying. Is that going to no longer be the situation?

MS. ADAMS: If the tribe takes over the program --

MODERATOR: Yes.

MS. ADAMS: -- and does the reform --

MODERATOR: Yes.

MS. ADAMS -- they can change the eligibility and they can change the dollar amount.

MODERATOR: Even though it may be less or more than what the state is providing?

MS. ADAMS: Yes, sir. But the bottom line is that there will be no increases.

MODERATOR: No increases.

MS. ADAMS: No increases.

MODERATOR: No decreases?

MS. ADAMS: I am not going to guarantee that.

MODERATOR: Okay. Thank you, Edie.

MS. ADAMS: You are welcome.

MODERATOR: We will get to questions here in just a moment.

Mr. William Clarke from the Cherokee Nation, deputy executive director. Tell us how you are meeting the emergency assistance needs for the Cherokee Nation.

MR. CLARKE: Kind of tough. One of the things that we have accomplished is in 1996 we did create a program, an integrated service program, that had kind of sprung off of an angel tree project we had for Christmas, and there was a lot of benevolent people that had started donating to us.

We were able to get involved with various church groups, various corporate businesses and this type of thing. And as a result of that we have been able to take some money, some of the supplies that we received, clothing, furniture, stoves, refrigerators, whatever, and we have been able to use it with people who come in, particularly those folks who have children removed from their custody through the state court systems, or maybe even the tribal court system, and needed certain things in order to have reunification.

We are able to do that and we have been able to help people who have had burnouts, people who are not eligible for services elsewhere. We serve somewhere around 400 people in that area. That's as close to emergency assistance as we have.

I am like John and Edie. That's just something kind of form as far as having the ability to do that. But we do have the general assistance programs, miscellaneous programs, and this type of thing. But our most important one that we have is that integrated service. And we do have a display table out there that has some brochures, and we do highlight that particular service if you are interested in that.

MODERATOR: Have you applied to run TANF, the Cherokee Nation?

MR. CLARKE: No, sir.

MODERATOR: Why not? I am surprised because you seem to have had a long term -- putting you on the spot here -- long term organization to provide social services. One would think the Cherokee Nation would be at the forefront in applying to run their own TANF program.

MR. CLARKE: We were told that we were going to be running one and all this. I heard that everywhere I went, that the Cherokees are going to have a TANF program. But we decided not to because at that time, Dr. Brown, we were not able to get the state to agree to assist us in any type of the matching dollars or whatever although I understand now they are ready to, maybe, start making some movements towards that way.

I had a conversation with John day before yesterday. So with that in mind we will be taking another look at that. But we just could not afford to take that task on.

MODERATOR: Thank you very much.

Questions.

A PARTICIPANT: (Inaudible).

MODERATOR: It's not on.

A PARTICIPANT: (Inaudible) -- that decision based upon the potential financial liability to the tribes?

MR. CLARKE: Yes, we did. One of the things that the state could not do, they could not give me the numbers of people that they had served during that period that we were allowed to use. So it just didn't seem financially worthwhile to us to go into that.

A PARTICIPANT: The questions is (inaudible).

MR. CLARKE: Yeah, yeah. They did tell me that they may would let me have an extra 10 percent or something like that, but we haven't decided to do that yet. But we will be taking another look at it based on the information that John shared with me yesterday.

MODERATOR: You know, it's interesting. John Bushman said, hey, guys, that money that you received on TANF, if you negotiated you can use that. That doesn't necessarily have to be spent on monthly stipend or a monthly allowance. It could be used for transportation, it could be used for a number of things.

However, that sounds good except when you start, if you don't necessarily have the state match, or even if you have the state match, if you take money from that you are taking money from already at a loss or a negative. So while that sounds good I am not sure how you can be -- it's going to require some creative thinking and accumulation of dollars.

Maybe 477 is the answer. Maybe how you begin to organize and put your money together.

Mr. Yaza.

MR. YAZA: Good afternoon again. Alex Yaza of Navajo Nation.

I have got a question here for the panel. first with John. John, just real quick on the innovation thought. When you talk about creativity I think this is where --

(End Tape 2, Side A.)

MR. YAZA: -- between the agencies as well because that's where the barriers are at the home level, where we are at, and getting the programs together. And I think Dr. Brown here kind of touched on with regards to 477. Not all tribes are 477. But the idea of consolidating and integrating some of these programs is a must. And I think that's something that needs to start at the top as well.

But I have got a question for you, John. Where is the regs on the TANF program thus far?

And then, also, for Edie on the changes regarding the emergency assistance. You were talking about GA. Is that also involved in the TPA to some extent? When you are talking about changes or amendments to the assistance program, is that going to involve TPA as well?

So those are just two questions to John and Edie.

MR. BUSHMAN: Alex, I agree that change also needs to occur at the federal level. The thing about TANF is that -- this is one of the reasons why TANF was passed. I mean, we had experts saying that the welfare system was broken, and then we had states saying let us fix it ourselves without the mandates of the Federal Government. You are telling us what to do all the time. So Congress passed the law and the president signed it.

The TANF legislation, the Federal Government has virtually no say-so in how the states design their programs. For the tribes the legislation requires the Secretary of Health and Human Services to negotiate some of the statutory specifics of TANF with each tribe that comes in.

But our position, and the 12 that plans have been approved thus far, as long as the tribes propose and keep -- propose a plan in keeping with the statute, the tribes can design programs any way they want to do them and they will be approved.

Now, in answer to your last question about where are the regulations. The regulations have been approved by the Department of Interior. They are now at the Office of Management and Budget for review. They have 90 days -- they can take up to 90 days to review them. I fully expect when I get back to Washington next week that I will begin talking with OMB. And I hope that that process is merely an education process.

But I think that we have developed regulations that give the tribes a lot of flexibility. I am fairly certain that the tribes are going to be fairly pleased with what they see in these regulations.

MODERATOR: We can have as much flexibility as the states have, John?

MR. BUSHMAN: Yes, yes, absolutely.

MODERATOR: No surprises still?

MR. BUSHMAN: No surprises.

MODERATOR: Okay, great.

Let's see. The next question was in regards to the tribal priority system question and GA.

MS. ADAMS: With regards to the tribal priority systems I think we are all aware that the General Assistance program is supposed to go under the tribal priority system. It's waving back and forth there. I think we all know that it really hasn't gone onto the tribal priority system as we all know it.

MODERATOR: Why not?

MS. ADAMS: I don't know that answer. That's a tough question. I really don't know that answer --

MODERATOR: Wasn't that directed by Congress to happen?

MS. ADAMS: Yes, it was.

MODERATOR: And it hasn't happened. Is the BIA dragging its feet? (Laughter)

MS. ADAMS: No, we are not. We are racing. It just takes us longer to get some things done.

MODERATOR: Okay. Any other questions here? We want to take about two more questions and then we want to move on to Medicaid here.

Yes. Let's have the lady here.

MS. HUNT: Debra Hunt from Graduate School of Social Work at the University of Utah.

Bill, it was interesting to me to hear you say that the tribe didn't pick up the TANF program because the state did not match the funds because I think that's a piece that isn't getting out as far as why the tribes aren't picking it up.

It doesn't look real good that only 12 tribes have picked up running their own TANF program when we are looking at tribal sovereignty and self-sufficiency issues. But now I hear you saying the state is more interested. And of course the state, if it consumes the tribal members under their TANF program we are going to lose dollars based on the joblessness issue that we have all talked about this morning.

I think that's another area where tribes are going to need to pressure the state governments and to educate the state governments because who knows whether the states are really assessing the impact of the unemployment rates or the joblessness rates among the tribes.

I also had a quick question. Has the deadline been extended as far as when tribes can pick up TANF? Because my understanding originally that it had to be declared by last summer.

A PARTICIPANT: No.

MS. HUNT: Is it an ongoing thing? I mean --

MODERATOR: Quick response.

A PARTICIPANT: There is no deadline. The tribes couldn't start operating before July 1 of last year. But there is no --

MS. HUNT: Other than the lifetime limit

issues --

MR. BUSHMAN: I just want to quickly touch on this funding issue. I do want to say that tribes have only been authorized to operate this program since last July. So the fact that we only plans approved thus far is not indicative of the interest out there.

My recommendation to any tribe would be to not run TANF without state funding. And it's certainly in the state's interest to provide that funding. In fairness to the states a lot of these legislatures are bi-annual legislatures, and they are only now having to deal with the issues of state match for tribal governments.

The states have been struggling mightily to implement their own TANF programs let alone start thinking about, well, what are we going to do about the tribes. But there are certainly many arguments that can and are being made to the states for the tribes as to why they should give that money to the tribes.

MS. HUNT: In Utah we have cut back now to 36 months lifetime limit. So the time frame is running out.

Also I want to ask is there any attempt to redefine work or to define work in a way that would encompass entrepreneurial tribal efforts or something like that with the money?

MR. BUSHMAN: Under the TANF legislation and under the proposed regulations we would leave it up to the tribes to define work activities as the states do now.

A PARTICIPANT: Don (inaudible) with Tanana Chiefs Conference. I have a question for the Bureau representative. Does the Bureau plan to take the lead or to follow the lead as they did in TANF programming, and that is to basically formulate funding distribution based on historical funding?

And I have a second follow-up question. That is, does the Bureau plan to initiate any new time limits on General Assistance?

MS. ADAMS: On the eligibility of General Assistance time line; is that what you are talking about, sir?

A PARTICIPANT: No.

MS. ADAMS: In the new regulation there is no mention of that.

And following the lead on TANF, I guess we are trying to -- our attempts, the team's attempts, we are trying to fill the gap so we won't have so many people fall through the gap. But they are not finalized. I mean, the tribes -- the people need to really have their input into the one consultation meeting that we are going to have.

MODERATOR: When are those draft regulations getting out to the tribes prior to the meeting in June?

MS. ADAMS: Probably --

MODERATOR: Tomorrow?

MS. ADAMS: -- in two weeks.

MODERATOR: Oh, two weeks? We have heard that before.

MS. ADAMS: I know. I have my feet crossed, my fingers crossed. I am looking you in the eye. We are going to work really hard to try to --

MODERATOR: Okay, be looking for it.

Those of you that aren't tribal leaders and may not get --

Who are you mailing those out to? Are you mailing them out to chairmen or to social service directors or who?

MS. ADAMS: The letter is going out to Dear Tribal Leaders.

MODERATOR: Okay. That means --

MS. ADAMS: And then I would assume that --

MODERATOR: -- chairmen and tribal councils.

MS. ADAMS: -- we would also send them to the area social workers.

MODERATOR: Okay. Make sure you see those. Make sure that when you go in June that you are prepared to respond to those. And if there is things that need to be pushed we need to be together on that.

Mr. Cummings.

MR. CUMMINGS: Can they be posted on the BIA web page?

MODERATOR: Will they be posted on the BIA web page?

MS. ADAMS: We are hoping that they will be.

MODERATOR: Okay. Now, what does "hoping" mean?

MS. ADAMS: That's a way that they need to get out to everybody and so -- we have been working on getting other things on the web site so --

MODERATOR: Can we count on the efficient work of Sara Hicks to make sure that that gets on there since she is --

MS. ADAMS: We will give her that responsibility.

MODERATOR: I know she is a very talented student that has been trained and educated very well.

Okay, yes, please, Mr. Cummings.

MR. CUMMINGS: Leo Cummings. For the Bureau there, the change of regulations is something. I think we really comment that there has been no leadership coming down from the Bureau in a lot of their programs, social services and education. We do need education, maybe, to follow suit in some other programs that can help the TANF recipient. There has been nothing.

For John. As you said, the 12 plans that came in and -- these plans then have all been approved -- has there been anything innovative about the plans that goes beyond state law, that goes beyond the flexibility you are talking about in regards to work participation, the percentages, and maybe talking about the length to 60 months? Anything different? I think we need tribes to look at that, doing stuff different, and not just following the regular route of state planning.

MODERATOR: John, if you could briefly answer that question.

MR. BUSHMAN: The 12 plans that have been approved thus far are all different. I mean, they are -- each one is unique unto themselves. Like I have said, we leave it to the tribes to define their work activities so there is innovation there.

The kinds of services that each of the 12 plans are going to approve are all different, so there is a lot of innovation there. It's hard to generalize about any one plan because it's up to each tribe to determine what their unique circumstances and needs are and then develop and design programs that will meet those needs.

MR. CUMMINGS: Any plans are going to be approved beyond the 60 months?

MR. BUSHMAN: No. But each -- we have plans where the tribes have said we will follow the states time limits or we are going to take -- if the state is less than 60 months -- the federal limit is 60 months. Some states can choose to have less number of months.

But the plans that we have approved thus far have not been approved for more than 60 months. We have only had one tribe propose months in excess of 60 months. I think they proposed a 72-month. They were approved for 60 months but were told you run TANF for a while, you see how it works, see how you are getting the people to work, and you can come back with a plan amendment within the three-year period to propose new things. That can include new time limits.

MODERATOR: Okay. One last comment, then we need to move on to Medicaid.

MS. HUNT: I think one of the most important things, even though for years and years tribes have not trusted the Federal Government or the Bureau and the state people, I think it's very important right now for we as tribes and the Bureau to come together and go to Congress and give them statistical information to show much money we need and what really is going on.

I believe when TANF came about that Indian people came as an afterthought, and nobody really knows what to do with them. The states are getting bonuses that the tribes aren't, so we are falling through the cracks somehow. That's one reason why a lot of tribes have not taken on TANF. And it depends on your state. If they are willing to give some of their match, where is the other match going to come from?

They have been set up for computerization and have the staff for hundreds of years and suddenly tribes are supposed to do it within two or three years. Well, we can't do it. But it's strong here. That's what I say we came as an afterthought.

But I think it's time that we all work together and work for the same thing, our Indian people, the children, the future generations, and the lives of all of us. And walk that red road, and talk it, and believe in it because we are all Indian people. We all want the same thing. We want the survival of our people.

And I see the only way that we can do it is nationally, come together and do it together. And we have got to quit the fighting amongst each other and et cetera, et cetera. Someone thrown the blanket down, and here are some pennies, and everybody going to fight for it.

MODERATOR: Thank you.

We want to move on. We are running just a little behind time but we want to make sure we get the questions out and so forth. Let's move on now to the impacts of Medicaid.

All of you are aware that when -- in the old of D.C. programming you went in and you filled out a state application. Many of those state applications, probably every state in the nation now, you filled out one application that they looked at your eligibility for food stamps, AFDC and Medicaid.

Now that things are moving, and things have changed in regards to TANF program, there is a real concern on two fronts. One, if a tribe takes it over and a person moves from the state TANF to the tribe they could lose their Medicaid eligibility or they would be taken off and they will have to reapply to Medicaid.

The other is if you are on state and you get sanctioned, and you get kicked off of -- I guess that's the way to say it, dropped off the roles, Medicaid is still and entitlement program. Some states are requiring that you have to go back and reapply. There are many American Indian women right now who are being sanctioned, who are being dropped off the roll as we speak, who do not know that they are at risk of losing their Medicaid unless they go back and apply for Medicaid.

And the result of this is if they would then go to IHS for services, IHS which normally can third-party bill to Medicaid to supplement their budget at 100 percent of what it costs, is then unable to. So that we lose dollars in our IHS in that situation. So there is real concern in regards to what's happening in Medicaid as well as SSI.

So we need to talk on that a little bit. We have four individuals. We are going to move quickly on this. I apologize. But we have Mr. Bruce Greenstein, and Sue Klane (phonetic) from the Health Care Financing Administration. We have Mary Ann O'Neill who is chief of the mental health and social services program from IHS, and Ed Fox who is the health policy analyst from the northwest Portland area, Indian Health Board. And we will start with Bruce.

MR. GREENSTEIN: Actually, we have a different order.

MODERATOR: Oh, different order. Come on now, Bruce, get them together there.

MR. GREENSTEIN: We do have a different order now.

MODERATOR: These two ladies have it all organized for you.

MR. GREENSTEIN: Perfect. I want to thank everybody for inviting me here today. My office is in Seattle so I am not that typical government bureaucrat. I am a little bit separated from Washington, D.C., so sometimes we have a unique perspective.

I also want to say thanks to Mr. Andrews for that prayer before. And while I was sitting in the audience thinking about the spiritual connection to what these issues are, they reminded me when I was a small kid I used to go to temple with my grandfather. And before I learned how to speak Hebrew the rabbi would be doing the prayers in Hebrew and I wouldn't understand really what anybody was saying, but I got a feel for what the prayers meant. And I had that same feeling here this afternoon. So thanks for bending the rules and allowing non-Indian people to hear that.

I have been asked to speak about the relationship and impact between welfare reform and Medicaid. So what I was going to do quickly was go through what Medicaid is, who is eligible, what Medicaid covers, and then talk about what welfare reform did, and what the effects are right now.

I have, what, about two and a half minutes left?

MODERATOR: Right.

MR. GREENSTEIN: All right. Quickly, Medicaid is a state federal partnership that's operated by each state. So the Medicaid program is something that is going to vary across state lines. They determine who is eligible, the scope and amount of services that are offered. The state gets generally about 60 percent back on the dollar from the Federal Government which varies across states, differing by the income level in each state.

Medicaid basically covers people from low income families, dependent children, the aged, blind, the disabled receiving SSI, pregnant women and children up to age six, and low income children and families that came in the program after 1983.

During the 1980s there were a lot of new changes made to Medicaid eligibility which complicated matters. And then welfare reform came around and complicated matters much further for Medicaid. Basically what welfare reform did was de-link the two programs.

Previously if you were eligible for cash assistance you were definitely eligible for Medicaid. That's now not the case. States were also given discretion to reduce the income ceilings consequently making it more difficult for people to qualify for Medicaid. And they also increased the amount that the states could look back on resources for individuals therefore making it more difficult to qualify for Medicaid.

But the case has been that states haven't been moving in that direction. In fact in the most recent study roughly half of the states are continuing to use the same application for cash assistance and Medicaid. None of the states have made it more difficult to get on Medicaid.

In fact some of the states -- maybe this is due to good economic times, but many of the states have expanded their Medicaid program despite welfare reform making these benefits available for more of low income populations particularly children.

States have demonstrated their interest in not scaling back in any of the categories. While they have expanded some they have left the other ones alone without scaling back. It's clear that many of the states are trying to keep that link between Medicaid and cash assistance. Medicaid has the ability now for a special eligibility group that retains that link, and many states are applying for state plan under that authority.

My only concerns here are that while so far the wrath of welfare reform hasn't affected Medicaid as drastically as some analysts had originally suspected, things to look out for will be an economic downturn, ineffective outreach efforts. Because there are now people that would be otherwise qualified for Medicaid, but since there is not a link with cash benefits a lot of times they don't know. There is roughly three and a half million kids out there now qualified but are not enrolled.

My last concern is that varying by states that state policymakers, after a couple years go by, take a monolithic view of what the problems are without paying attention to within a state. Particularly for the group here, difficulty in enrollment may not be the same here as it would be in urban areas or southern states or northeastern states, et cetera.

And I will take questions at the end, I believe?

MODERATOR: Yes.

MS. KLANE: Moving right along, I am Sue Klane with HCFA's Office of Legislation. Let me begin by saying I am not a program expert like my friend Bruce here. So if you ask some questions I can't answer, I am going to turn to you, Bruce.

What I do do, is I focus on Indian health issues in Medicaid and Medicare legislation and in the Children's Health Insurance Program. I would like to talk with you for just a few moments about that Children's Health Insurance Program.

And, as Bruce said, the Medicaid program is complicated and difficult, and many in this room wish there were more opportunities for tribes to have a direct involvement in it. If you felt Medicaid was bad in that respect, the CHIP program is no better. It is also complicated. It has a focus on states. There are limitations that we all wish were not there, but there are also some opportunities. I would like to highlight some of those for you.

First of all you will recall that Congress tried to turn the Medicaid program into a block grant, to limit the amount of federal money, to do away with the entitlement for individuals to Medicaid. Congress did not succeed in that. But what they did not succeed in doing to the Medicaid program they did succeed in doing in creating the Children's Health Insurance Program.

Unlike Medicaid CHIP is a block grant. The entitlement goes to the states. States are entitled to receive federal funds if they submit a plan that meets the requirements in the law. There is no individual entitlement to Children's Health Insurance.

The funding is a higher federal match for states than was the case under Medicaid, but there is a limit on the total amount of federal dollars. Under Medicaid there is no limit to how much money a state can draw down as long as they come up with their state match for covered services for covered individuals. There is an absolute limit on the number of federal dollars that will go to the CHIP program.

There is even more flexibility for states in the CHIP program than there is under Medicaid. There is a corresponding lack or reduction in the amount of federal leverage we have in telling them how to operate their programs.

Another thing that's different between CHIP and Medicaid that you should look out for is that the legislation permits a state to vary the services within the state by geographic area. As soon as I saw that in the legislation I started to worry that some states, which shall remain nameless, might come in and try and write out the reservation areas or provide lesser services in reservation areas.

So far we have not seen that happen. We have not seen any state plan come in, yet, that varies by geographic area. But that is possible, and it's something you need to be watching for closely.

Another one of the limitations in CHIP is that only the 50 states, the District of Columbia and the Territories can submit a plan, receive federal funding and operate a CHIP program. Tribes did try, as the legislation was going through, for a tribal set-aside. That was not successful.

This points out in my mind -- I would never suggest anybody lobby. I can't do it, I wouldn't do it. So that's not what I am suggesting here. However, as you educate members of the executive branch and the legislative branch on your needs and your issues, it's important to note that the House Commerce Committee, which has jurisdiction over Medicaid and the CHIP program, has been among the areas of the Congress that has been least receptive to some of the Indian initiatives including the CHIP set-aside.

So that there is perhaps the need to have Commerce Committee staff, OMB, White House staff and others make some visits to Indian country, learn first- hand what your needs are, what your issues are, and the capability that tribes have in operating a number of complex programs.

One of the smartest things Indian country ever did was to take Nancy Ann Min (phonetic), when she was first appointed to head the health part of OMB, out to Indian country. She visited the Navajo Nation. She still talks about that experience.

Those of us in the administration saw direct results from that. As the president was developing his Medicaid reform proposal there were provisions that were put in there at the department level, that were attempts to benefit Indian country, that would not have stayed in previous OMB eras. And there were things that OMB itself put in even beyond what the department did, to benefit Indian people. It made a difference.

Bruce Vladeck, our former administrator of HCFA, came from New York City, probably had never been to Indian country before. We had a hard time explaining Indian health issues to him until he visited the Confederated (inaudible) at the Flathead Reservation. He came back, he had a much better understanding of Indian issues. So I can't highlight the importance of educating enough.

Quickly, the CHIP program has a couple of other opportunities and limits you need to be aware of. States have the choice between setting up a separate insurance program and Medicaid expansion or some combination of the two. Important for Indian country, if they choose the Medicaid expansion route there is no cost sharing for services to the children.

If they choose the separate insurance route, cost sharing is permitted. There is limitations on how much it can be. But if cost sharing is an issue, as it is in many places in Indian country, then you might want to encourage your state to pursue the Medicaid expansion option.

Early on the CHIP program there were ugly rumors circulating that Indian kids were not eligible for CHIP. That is not true. Starting in November we put out a Q&A on our web site and published it. Indian children are eligible for CHIP on the same basis as other children in their state. If they meet the definition of targeted low income child they are eligible on the same basis. They are not entitled. They are eligible.

Two other things. The state plan for CHIP must include a description of procedures to be used to ensure the provision of Child Health assistance to targeted low income kids who are Indians. This does not require consultation, per se, but it makes good sense for a state to consult.

And that's why partly in response to NIHB and NCAI resolutions, and partly in response to that legislative provision, the department sent out a letter in February requesting states to consult with tribes, tribal organizations, urban Indian organizations, IHS units and others on their development of the CHIP plan. That's available on our HCFA web site and includes a list of HCFA regional office, American Indian and Alaskan native contacts, and CHIP regional office contacts.

One other thing that's on our web site is recruitment notices for HCFA positions. We have very few Indian people in our HCFA organization. We could use some more. We could use people who have the sensitivity, the knowledge and the expertise of people in this room within our organization. So I would encourage you to check out the web site, check out the recruitment notices, and encourage people you know to apply. Thank you.

MODERATOR: Thank you.

We know that there is a lot of information that has to be given, so we would appreciate again to keep our comments directed directly to the topic at hand here.

Next we have Mary Ann O'Neill, Chief of the Mental Health and Social Service Program of the Indian Health Service.

Mary Ann.

MS. O'NEILL: I would like to make that correction, Ed, if I may. As you know, we are going through a lot of changes at headquarters and I am not really sure what my title is anymore. But I am here representing --

MODERATOR: Are you sure you have a job?

MS. O'NEILL: -- the Mental Health and Social Services -- that I am not even sure about either.

MODERATOR: Oh, okay. We don't want to surprise you when you get back.

MS. O'NEILL: Maybe that's why they sent me over here.

Today I would like to share some information with you on the welfare reform and its impact on Medicaid and the IHS system. And given the short time that we have I will try to do that. And I would like to make myself available for the rest of the day.

And I would also like to highly recommend this report that the Kaiser Foundation and the Center on Budget and Policy Priorities has produced, Native Americans and Medicaid Coverage and Financing Issues. This is an excellent report that really speaks to how critical Medicaid is for the future of Indian Health Services in this country.

And I encourage you -- if you want a copy and don't know how to go about it, please call me. We have some extra copies at our office. My phone number is 505-248-4245. I am at Albuquerque Headquarters West,

IHS.

Originally some of the concerns from the welfare reform and its impact was primarily due to the de-linking of Medicaid from TANF that Bruce spoke to earlier. Some of these concerns were around the question of whether individuals were going to be following up on their Medicaid eligibility. Even if they were eligible, once their cash assistance to them had been severed through the loss of AFDC or SSI payments.

The other concern was the disproportionate risk that was being faced by children because their health needs are primarily preventive in nature. And because of that there was the thought that there would be less likelihood that Medicaid enrollment would be sought out for them.

The third was that there was a concern that the reductions in the welfare enrollment throughout the U.S. under the Act would produce migration of Indian families between reservation and city environments depending upon job opportunities, medical crisis, travel resources and welfare benefit options by state.

Now, hopefully, Ed can speak to some of that, Ed Fox. At our level we have not been able to really see the extent to which any of these concerns have been realized, and it still needs to be determined.

Very briefly, I will go over five significant roles that Medicaid plays for Native American health care. The first is that the Medicaid program acts as an insurance program covering physician, hospital, and other basic health care services for eligible Native Americans, especially families with children.

Second, Medicaid acts as a source, a revenue for IHS and tribally operated clinics and hospitals.

Third, it acts as a purchaser of managed care products. And in this manner Medicaid is reshaping the health care delivery system for many Native Americans and other under-served low income populations.

Fourth, Medicaid also assists low income elderly and disabled Indians who are eligible for Medicaid in meeting their premium and cost sharing obligations.

Five, and finally, Medicaid offers coverage for nursing home and other long term care services needed by frail, elderly and disabled Native Americans.

I would like to stress the role that Medicaid plays as a source of revenue for Native American health facilities. In Fiscal Year '97 IHS and tribally operated facilities received about $187 million in Medicaid reimbursement which is about 10 percent of the 1.8 billion which is appropriated for IHS and tribally operated health services. The Medicaid reimbursements for '96 was 154 million, and for '95 it was 108 million. So that clearly you can see how important the revenue from Medicaid is for the Indian health care delivery system.

The amounts from the last three fiscal years are the result of collections from about 25 percent of the IHS user population which is enrolled in the Medicaid program. This percent of the Medicaid population within the IHS user population has remained relatively the same within those last three years.

The increased amounts of Medicaid reimbursements during the same period is largely due to the change in the method of computing reimbursement rates and the improvement in the IHS and tribal billing for Medicaid services.

I would like to also look at how Medicaid is the source of revenue. I would like to stress that a little bit more as well. IHS --

MODERATOR: Mary Ann, what percentage of the IHS budget did you say that Medicaid supplemented --

MS. McNEILL: Ten percent.

MODERATOR: Ten percent?

MS. O'NEILL: Mm-hmm.

MODERATOR: Okay. Take about ten more seconds, if you would, please.

MS. O'NEILL: Okay. I would like to point out -- gee, ten seconds. You definitely need to get that report.

MODERATOR: Okay. Five seconds.

MS. O'NEILL: One of the things to remember is IHS, as an appropriated program, is not an entitlement program, but Medicaid is. When the funding for a given year is consumed the provisional purchase of service must be postponed until the next fiscal year when new appropriations become available. This is partly evident in the case of contract health services for which waiting lists for non-emergency services are not uncommon in the areas as many of you already know.

In contrast, though, Medicaid is an entitlement program. This creates some uneven levels of appropriations from the two sources of funding for health care, IHS, and for Medicaid. And the tribes in IHS really need to be more aware of that.

Also, under the Balanced Budget Act the growth and spending and appropriated programs such as IHS has become tightly constrained and will be for the next five years due to the across the board caps that IHS and the other domestic programs have been subjugated to.

IHS funding is not likely to grow nearly as fast as federal spending on an entitlement program like Medicaid which is projected to grow around 7 percent per years. The result is that the revenue for Medicaid is likely to become increasingly important to many IHS tribal and urban programs to help relieve the appropriated funding limitations over the next few years.

Lastly, I would like to emphasize that we all need better data in order to help us with our planning, and I would like to recommend that tribes consider in the context -- I will go ahead and make the recommendations even though Sue was very careful about that from her speech.

Reliable data is desperately needed around how many Native Americans are enrolled in state Medicaid programs. How many of these individuals are enrolled in Medicaid, MCO or other managed care organizations, and the average cost of covering these beneficiaries through fee for service or through managed care.

MODERATOR: We need to cut you off here and move on. I am thinking one of the others, if there is questions, we want to make sure that we have time for questions here so that we can move forward.

MS. O'NEILL: Okay.

MODERATOR: Ed.

MR. FOX: I am Ed Fox and I work for the Northwest Tribes in the states of Oregon, Washington and Idaho as a policy analyst for northwest Portland area, Indian Health Board. That give us a unique perspective on the impact of welfare reform on health care, but it is somewhat of a northwest perspective, so it will be up to you to see how it applies in different parts of the country.

That's also a good perspective because we operate one of the administration for Native Americans grants to provide welfare information to tribes in our three-state area.

In the northwest I facilitate quarterly meetings on health care in the states of Idaho and Oregon, and every other month we have meetings in the State of Washington, the American Indian Health Commission for Washington State, and we help facilitate those meetings.

I can tell you that since 1995 when the Republican Congress arrived we have been watching for the impact of welfare reform on Medicaid and on health care generally.

I haven't been to the doctor in 20 years for anything important and I haven't been without a job for 20 years. And, guess what, people that are on welfare have children. The young women that often visit doctors, maybe in childbirth or for other reasons, to immunize their children, they need health care.

One of the keys to moving from welfare to work is to have health care services. There isn't a group in the United States that should be more well positioned to move from welfare to work, in terms of having health care, than American Indians. Our board works hard to get a fair appropriation for the Indian Health Service budget. All Indian people should have what they need in terms of health care, that key element of moving from welfare to work.

Unfortunately, the appropriation isn't there. We need Medicaid resources. In the northwest it's not just 10 percent, it's probably 20 percent of our budgets for Indian health programs. It's important for us to monitor what happens to Medicaid, and we have done that, and we have done it in each of our quarterly meetings. And in Washington we talk about it at almost every meeting of the Indian Health Commission.

What have we found out? Well, as Bruce said and Mary ann reiterated, Medicaid was not block granted. Medicaid is still an entitlement. There should be no negative impact on the Medicaid program because of welfare reform.

What are we hearing from tribal health directors? I also facilitate quarterly meetings of our tribal health directors and we have talked about it at almost every one of those meetings. We are a bit worried. We have anecdotal evidence. People have told us stories that they believe we have fewer people on Medicaid because of welfare reform.

Do we have any good data on that? And as Mary Ann said, we don't. Mary Ann and I have talked about this since 1995 or 1996, when the Act passed, about how would we monitor this. Well, we really don't know. Unfortunately we mightn't know before it's too late unless we act now.

And we have acted to tell state Medicaid directors that we don't want to have a negative impact. We want them to train their work force properly so they let people know that they are probably still eligible for Medicaid even if they are no longer eligible for welfare services.

The evidence that there are fewer eligibles is again anecdotal. Northwest Tribal Social Service and Health Programs staff have reported that there are aspects of TANF programs in our three states that appear to have reduced the number of people.

Well, how would this happen? We heard the story at a meeting at the Health Commission in January where someone said they heard that when a person is told by letter that they are no longer eligible for welfare services, that they are automatically disenrolled for Medicaid.

The state Medicaid people at the meeting thought that could be true. They didn't know. And we still haven't had a final determination to actually think that that is true. Well, they need to stop doing that. They need to stop automatically disenrolling people from Medicaid when they are no longer eligible for welfare services.

And they promised us a letter and some training of their staff so that people know that you may still be eligible for Medicaid even though you are no longer eligible for welfare services. That will be more important two years into Idaho's TANF plan when everyone is off welfare unless the tribes run their own programs, and in five years in the other two states.

Another reason people may be disenrolled, imagine you are in Idaho. The grant is $276. There is a two-year time limit. You have to sign an individual responsibility contract. You don't have transportation to get to the jobs anyway, and you are sitting there thinking should I even apply for this, is it worth the effort.

You have got four or five kids, perhaps, or you have got one child. So you are just a single person, young white male, we don't need that. But you are saying is this worth it? Should I do this, $276? Come on, I have more pride than that. Indian people clearly have a lot of pride. We can see that because they widely under-enrolled in welfare programs. They don't want to be on welfare.

Unfortunately, their decision to not sign up for welfare may mean they are also not signing up for Medicaid. Our Indian health programs will not get the money that we need to maintain our programs because of that. So that's the two ways I think that we may be seeing an impact of welfare reform on Medicaid.

We have people that are being told they are no longer eligible for welfare services and perhaps being automatically disenrolled for Medicaid and not told you need to reapply for Medicaid.

And we also have people sitting there in an office in a not very nice environment being told that we have all these conditions for you to get welfare services, and they are getting up and walking out the door. And they are not signing up for Medicaid. So we are going lose people that way.

I don't think we will know for sure for about a year or two. We know we have absolutely flat Medicaid enrollment in the State of Washington. It has not increased. The trend was for it to increase. We know that there are Indian people that are eligible that aren't enrolled. I think that there may be an impact. We are just not sure. We have asked tribal health directors to report on this. The stories aren't widespread so the impact doesn't appear to be too great for now. But I think over time we are going to see fewer people.

MODERATOR: Ed, two questions and then I am going to ask for a couple of questions here.

The idea that Medicaid -- can tribes third-party bill on Medicaid if they take over some of the Medicaid eligible programs?

MR. FOX: Yes, we aggressively third-party bill. Beyond Medicaid?

MODERATOR: Yeah. No, just within Medicaid.

MR. FOX: Just within Medicaid.

MODERATOR: Okay. Do you find in the northwest most of the tribes are third-party billing for any type of in-home services, any type of -- for the elderly, anything like that?

MR. FOX: Actually, we are going to talk a little bit about that later this afternoon. We are doing more of that. We are even trying to expand it for possibly having CHRs get paid for providing paternity management services.

I think we do a lot of third-party billing, and we are aggressively expanding what we can bill for, working with states, and I think we have a good working relationship at this point with all three of our states.

Idaho's Medicaid programs doubled in size in the last five years. So even Idaho, in terms of Medicaid, has a fairly decent program.

MODERATOR: Okay. One last --

A PARTICIPANT: The tribes do a better job at billing for third-party Medicaid than the IHS facility.

MODERATOR: The statement was just made that the tribe does a better job at third-party billing even, perhaps, than IHS. IHS is just getting around to figure out how to third-party bill even more, but there is the dollars there that if tribes take over IHS programs they can begin to third-party bill.

One last question before we go to three. When are the tribes going to do Medicaid eligibility? Why is that being kept from tribes to do Medicaid eligibility? We can --

MR. FOX: I think those of us that have TANF, and more of us will, I think they will start to do their own eligibility. Because in Washington State it was the Department of Social and Health Services people that did Medicaid eligibility, that actually did it for the Medicaid program. So the welfare people did Medicaid eligibility.

So if a Washington tribe begins to have its own TANF I think it will be easier for them to move into doing the eligibility on site. You would get more people on the role by having Indian --

MODERATOR: Would it need a change in the law to have such a thing?

MR. FOX: I don't think so, I don't think so.

A PARTICIPANT: We are actually researching that right now. That question has been raised by several tribes. There is a lot of flexibility especially if a state is willing to work with you and what you can do up to the final determination of eligibility. It's that final determination decision that's tricky, and it's tied up with state --

(End Tape 2, Side B.)

A PARTICIPANT: -- and whether it's actually possible for a state to do or not. I am from the State of Idaho and our tribe also has, that works with me, a welfare reform task force. Included in the welfare reform task force we have a representative from our region.

During our meetings, when we talked about food stamps, and we talked about TANF, and we have also talked about Medicaid and how they are all affected by the law, the State of Idaho is possibly looking at -- they already are.

For the food stamp program they also have to do a job search to get their food stamps. The participants do. They are also thinking about doing that for Medicaid.

A PARTICIPANT: No go. They can't do that.

A PARTICIPANT: Okay.

A PARTICIPANT: Your Medicaid eligibility cannot be dependent on things other than --

MODERATOR: Would you speak in the mike here so that we can get that on the recorder?

A PARTICIPANT: The Medicaid eligibility can be dependent on only what's in the law which is income and assets. So these extraneous tests, if it were dedicated to job or something related to the family then that wouldn't be allowed to be counted in the eligibility determination.

MODERATOR: What's our next question over here?

MS. SHELLER: I am JoAnn Sheller (phonetic) from the Stockbridge Mosinee-Biana (phonetic) Mohegans in Wisconsin. We have run an AFDC program, Medicaid program, (inaudible) program, food stamps program for many years.

So when the TANF came along and the difference between TANF and W-2, and looking at the choices, we went to TANF only because we already ran the programs and we wanted to continue to do it. And then we were able to do the TANF the way we wanted to do it.

So that is the question. That does work well for us because we do still send up our own people for MA and for our TANF at the same time so they don't get lost. And we do it not only for our own people, but we do it for all the people in our two townships that we have.

The other thing that we are doing working with the state is they are now looking at having our Medicaid benefits specialist to work in our different clinics. IHS and the different directors in our state have gotten together and asked the state if we can have that specialist in our clinic. And we have applied for that now. So we will be able to do that hopefully.

A PARTICIPANT: Helen Spencer, Legal Services. I am real concerned about the EPSDT, the Early Periodic Screening Detection whatever. I know the rate in Washington State. And Washington State usually takes every Medicaid option -- very, very good about waivers and options and things. But it's fourth from the bottom in the states on EPSDT enrollment. There is just a lot of children that are eligible under that program, and a lot of them have to be Indian kids that aren't getting enrolled.

And my other issue is I really worry that the managed care programs that have Indian children in their managed care aren't doing the periodic testing and aren't doing the good screening and aren't being really held to the fire to really fully give those children all of the health care benefits that they are entitled to.

So I would like to know if our HCFA panelists in particular are working on getting more children, who are currently eligible, located and receiving benefits and monitoring the managed care programs.

Then my other comment, I would say, at least in the State of Washington there is a consent order. It's an old Legal Services case that we are happy to dust off. If people are losing their Medicaid benefits the State of Washington is obligated to look at all eligible programs, if they knock you off one medical program, to look at all the other programs before they terminate you. It's the best practice and it should be the practice in every state.

But at least in our state if you have one of those clients we have got a consent order you would love to see.

A PARTICIPANT: I don't know of a coordinated outreach effort that's run by HCFA in trying to either cajole or help states in pushing outreach for ESPD. That's not my area so I don't know. And it may be the case.

I don't know of a relationship with the State of Washington that we would have with them to ask them to do it on something other than a national basis. It's an area I just don't know enough about.

MODERATOR: Let's take a question back here and follow it up with one over here.

MS. DAVIS: My name is Julia Davis, and I am chair of the Northwest Portland Area Indian Health Board. But I am also on the Nez Perce Tribal Council.

One concern that I have is I belong to the State of Idaho Medical Advisory Committee. And as a tribal representative on that board what I see happening is because the tribes aren't involved with the states at the table talking with them there is a lot of misinformation that the state is getting regarding the tribes. They don't understand our unique problems.

So I appreciate both of the people on the panel being there. But also besides the education I am quite disturbed about the CHIP program. Only the states that can apply. But we as tribes, we also need to be involved in that because it involves our children. And it goes back to working together with the states.

And so the tribal leaders that are here I know it's hard and we all have other meetings that we need to attend, but if we don't attend those meetings we are hurting our children more by not going.

One other quick comment I wanted to make. With the lady from Albuquerque from IHS, were you here this morning?

.MS. DAVIS: There is a lot of concern on the alcohol and mental health issues on the reservations, and we hear it all the time. We see it every week and we feel it. There needs to be a collaborative effort between IHS and the BIA to work with the tribes on addressing that. Because this is being recorded I would make this a very strong recommendation from us as tribal leaders on the welfare reform.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  TAPE 3B

A PARTICIPANT: The answer is yes. I think they work remarkably well. The problem in Oregon is when we started off with the 4E contract the state did not volunteer nor did Warm Springs offer on the match issue. And as we all know, matching 4E is an expensive proposition.

Warm Springs has about 50 kids in care at any one time in substitute care, and you multiply that on just an average of $100 a kid per month times 50 times 12, and we have come up with a lot of money.

I can say that I have been working on that particular issue for almost a year and a half now, and as of last month the Oregon legislative assembly has approved the matched fund for the Warm Springs Tribe. So we have moved in that direction.

We have always made a match for (inaudible) Grand Rond (phonetic). We had a cap on it of 10 children because when we originally struck that deal that was their need. The Grand Rond people will tell you their needs expanded to about 60 kids now, so it is time to revisit that to look at match for Grand Rond.

The offer is on the table for every tribe in Oregon to enter into a four-year agreement with us if they choose to.

MODERATOR: Okay, good. Thank you.

A PARTICIPANT: And I am going to give the mike to Terry. And then I will come back up with a few other comments that I have.

MODERATOR: Okay. As Terry is coming up to the mike it's interesting to note we looked at research in Arizona, Terry, and we see that GA over the last few years has decreased. But almost in direct comparison to that, child neglect and abuse cases have increased. Perhaps, maybe, you could mention some response to that.

A PARTICIPANT: Right. Ed, that's consistent with what's happened in welfare reform in those states that had it before this act was passed. In those states that had welfare reform, prior to welfare reform at the federal level, the child abuse neglect rates went up as the welfare rates went down. So we know that there is a problem in that. Partly that's due to the pressure on single parent families and families living in poverty. Those are the families who are often most likely to neglect.

And in Indian country it is primarily an issue of neglect rather than abuse though abuse still is a problem in our communities. The highest percentage of the people who get into trouble with the system are those where the factors are neglect.

And the research also shows that the neglect of children seems to have little to do with parenting knowledge. It has everything to do with poverty and substance abuse so that when people are overwhelmed and -- it's the depth of poverty, not just income that gets our families in trouble.

It's when you don't have housing or transportation or furniture or your plumbing doesn't work. And all of those things add up so that people aren't able to meet the needs of their kids.

We don't know yet in so many areas what the long-range impact of welfare reform is going to be for the well-being of our kids. And this is an area I want to emphasize. We are talking about child abuse, child neglect, child sexual abuse, abandonment, adoption, foster care, all of those things that have to do with the dependent needs of children.

The Child Welfare League of America estimates that there will be a million new children in the foster care system as a result of both welfare reform and the Adoption and Safe Families Act.

If you take the numbers, as we have done at our association -- I am with the National Indian Child Welfare Association and we try to watch what these things mean in a larger picture. We are about

1 percent of the population but we are about 3½ percent of the foster care population nationwide.

A million new children in care translates into about 35,000 new Indian children in care. And we know that just over half of those are in urban areas. So at the tribal level we are talking about 15,000 new kids in care. I don't see on the horizon new dollars coming in any of the budgets to respond to that need if it in fact develops or is developing out there. And it's one of the things we need to be able to do is to track those numbers.

You can imagine what that's going to do at the state level and tribal level with not only 15,000 new kids in care at the tribal level, but another 15,000 EQUI (phonetic) notices coming to your tribes that you need to respond to and determine whether kids are members of your tribe and whether you are going to intervene in those cases.

So budget impact, you can take some guesses at what that might be. And, again, this is speculation. But one of the things we have to keep in mind here in the relationships between welfare reform and child welfare is the whole larger policy picture with the way families and children are being treated.

And I think the most recent evidence of that is the Adoption and Safe Families Act that is showing us that families -- it's a much more punitive kind of system. What the Adoption and Safe Families Act is saying that child protection, child safety and permanency is paramount above the family reunification and family preservation.

We are basically seeing termination plans started at the moment a child comes into care, so parental rights termination is going to happen much earlier in the process.

We really encourage people to read that Adoption and Safe Families Act and look at it pretty carefully as to how it is going to impact tribes. And while there is no specific language in that act about tribes, other than the extension of the family preservation funding, it will impact any tribe that has 4B funding, Part 1 or Part 2, the child welfare funding or the family preservation funding, or anyone who has a 4E agreement will be impacted by the Adoption and Safe Families Act.

There is a symposium next Tuesday in Seattle on the Adoption and Safe Families Act being put on by Region 10 Office of Administration for Children and Families.

Specifically one of the things we are concerned about with welfare reform is the stress on relative caregivers and grandparents and how those cases are counted, and if grandparents are taking care of kids and receiving welfare.

If the unit that's counted as only the child, we understand that it's not as great an impact. But if the unit is the family, then grandparents may have to go to work under the rules of TANF. So we are going to watch that.

Kinship homes. Especially workers will have greater task and case management in order to make sure that eligible children are receiving the benefits and their families are receiving the benefits under TANF.

There is going to be struggle and pressure between parenting versus work. We estimate that 11 percent of Indian children out there have some form of serious emotional disturbance or serious disability. Those children, we are concerned about the pressure of whether or not you take care of your kids, who needs extra attention, or whether you go to work.

The high percentage of teen parents in our communities is a concern. Teen parents are required to live under adult supervision. Many of those teen parents are also victims of sexual abuse and may be forced into the foster care system if they are going to get any benefit because they can't reside at home.

SSI was cut back for many children. Parents may have to relinquish custody of their children just to get services for their children.

The last issue is child support and whether or not the involvement of parents, especially abusive parents, how we are going to get them to participate in the child support enforcement, and whether or not that's going to raise issues and problems around visitation, access to children, and how well protected that information is about where children and families reside.

And that's just kind of a laundry list of what the potential impact of TANF is.

MODERATOR: Terry, I am kind of interested because I do agree. If the kind of stress we are talking about is going to be placed on those TANF mothers, the chances of child abuse or neglect are dramatically going to increase.

And statistics have shown that through the Indian Child Welfare Act 4E and a number of the other agreements on foster care and developing of foster care, we have been very efficient in the Indian community of removing children and putting them in foster care and haven't spent too much time about how do we preserve the family, how do we keep the family together.

So in some ways we have actually done more placement in foster care, even though it's been with other Indian homes, than when the state was doing it. The question is what's going to happen in the Indian community to keep families together rather than to support foster care or adoption.

A PARTICIPANT: I think it's a legitimate concern. On the one hand you could expect the number of placements to go up as tribes take on responsibility for protecting our own children and we begin to own the problems of child abuse and neglect.

The good side of that is that we are recognizing that there are problems and we are intervening. The negative side of that is that we haven't had the resources to keep families together and to intervene at a time and at a level to prevent those problems rather than having them erupt into more serious problems or we haven't been able to get kids back home quickly enough.

Nationwide, family preservation and family support services are under attack. I don't know if you have read the Adoption and Safe Families Act, but there no longer is a federal statute covering family preservation and family support. That language was done away with under the Adoption and Safe Families Act.

Even though the program of 4B, Part 2, was extended for three additional years, it is no longer called family preservation, family support. It's got another -- services to safe families or something like that. and it added three programs. It added support for adoptive parents, it added family reunification as a service. And there was one more. I think it's pre-adoption services.

So what they are doing is saying that the money that had been set aside before for family preservation, family support, you can now use it for adoption and permanency things, and we are not even going to call this piece of legislation family support and family preservation anymore. We are going to reduce the extension to three years instead of five. And my guess is in the year 2001, unless there are significant changes in our legislative process we will not have family preservation dollars.

The larger mentality, I think, is an anti-family mentality. The Personal Responsibility Act is aimed at that same mentality.

MODERATOR: It's interesting because one of the goals of the act is reunification of family.

A PARTICIPANT: Right.

MODERATOR: So it may have some indication.

Please, questions?

A PARTICIPANT: I would like to share also the concerns that we already have. Many families are refusing to be on TANF because they have been sanctioned already. They are not able to meet those needs because of the barriers, the mental health issues. Either it's alcohol and drug issues that they are not able to deal with, not able to get proper treatment and follow-up afterwards. So reunification is very difficult for these families.

Families are already looking at how they are going to break up their family and plans on how they are going to place their children with other relatives. For the other relatives, their homes are already overcrowded and taking on more responsibility as a parent when they are a grandparent or an uncle.

We have grandparents refusing to go for TANF assistance or No Parent In The Home grants because they have to go to work, they have to get training, and they are already disabled, and they can't deal with that. And they are not able to force the kids to stay in school. Now, if you can't keep your kids in school then you are sanctioned also and you are taken off of the program.

So we have many barriers we are dealing with, just to get the people on TANF and keep them on TANF. Without the assistance of dealing with the barriers it's going to be impossible for us to make sure we are successful in making them self-sufficient.

A PARTICIPANT: Thank you for that comment because this is exactly the kind of thing that's so important for us to document to be able to carry this message back to the policymakers. We can do a policy analysis and try to predict what we think is going to happen, but your case experiences are essential for us to be able to document and to give that information back.

MODERATOR: One other question back here before we move on to the next panel.

MS. MILLS: My name is Robin Mills, and I have a question. As a tribal program, working in tribal program, and not being a mandated reporter, where can I go if I suspect child abuse and/or neglect on our Indian children if we don't have working collaborative relationship with our state CPS office?

A PARTICIPANT: Do you have a child protection or child welfare program on your reservation in your community?

MS. MILLS: That I don't know.

A PARTICIPANT: Because that's where you should start. At this point there are very few people who are not mandated reporters. And even if you are not, going to the child protection authorities is the place to go. Short of that, if you are -- it's often a hard call to know what to do with knowledge about child abuse. Definitely call someone and discuss whether or not you have an appropriate referral either at the state or your child welfare program. If that referral fits, then by all means make it.

MODERATOR: Thank you, Terry. Appreciate that very much.

Let's move on to the area of child support enforcement. Child support enforcement is something that the tribes have not been heavily involved in in the past as we all see here in the future. Basically child support enforcement is the fact that if you have individuals living on the reservation, single parent mothers or single parent spouse with children whose spouse is capable of paying child support, the question is you have got to know who that person is and how do you track them down to enforce the payment of child support. And in order to do that you have got to have a very rigorous state system to track individuals.

So part of the 4D program was added to the welfare reform which basically said if you are going to receive TANF services you must declare who the parent or the father of your children -- in most cases it's the father -- so that that person can be tracked down to make sure or to ensure that they are paying child support.

The question then came on some reservations that are non-280 of the jurisdictional issue of people going on to enforce American Indian people to pay child support. So under the law, as it stands now, welfare reform law states that realizing that the child support enforcement is a rigorous kind of system to be put in place, they have indicated that tribes are able to develop their own. But as an interim step that they might want to sign an agreement with the state that would allow that collection of child support enforcement on reservation.

This is again a relatively new program. But as people are beginning to look at it, particularly as tribes take over TANF program, they can begin to see the possible savings that might be to them in getting child support enforcement payments. However, it's kind of hard -- what do they say, squeezing blood from a turnip or whatever? Most of our people in poverty it's going to be very difficult for them to pay child support.

So there is a lot of issues out there. But a lot of tribes now are beginning to look at how do we get involved in that, how do we make sure that we work, if not in coordination with the state, then how do we begin to develop our own.

Addressing these issues is Sara Coleen (phonetic)

-- excuse me, I didn't get your last name.

MS. SODAMISH: Sodamish (phonetic).

MODERATOR: Okay. Economic Services Administration, Department of Social Human Services, the State of Washington.

And then we have Mr. Jim Olson, Office of Child Support Enforcement, the Minnesota Department of Human Services.

Please.

MS. SODAMISH: It's going to be interesting because they have given me three minutes, maybe four. Can you hear me?

A PARTICIPANT: Mm-hmm.

MS. SODAMISH: Okay. For me that's going to be an awful big challenge, so I am going to give it a shot. We do have handouts at the back and there is a page in there that addresses the tribal child support provisions in the new legislation and also in the Balance Budget Act.

And there is also an action transmittal that's in draft form that addresses cooperative arrangements or cooperative agreements with states and tribes. And there is a couple of other documents there that are helpful in taking a look at child support enforcement in Indian country.

It was very interesting to sit through a lot of the other presentations today because I saw such a trend in a linkage with child support kind of just tying into some of the other programs. And I think that tribes really need to think about this and think about it very seriously.

Child support is tying into TANF, child support is tying into tribal jobs, child support is tying into Medicaid and Indian Health Service.

And it was interesting to see the similarities between child support and Medicaid. There is the state federal partnership. Child support is still an entitlement under the new legislation. The state has to have a state plan. There is a requirement for a state match in order to pull down federal funds, and the federal funds are uncapped. I just found that was really interesting.

In 1976 child support was mandated by the Federal Government to all tribes in the United States. In order to qualify for public assistance monies, AFDC, every state had to have a child support program.

And since then, and that's been quite a few years, there has been a lot of legislation that's provided the states with incentive monies, technical assistance monies, monies for computers, and along with that a lot of rules and regulations and requirements about what we do, how we do it, when we do it, why we do it. And so there has just been a development of some very, very comprehensive child support laws that relate to the state and the Federal Government.

Tribes were, up until recently, practically and for all purposes ignored in the legislation. And so it's been difficult to figure out how the tribes fit into this process.

With this legislation I can see that there is kind of a glimmer of hope, a glimmer, that there is going to be some opportunities for tribes. I am going to just say one thing. Right now it's going to be critical for tribes to think about how they want to do child support. They need to get up to speed on how it's done now so that they can tell the Federal Government how not to do it.

And we need tribal leaders, we need judges and attorneys, and we need everyone here, social services people, to think about it and take some time to prepare some testimony and get involved in some tribal consultation that's going on. Actually there is one session going on right now in Albuquerque.

Some of our basic functions are locate, paternity, support obligations, establishing support obligations, support amounts, enforcement and interstate. The state has been involved in the arena because the tribes, I think there is a void there.

And I am hoping that tribes can involve themselves in this process and kind of take over control, establish their own programs, their own schedules, and do their own thing. I think there are some benefits to that.

I am going to let Jim fill in the rest of the blanks in terms of a little bit more information on the legislation and also the tribal consultation.

MODERATOR: Sara, let me ask you a question before you leave. If the tribe didn't take over TANF, and the state was administering TANF, what is the payoff, or what would be a reason that the tribe would want to have a child support enforcement program of their own? What's the benefit to the tribe, if any?

MS. SODAMISH: So your question is, the state has a TANF program --

MODERATOR: State operated.

MS. SODAMISH: -- and the tribe doesn't?

MODERATOR: And the tribe doesn't. What would be the incentive for the tribe to get into child support enforcement?

MS. SODAMISH: One of the issues that we have seen is that the state does do the child support. They do paternity, they do setting the obligation and the amount, and they attempt to enforce especially those assets that are off the reservation.

The concerns that tribes have is that the state doesn't understand tribal economies. They are setting unreasonable child support orders. I think the tribes, the ones that we have got within in Washington, are saying we can do it better, and we can have our own schedule, we can have our own laws, we can do it according to the way we want to do it.

We don't have to set the amount according to what the state schedule is, and we can use our tribal custom, in-kind support, so we don't have to just set money value to the child support amount. There is a lot more flexibility for the tribes to get involved to take over.

MODERATOR: If they collect that child support enforcement do they have to pay it back to the state to supplant the TANF, or can they keep it as part of their own?

MS. SODAMISH: If they have a tribal TANF program -- actually there isn't a good answer to that right now. It's been very controversial especially in Oregon. Some of the Klamath members here are laughing.

That's another good reason to come to the tribal consultation and to tell the Federal Government how you think money ought to be distributed because right now if a tribe has a TANF program the state is collecting, the assignments to the state, there is a lot of variables in here.

It's very likely that the states are going to be required to collect and send the Federal Government its fair share.

MODERATOR: Okay, thank you.

MS. SODAMISH: Right now there is kind of a whole harmless process going on where the tribes and the states have made agreements already, there is no regulations, there is no rules, and the Federal Government is holding the state harmless.

But if you look at the history of child support the Federal Government really implemented child support to kind of recoup expenses. We talk about requiring parents to be responsible. But the other half is that the Federal Government was spending a lot of money on AFDC. And child support is a very good way of bringing money back into the treasury when they required the assignment for child support and for the states to collect it.

MODERATOR: A lot of unresolved issues there.

MS. SODAMISH: Yes.

MODERATOR: Okay, Mr. Jim Olson is going to tell us how it works in Minnesota.

MR. OLSON: Actually just to expand what Sara Coleen just said because I disagree with her on remitting the monies back to the feds on tribal TANF program. So I think it's unclear all the way around on how distribution will occur under a tribal TANF program. And it will be interesting to see how it plays out.

I am just going to briefly talk about two provisions within (inaudible) that as Sara Coleen talked about, do address tribes and child support. One provision in 42 USC 654-33 provides for the ability for states and tribes to enter into government to government agreements for purposes of child support enforcement, which could mean either the state collecting child support on behalf of the tribal TANF program or the tribe collecting on behalf of the state program or any which way you want to look at it.

It's interesting because Sara Coleen and tribes within the State of Washington have been going down this road for quite some time. But it will be interesting to see how the feds come out, how flexible they are going to be in that area.

The other provision which is in 42 USC 655F, which allows the Secretary of DHHS to contract directly what tribes provide child support services, bypassing the state, that is where the consultations are occurring right now. There is one going on in Albuquerque right now. There is one in Portland, what, in May?

A PARTICIPANT: May 22nd.

MR. OLSON: May 22nd. And then there is one at a future date in Nashville, Tennessee.

That relationship in the child support arena, as I read law, cannot occur until the Secretary does publish and finalize regulations. So it's a wide open game right now. As Sara Coleen said, it's vitally important to get input because nothing is going to happen until those regulations are out in that area,

As Dr. Brown kind of alluded, there is a whole lot of variables. This is totally separate from tribal TANF programs as far as tribes running or not running child support programs. But you can get into a whole bunch of mishmash if the tribe is running the TANF program, not running the child support program, or the state is running the child support program and the TANF program.

I think this is all going to be playing out for quite some time. And as I have said, some people are kind of making a lot of this up as we go along because we have not had a whole lot of directions from the feds at this point.

I am going to quit because I know Dr. Brown is going to come up to this magical line. He is going to give me 15 seconds.

But I did want to just quickly say as of about three days ago Minnesota at least now does have the legislative authority to financially participate with tribes located in Minnesota in the TANF program. We needed legislation to do that. So as I hear, some states were choosing not to participate for whatever very strange reason.

MODERATOR: Jim, let me ask you the question before you sit down. If I were a TANF administered tribal program, what are the benefits if I would want to have a child support program in place in agreement with the state? What's the payoff for the tribe who wants to run their own TANF?

MR. OLSON: Under these provisions there is good and bad about, in my mind I guess, under each provision. There may be more flexibility on a tribe that may go directly to the Federal Government to start a child support program. That's unclear to me at this point.

On the other hand they may lose opportunities. Again, Minnesota, part of our legislation allows the Department of Human Services to share access to all its statewide computer systems to put in child support or TANF system. Or tribes may want to utilize parts or all of those systems. That may be lost if a tribe creates a direct relationship with the Federal Government.

I think until they deal with some of the distribution issues, I don't know that I can fully answer your question. In other words, where child support collections go and who is going to fund -- again, which is another important part, by the way -- the consultation. If a tribe enters into an agreement with the state, the states get 66 percent federal participation to run those programs. The rest of the money is paid for by the states.

You have got that issue to deal with, if a tribe enters into an agreement with the state who is going to cover the non-federal share of administering the program. I think it's unclear and there is opinions all over the place on what will happen when the Secretary issues regulations on the direct relationship.

I don't think they are bound by that 66 percent FP that states are in their relationship with the feds. So I think that's still an open question to be dealt with. Theoretically in my mind it could be 100 percent federal funding of the administration of the child support program going down that road.

MODERATOR: I want to ask Klamath. Do you have a child support?

A PARTICIPANT: Yes.

MODERATOR: Who are you looking for? Aren't you Klamath? Tell us just a little bit how it's working there because it would be interesting. Klamath runs their own TANF program, and you also run a child support with an agreement with the State of Oregon? Or how do you do it?

A PARTICIPANT: Okay. We are developing an agreement, the State of Oregon. Right here is the Oregon child support contact for us. I want to embarrass her while I have the chance.

We do child support enforcement for our TANF program, and they could do the collections for us. I think that, Celeste (phonetic), is the same type of arrangement. We refer the cases. We have the clients fill out the necessary paperwork that we developed to collect information, questionnaires on child support, and refer them over to the State of Oregon to do our child support enforcement collection for us. And they in turn pass 100 percent of the monies collected back to us.

There is no federal match because that whole harmless thing they were talking about earlier. At this point in time the Federal Government has backed off on doing it. Although there was a glitch at the beginning of the year which has been since worked out to some extent.

That's essentially it in a nutshell is that we collect the information, we turn it over to the state, the state collects for us, sends the checks back to us, and we use that then to pay down the amount of money we have been actually paying out in benefits.

It creates revenue for the program and it's kind of been the lifesaver for us because we have had to spend so much money out in expenditures just for our TANF clients. Our case loads, when we took it on, jumped way above what we were expecting them to and what the state identified in 1994. So without that money coming in we would have been really hardpressed to continue the program.

We have had very good cooperative relationship with local regional branch and with the state in Salem. And I want to say that right now up front that we have excellent working relationship with our child support people.

MS. GASPIRINI: I am Chris Gaspirini (phonetic) with the Department of Justice, Support Enforcement Division. The things that John said is true, and we are also working with this in a similar way. I really wanted to stress the consultation that's going to be held. It's tacked on to Northwest Affiliated in May, and it's going to be on the 22nd.

A PARTICIPANT: It's going to be three days, the 20th through the 22nd, and it's going to be --

MS. GASPIRINI: Wednesday, Thursday and Friday.

A PARTICIPANT: -- Wednesday, Thursday and Friday. And then they will have another one in June, June 4th, 5th and 6th in Nashville, Tennessee.

MS. GASPIRINI: The reason why this is so important is right now the feds have not decided how those regulations for child support will be. At this point tribes cannot access money directly from the feds anyway because there is no regulations written. And that's what this consultation process is all about.

The important piece is the distribution of money and really pinning the feds down on exactly how they are going to do it and make sure that it's done tribally sensitive so that we don't end up having to -- either the state run the program and send the

66 percent back to the feds, or they may design regulations that look similar to the states for the tribes, and then the tribes would end up having to pay that 66 percent back to the feds. Frankly, I don't think it can be done.

So I think it's really important that you attend the consultation and ask some really serious questions.

MODERATOR: We are going to have a clarifying comment from John Bushman and then we are going to move on. We have one last comment -- okay, two last. John Bushman and the gentleman up in front.

MR. BUSHMAN: I have a question for the gentleman from Minnesota. I didn't hear your comment because I was buried back here in the back. But I think I heard you say that the State of Minnesota is now going to contribute to tribal TANF state funds?

MR. OLSON: We have the legislative authority now to do it and we (inaudible) authority to do that.

MR. BUSHMAN: You do. And that's just recent?

MR. OLSON: About three days ago the governor signed the legislation.

MR. BUSHMAN: So the governor did sign it?

MR. OLSON: Yeah.

MR. BUSHMAN: Great, thank you.

MODERATOR: One last comment and then we are going to move quickly into our last panel. So try to keep true to time. So if we can have the last.

MR. McKAY; My name is Bob McKay. I am from California. Just a little brief background. California, actually the majority of the tribes live off of their reservations. When we are talking about this TANF are we talking about tribal members that live on the federally recognized land? Because in California at least 50 to 60 percent of the tribal members live off of their reservation.

MODERATOR: John, do you have an answer to that?

MR. BUSHMAN: You define your service area in your plan. You don't have to stick to the reservation. You can define your service area and where you are going to serve. For example, Celeste, you serve what, 11 counties? Klamath serves one county, one big county, one of the biggest in the State of Oregon.

And, again, the law says -- if you go back to Section 412 it says the tribes define the service area, and it's not having to do with anything having to do with the --

A PARTICIPANT: (Inaudible).

MR. BUSHMAN: Oh, yeah, they also define their service population as well. Thank you, yes. So you can serve all Native Americans in that area or just tribal members.

And the other thing the law does is when you go to the state and identify Native Americans in your service area, it just doesn't have to be tribal members in your tribe. It has to be all Native Americans. That's what the law says.

I want to add in one other thing on child support. Since Dr. Brown is back there and I have got the mike, I would like to sing a song. (Laughter.)

Carioca time. We could do with some humor in here.

MODERATOR: Hang on, hang on just a second. Hold that humor while we change panels, please. And then let's go ahead.

MR. BUSHMAN: The thing I want to point out is that child support enforcement is important for Indian families in that once a family transitions from being on TANF to being self-sufficient or having a job and being employed, the child support can follow them. You already have a child support order and everything already established, and it can follow them. And that's real important for self-sufficiency.

(End Tape 3, Side B.)
 
 

MS. O'NEILL: I would like to --

MODERATOR: Please don't hesitate. If you have something, keep prodding us and make sure we get your question voiced.

Welfare of the elders. You have heard several times today people talking about welfare reform and elders who are tending their children. What is interesting in some places we are finding that some of the welfare mothers who have small children, single parent mothers, concerned about themselves finding work, have started to leave their home communities and go into the more urban areas to look for work. And in the process they have left many of their children at home to be cared for either by extended family or grandparents.

Now, we don't know how widespread that is but we have some indication that that is occurring or just because of other alcohol and substance abuse and foster care issues we have grandparents who are taking care of elderly -- taking care of children, excuse me. But now are saying are they or are they not required to meet the same time requirements and work requirements as someone else. This has raised a number of questions and issues in that regard.

We also have the idea of access to health care and how elderly are being signed up. So we have got kind of a wide variety.

We are going to start first with Mr. Dave Baldridge, Executive Director of the National Indian Council on Aging. And then we will move -- we are going to take both of those groups together. So we are going to listen to all of the presentations and then we will go into questions unless you have some burning question that needs to be answered, we will address that as well.

Dave.

MR. BALDRIDGE: In order to understand Indian countries' ability to deal with elder abuse we need to also talk about some pressures on the Indian criminal justice system. A recent Department of Justice report to the attorney general points out that law enforcement in Indian country fails to meet even our basic public safety needs.

In contrast to national trends violent crime is rising sharply in Indian country. A '96 IHS report says the homicide rate for Indian males is almost three times higher than for white males. A reported crime in Indian country is twice as likely to be violent than elsewhere in the U.S.

Between '92 and '96 violent crime in the U.S. dropped by 17 percent while it skyrockets on our reservations. In '95 the murder rate on Fort Peck Reservation was more than twice that of New Orleans. In '96 the Navajo Nation, our largest reservation, had 46 homicides which would place it in this nation's top 20 most violent cities. That same year Laguna Pueblo's nine officers were assaulted 34 times mostly by juveniles. At Salt River (inaudible) drive-by shootings rose from one in 1992 to 55 in '94.

We need resources. The report says we need 4,000 new Indian police officers just to come up to the par with rural America. So it doesn't take a lot of imagination to figure out how well this system is going to serve Indian elders, the victims of silent crimes of abuse.

The few studies suggest that our elders are most frequently suffering from abuse of neglect or financial abuse. Neither is violent, neither results in calls to the police. We don't even like, as Indian people, to talk about it. It's interesting that honoring our elders is a value that we all share regardless of our tribe. And it's a proven vote-getter at election time, that's for sure.

But I think we had better not ever kid ourselves that our current criminal justice system will be able to take care of abuse because it's being overwhelmed by a wave of far more visible violent crime.

As thousands of our young Indian people are losing their welfare benefits, who do we imagine will take care of the grandkids when they leave the rez for their new jobs? When it's Social Security check day, who is going to be first in line to help grandma get to the mailbox?

When junior is out of work, frustrated and drinking, who is the most likely victim? I can tell you it will be his family, his wife, his kids and those same elders.

I am not being flippant about it at all. I am just trying to say that criminal justice may not be the only way that we want to address this problem. We need community base programs such as the Justice Department's new TRIAD program. Creates community partnerships with local law enforcement.

We need day-care centers on our reservations. We need tribal support for Title 7 of the Older Americans Act which has the potential to put five million dollars in the pockets of tribes to help with elder protective activities.

And we need, I think, to better utilize the resources we do have, such as our Title 6 sites, as vehicles to educate elders about abuse, give them a safe place to talk.

I have just received the draft recommendations of a brand new elder abuse report. It's just being published by Dr. Arnold Brown at Northern Arizona University. He points out that elder abuse is very complex for us.

He feels we need a two-prong training program on reservations to first train our families, to understand the circumstances of caring for elders, and to help and plan to provide the care. The second would be training for Indian families on how to do it. I like his thinking.

We thought that elders would probably share our concerns about welfare reform. So we asked our 13 elder board members two weeks ago to distribute a TIN (phonetic) questionnaire form to some elders. They responded with more than 200 of them.

I will stop and not talk to you about these, but these are very interesting questions. As soon as we get them quantified we will supply the results to you because our elders have some very real fears. Eighty percent of them are afraid of abuse. As we get this published we will distribute it to you. Thank you.

MODERATOR: Thank you.

Next we have Yvonne Jackson, Director, the Office of American Indian Alaska Native and Native Hawaiian Programs on Aging.

Yvonne.

MS. JACKSON: Hello. Everybody is still awake, I see. I am going to start my short presentation off with some good news. And the good news is Indians are living longer. We now can look forward to a very long hopefully healthy and happy life for many of us. For some of us that's not the case.

Indian elders are like elders of the general population. All of our life experiences live with us. So when we get a certain age we start developing the chronic diseases, arthritis, many of the conditions that don't allow us to continue functioning the way we did as younger people. That means we often need somebody to help take care of us. And I see this as one of the really big unplanned consequences of welfare reform.

Ninety-five percent of care of elders in our Indian communities is done by family members. All of that, probably 99.9 percent of that, is unpaid for. So if family members are having to move off the reservation to get a job that leaves the elder without care. If the family member has to get a job to work, even if it's close by the reservation, that still leaves the elder without someone to care for them.

For some reason this country has equated work with pay. If you are not getting paid for something it's not considered work. But we know, talking to the care-givers for elderly care, it involves a lot of work.

A lot of what has been said previously today applies to the elders too. The family stresses, the dysfunctional families, all contribute to the elder abuse. And a lot of the elder abuse is not what we see as child abuse. A lot is neglect. The person just does not have someone to take care of them.

I see that this is going to increase in the future. But just like many of our previous speakers said, we are not going to know the increase because we don't have documentation. Unlike child abuse, most states do not require reporting of elder abuse, so we can't say what elder abuse is today and what the difference has been in two or three years.

So getting back to a lot of what Dave said, our judicial system is not set up to deal with elder abuse in the same way that it's set up to deal with child abuse.

I see Dr. Brown walking up here so I will close with that and will be ready for any questions at the end.

MODERATOR: Yvonne, let me ask. What about the whole question, are grandparents tending for their children? Are they going to be held to the same time requirements and work requirements as other individuals?

MS. JACKSON: It's my understanding a lot is age dependent. If you are age 65 and older then you won't be required to work. If you are under age 65 then potentially you will be required to work.

MODERATOR: Yet many of our grandparents who have teenagers who have children, who have left them with their children, are in that under 60 age group --

MS. JACKSON: Right.

MODERATOR: -- that may never have worked before, and have raised their children, and are now raising their grandchildren. Is there any movement to change that or any direction or discussion going on currently?

MS. JACKSON: I have not heard any of it.

MODERATOR: Has anybody in the audience?

A PARTICIPANT: I think our state is looking at that. I have heard DSHS people in Washington State say this is something that they want to look to fix at the state level. I don't know how far that's gotten.

MODERATOR: You know that if you are in a TANF tribe you can set the qualifications however you would like it. But that is a concern and it does raise a number of issues. Okay, thank you.

Let's go on now to Ms. Rebecca Barker, Managed Care Consultant, National Indian Council on Aging.

Rebecca.

MS. BARKER: Good afternoon. I am glad you are still awake.

Through an initiative funded by the W.K. Kellogg Foundation, a voice for Indian elders, the National Indian Council on Aging is conducting a project to help Indian elders understand and influence managed care and health related policy.

The interface between today's health care policies and the Indian health care delivery system has enormous implications for how health care is funded and delivered in Indian communities.

Problems with nutrition, transportation, housing, education, unemployment and health make improving access to quality health care difficult for Indian elders.

The 1990 census shows that 30 percent of Indian age 65 and older who reside in rural areas have no vehicle available to them, 34 percent have no telephone in their living quarters, 24 percent speak English poorly.

In coping with the complications and confusion created by health and welfare policy, change is difficult for elders at best. However, despite the barriers that elders face, Indian elders have overwhelmingly responded to NICOA's initiatives to focus on solution oriented activity to address their most pressing concerns regarding health care.

For example, in New Mexico when we asked Indian elders if they would like to attend a forum to discuss their health care concerns we had 300 people who were primarily Indian elders attend a conference three weeks later.

By conducting forums with Indian elders health care providers and key national state and legislative leadership we hope to identify pressing access and health related issues affecting Indian elders, determine how we can access and target good health care for Indian elders, identify viable solutions to health issues and concerns, and encourage and support collaborative solution oriented activity that will enhance and improve health care for Indian elders.

At these forums elders discuss their most pressing concerns and fears regarding their access to appropriate and adequate health care. In addition health care professionals, who are committed to providing health care to Indian elders, participate and express that they find it difficult to provide quality health care when they are faced with inadequate funding and limited staff who are often insufficiently trained.

Indian elders basically say that they want comprehensive health care delivery that is sensitive to their cultural needs, they want adequate funding sources to obtain comprehensive health care services including preventive health care and long-term care, and they need educational training resources so that they and their families can understand how to obtain these health care services that they need.

Existing programs which could provide funding and resources for access to comprehensive health care services do not often reach Indian elders. Resources from programs such as supplemental security income, Medicaid, Medicare, and other social and medical related programs could make significant difference in the ability for elders to obtain comprehensive health care and get needed items such as dentures, eyeglasses, durable medical equipment, home and community base care for frail elders, long-term care.

Yet Indian elders often are not informed of what their options are. And by the way, IHS cannot provide long-term care services for Indian elders.

Elders tell us that they want to play a role in creating viable solutions to their health concerns. And with the help of AARP, NICOA is currently developing an educational program to help elders help them understand their options. However, without collaborative and cooperative support from federal and state agencies who provide needed funding for health care and education training programs we will be unable to meet those needs.

Welfare reform will place added pressure on elders whose resources are already limited. Indian elders must be able to access health programs and funding resources if we are to limit further negative impacts to the already growing needs of a rapidly expanding Indian elder population.

Thank you for listening.

MODERATOR: My goodness, I can't believe how everybody has been just perfect. Okay. I should have waited until it was over to give the compliment.

Debra, I have a little difficulty on your last name. Help me out there.

MS. CORTORA: Cortora (phonetic).

MODERATOR: Cortora. Okay, Debra Cortora who is the policy analyst at the Office of Medical Assistance Programs, the State of Oregon. We are happy to have you.

MS. CORTORA: Thank you for letting me come and speak to you today. I am the policy analyst for the Medicaid program for American Indians and Alaska Natives.

In our state we do use the quarterly tribal meetings to talk about health issues that face the tribes not only for elders but for all the members of the group. This is an opportunity to move issues forward to the state's attention and for us to take a look and remove barriers and implement change.

When the MOA, the Memorandum of Agreement, was I guess finalized, this was an important forum for us to be able to communicate with each other on how the services would be reimbursed and how that would look. Wasn't an easy process -- a few people are chuckling

-- but we did get through it.

One of the things during that process that I discovered was that there were many services that were covered for people that the tribes felt that they couldn't bill for. And so what we really started doing in this process was taking a look at the services that could actually be reimbursed for.

For example, maternity case management. It took a while to determine that there were two different issues really happening. They were talking about home services being provided, medical, and then maternity case management which is a social support program for the pregnant woman.

Out of that process we were able to define how that could be billed for. And then, also, CHRs would be able to be reimbursed for when they provided the social support through the maternity case management.

We plan on using the same process on looking at potential health barriers for the elders and taking a look at what -- whether there are things that they just think we can't bill for, or if there is actual barriers that are preventing care for the elders.

I guess the biggest message that I want to give with this is that what we discovered was that there were many things that were just misunderstood. And so we took the time to take a look at things and make changes and not be content on just leaving things the way they were.

And I would invite you to question why they say that you can't bill for things, and who can provide those services, and get definitions from the state. I guess that's about it.

MODERATOR: Thank you.

If we can ask you to hold your questions we will take the last speaker and then we will take as many questions as there are.

Again we have Mr. Bruce Greenstein, Health Care Financing Administration.

Bruce.

MR. GREENSTEIN: For those that are still left awake, we will see if I could change that.

I am going to talk briefly about the interplay between Medicare and Medicaid and particularly about some changes that were made through the Balanced Budget Act last year.

Just by a show of hands, are there people over 65 here? Of all those, are you qualified for Medicare?

The new programs that were added that allow Medicaid to buy premiums and pay for some of the services associated with Medicare are limited to those who are qualified for Medicare to begin with. And in order to qualify for Medicare you have to have what is called 40 quarters of credit with Medicare which means you have worked for 10 years with an employer or self-employed that pays into the Medicare system.

So having said that, there are two new categories in Medicaid eligibility which allow for your Medicaid to pay for some of the Medicare expenses such as the premiums, co-pays and deductibles.

There is two groups. One is called the QI group. And for those with incomes between 100 percent and 135 percent of the federal poverty level, these people will be, once enrolled, have Medicaid pay for the Medicare expenses. And if I get too technical here just stop me for a question.

But what this means, oftentimes these individuals are not involved in the Medicaid program previously. So this is really a challenge for states, and in this case tribes, to do outreach for these individuals.

Oftentimes the cost of obtaining health care, even through Medicare, can become prohibitive. And this is a way to allow Medicaid to pay for it, and it also reduces any burden that may be placed on IHS facilities and budgets as well.

The other category is the second called QI, Qualified Individuals 2, for those with incomes between 135, which is the end of the first group, up to 175 percent. Now, this group was a product of Congress' insistence that nobody should establish an increase in their Medicare premium rate because home health was switched from one budget to another.

So the consequence is this benefit pays out $1.07 every month. So far only one state has implemented it. It's Oregon actually. And so individuals get a check for $1.07 at the end of the month to pay the difference in their premium.

But nevertheless this is -- and it's working though. But this is an example, though, that there may not be a great incentive, particularly in the second category, to push for outreach and enrollment. But clearly in the first category there is.

It's important for tribal members, social service organizations, people that have contact in kind of the non-traditional welfare stream where food stamps and cash assistance will be handed out, and people know this information there, but elsewhere to encourage older people that are seeking health care in this manner to get it at least paid for in the way that Congress had designed it to be paid for such as through Medicare and Medicaid. I'll stop there.

MODERATOR: Questions.

A PARTICIPANT: I would like to touch on a little bit, make a comment on what Yvonne Jackson said about elders are living longer now. I think that's great.

What I was going to ask people on the panel or anybody else that wants to answer to it, like on the NASDHAA Committee, we drew the line at 55 to be considered an elder, and above that would be older elders.

On TANF I don't exactly know where you draw the line there and what you are going to make for qualifications to qualify for TANF applications. If you are going to make them work, if they take children in, and this and that all down the line.

I just want to know what kind of flexibilities, all the programs, IHS, TANF, as well as our housing, how we can all work together to get safe and sanitary homes and atmosphere for the elders as well as the children. Would they all be willing to work together?

Okay. Let's say we have a couple that are, let's say, 55, and we have some children that need a place, and these are grandparents, how much flexibility would be allowed for these grandparents to take these children in without requiring them to go to work, and on down the line like that.

What kind of protocol process would we have our people follow. Where could we draw the line for our people to get into homes, decent homes, along with the children. How would they all coordinate together, I guess is what I am asking.

MODERATOR: Who has got a response to that? Dave, can you take that one?

MR. BALDRIDGE: My only experience is with federal programs. We find we are very much at the mercy of those. The Department of Labor, for example, with an employment program, states 55. Title 6 in the Older Americans Act has its own, to us, large and arbitrary limit. I would guess that this might be negotiable with states on an individual basis. Maybe somebody in the audience can help us out, Sue or Helen. I truly can't answer your question. I don't know that.

A PARTICIPANT: Excuse me, one more comment. I guess (inaudible) government to government, state to state would kick in because the reservations, aren't they considered a state within a state?

A PARTICIPANT: Hopefully, yes.

MODERATOR: Probably we could use some creativity and some good thinking that we need to continue to push forward.

Yes, ma'am.

A PARTICIPANT: I think he really touched on a key issue here. I think, really, what we are finding in talking with Indian elders is there are already some existing programs, in addition to TANF, that are not being accessed. And I think it has everything to do with outreach, it has everything to do with having the information and understanding it.

Indian elders need this information but it's got to be simple, it's got to be understandable, and there's got to be a support network out there in communities to help them understand. So basically we have to educate the community, not just elders, about these resources and how we tie them together.

MODERATOR: Okay. Quickly, we have got two more questions.

A PARTICIPANT: Just a question on the QI and the QI-2. I mean, this is an extension of QMB and SLMB in effect. Do you -- again, it's sort of like the EPSDT. It seems like -- the numbers I recall is like the participation already in QMB is only like 50 percent of all the people eligible or enrolled now.

Do you get involved in trying to educate people or getting more information, getting better participation? That's the same population that's addressed by the new legislation that already isn't applying, signing up for QMB or SLMB.

A PARTICIPANT: The answer is I don't have any direct participation, but I know that states have pretty wide variation in the enrollment rates. And they are all, in my estimation, kind of abysmally low.

This is a group that's really difficult to get out and contact because there is not a typical pass-through area like there would be for families, for instance. When Medicaid would be the secondary source of health care payment to Medicare, and Medicare doesn't have central pass-through as well, you lose that ability to a nexus. They would find people naturally.

The other issue is on the QI-1 and 2 they are capped allotments to the states so the states have a little bit of forecasting to do so they don't end up with too many enrollees such that they lose their match by the end of the year because they have too many people in their program, their money runs out and then they have to pay all out of their own pocket.

I don't think that's going to be the case, though. But nevertheless this is another outreach issue, that if states tend to focus on this population and also do a better job at catering to specific groups in, say, different methods of communication and languages, then they may have a better shot at --

A PARTICIPANT: Every reason to get involved earlier and try and locate these elders quicker because the money might not be there if you delay too long.

A PARTICIPANT: Exactly.

MODERATOR: Mr. Fox.

MR. FOX: (Inaudible) Ms. Cortaro if she could tell us how this principle that looks like we are going to establish for maternity case management or maternity use of CHRs to provide services, how that might apply to home and community base care for our elders. How might that go and how might it be a little bit different.

MS. CORTORA: Well, the reimbursement would probably be somewhat different. We would probably have to use like what we call a targeted case management methodology. Targeted case management is when you look at a specific population where you need to provide some social supports in order to achieve a health outcome. And I would suspect that this would in part be something we could take a look at.

The other piece of it really is you talk about the outreach. One of the things that does work for maternity case management is that Title 10, which is a family planning program, many of the Title 10 clinics actually initiate maternity case management on a positive pregnancy result. So at that time they encourage the person that is pregnant to apply for Medicaid to see if they are eligible, and they try and get them into maternity case management.

With elders there may be something similar where you could utilize a program that would initiate the type of outreach to help get them signed up so that they could access the needed medical care that they are eligible for.

MODERATOR: One last question, Mary Ann.

MS. O'NEILL: Yes. I was wondering if anybody up there or anybody in the audience has pursued an idea that some of us have been discussing in New Mexico, and that was since there is such a high level of family members taking care of their elder family relative, the idea of trying to promote work and meeting the requirements of TANF for those individuals that are providing care for their elders, and then developing perhaps working closely with the community colleges or other nearby universities to maybe even get some training for those providers, thereby maintain the family cohesiveness of our Indian families as well as meet the requirements of TANF.

MR. BUSHMAN: Ed, I am going to try to take a stab at this. This gets to the question that the gentleman from Colville (phonetic) -- is it Colville?

A PARTICIPANT: Umatilla.

MR. BUSHMAN: Umatilla. Close. You had raised the question or the issue of a grandparent or grandparents taking care of their grandchildren.

One way that some tribes have been trying to deal with that issue, without kicking in the time limits and the work participation requirements, is to create child only cases. We have to be very careful about child only cases because it's perceived as running counterproductive to the intent of the statute.

For example, you could count these caretaker relatives -- for lack of anything else to call them -- grandparents. You wouldn't count their income or their resources. They wouldn't be receiving the TANF assistance. It would be the child that would be receiving it. So the grandparents wouldn't be required to engage in these work participation regs.

I would be interested in knowing from the State of Oregon how they might deal with this kind of issue.

A PARTICIPANT: I was a dreadful football player. I am glad John didn't throw this at me. Probably would have landed right in the middle of my head.

There are a couple ways of us handling it. We do have a lot of what we call non-needy caretaker grants. Those are grants where grandparents or some other relative actually has an income or does not require assistance. Actually the grant is just going to the children. So that's one way.

Oregon is an aberration. And I mean that in the best sense of the word. We have been called other things, too. We used to have a motto. It said, "Oregon. Things look different here." And I think it's still applicable.

In Oregon we had a waiver to the Family Support Act which allowed Oregon to do some wonderful things. The waiver carried over. And now time limits are not an issue in Oregon. It's virtually impossible to be caught up in our time limits.

For instance, if we had some grandparents who were the caretakers and we were actually giving a grant to the entire family, they would not have to worry, believe me, about time limits. That's not an issue. Participation rates are not an issue in Oregon.

What we do is do a case management on a case-by-case basis. If a grandparent is taking care of children, and work is just really simply not a feasible thing to ask them to do, we don't ask them to do that.

We don't worry, again, about time limits. In the State of Oregon if you are cooperating with what we call the jobs program, and cooperation is if we don't ask you to do anything, and you don't do anything, you are cooperating. Time limits don't count.

If we ask you to do something it may be make sure the children are going to school. And that's your requirement. If you are doing everything you can to make sure the kids are going to school, you are cooperating. Time limits don't count.

So, again, it's a fairly humane system. There is probably a horror story somewhere in the Oregon system, but it's certainly not prevalent.

MODERATOR: I don't want everybody getting a bus and moving to Oregon now with that announcement.

Let's take one very brief comment and then we will move on.

A PARTICIPANT: I would just like to touch a little bit upon what the young lady asked from New Mexico about what kind of plans might be made on different reservations. I would like to use ours for an example on the Umatilla Reservation about what we might have in plans for our elders that might need care themselves.

One of our board members on the council brought it to my attention that her has talked to many people in different cities or counties that said that they would like to come back home to their own reservation and set up, be where they are at.

In our one-year and five-year plan in our housing plan we are going to try to set something up to that effect that we could build some units to where we could provide care for our elders that can't care for themselves.

That's something that you might want to address your council with, that you want them to work with your housing authority as well as the commissioners that that needs to be done.

We are taking a survey, not only on the reservation, but with the elders and with the ones that are off the reservation, of what they want their priorities to be. That's where we are at on that, and I hope that will help you.

MODERATOR: People, let me -- could we have a mike up here? One last comment, and then we are going to give me three to four minutes, and then we will be on our way.

A PARTICIPANT: Who is timing you?

MODERATOR: Mary Ann is timing me.

A PARTICIPANT: In the State of Oregon we have senior disabled services. The caregivers can get trained, receive an orientation, and be certified by the State of Oregon to be a care provider, and that would be one way to get a relative caretaker some money to care for their relative. And I am sure all states have some sort of senior disabled services.

MODERATOR: Thank you. I want to thank our panelists up here. I know it has been a long day for everyone. We covered so much.

But I think it really brings out that once we end this, or conclude it, we have said tribes have got to now, more than ever, because of devolution, that is, the passing of responsibility from the Federal Government down to the local level, in this case tribal governments, that now tribal governments to serve as a true government must begin in a more realistic way to act as a government, and that is the caring for the welfare of its citizens.

So tribal governs more than ever have a greater responsibility than ever before prior to the --probably more -- not since the Euroamerican first came over. So that we begin to see that there is a tremendous amount of pressure and need for creativity. Not unwise creativity, not jumping in when we know we don't have enough resources, but beginning to do some very critical thinking of how we identify those resources.

Now, to do this it's going to require a shift in attitude or in thinking or a paradigm shift or whatever you call it. If I held this glass up as a demonstration, you would describe the contents in this glass as, by saying the glass is --

PARTICIPANTS: Half full.

MODERATOR: -- half empty or half full? If you said the glass was half empty you would be following pretty much the way we have addressed Indian communities because we have addressed Indian communities from the point of problems.

We say Indian communities have the worst this, Indian communities lack this, until finally the word "Indian community" begins to conjure up what kind of an image? Indian communities are the problem. They are the problem.

When in reality if we look at this and say the glass is half full, we understand that the community is not the problem. But in fact the community is the solution. That the solution does not come from outside of the Indian community, but it's from within.

And when we begin to look that the glass is half full, we then begin to say, well, wait a minute. We have been running these social service programs, we have alcohol programs, we have child care programs. Why can't we begin to get those together? We have resources to draw upon.

True, we may not have the most money. But, you know, it's been stated, research by Fred Polack, who looked at all of the nations in the world through history and was trying to determine what made those nations great. And he found that it wasn't the nations that had the most people or that had the most resources or whatever.

He found the deciding factor that was the difference between a great nation and not a great nation was the idea of vision. And he concluded by saying, "Nations with visions are powerfully enabled. Nations without vision are at risk."

We can say the same thing about our own communities. And the question is as we go home clearly we have a challenge. No one knows exactly how we are going to tackle that challenge, but the law is there. But when we go home we must begin to see that the glass is half full.

We must begin to build on the strengths that we have in our communities and understand that if the solution is going to come, it's never going to come from the top down or from the outside in. It's going to come from within.

MODERATOR: -- that other major portion to welfare reform.

I hope you all travel safely, and God bless until we meet again. Thank you. (Applause).

(Whereupon, the conference was adjourned.)