S. 1929 (rs) To amend the Native Hawaiian Health Care Improvement Act to revise and extend such Act. [Reported in Senate] ...

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106th CONGRESS
  2d Session
                                S. 1929


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 27, 2000

                 Referred to the Committee on Commerce

_______________________________________________________________________

                                 AN ACT


 
To amend the Native Hawaiian Health Care Improvement Act to revise and 
                            extend such Act.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Native Hawaiian Health Care 
Improvement Act Reauthorization of 2000''.

SEC. 2. AMENDMENT TO THE NATIVE HAWAIIAN HEALTH CARE IMPROVEMENT ACT.

    The Native Hawaiian Health Care Improvement Act (42 U.S.C. 11701 et 
seq.) is amended to read as follows:

``SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    ``(a) Short Title.--This Act may be cited as the `Native Hawaiian 
Health Care Improvement Act'.
    ``(b) Table of Contents.--The table of contents of this Act is as 
follows:

        ``Sec. 1. Short title; table of contents.
        ``Sec. 2. Findings.
        ``Sec. 3. Definitions.
        ``Sec. 4. Declaration of national Native Hawaiian health 
                            policy.
        ``Sec. 5. Comprehensive health care master plan for Native 
                            Hawaiians.
        ``Sec. 6. Functions of Papa Ola Lokahi and Office of Hawaiian 
                            Affairs.
        ``Sec. 7. Native Hawaiian health care.
        ``Sec. 8. Administrative grant for Papa Ola Lokahi.
        ``Sec. 9. Administration of grants and contracts.
        ``Sec. 10. Assignment of personnel.
        ``Sec. 11. Native Hawaiian health scholarships and fellowships.
        ``Sec. 12. Report.
        ``Sec. 13. Use of Federal Government facilities and sources of 
                            supply.
        ``Sec. 14. Demonstration projects of national significance.
        ``Sec. 15. National Bipartisan Commission on Native Hawaiian 
                            Health Care Entitlement.
        ``Sec. 16. Rule of construction.
        ``Sec. 17. Compliance with Budget Act.
        ``Sec. 18. Severability.

``SEC. 2. FINDINGS.

    ``(a) General Findings.--Congress makes the following findings:
            ``(1) Native Hawaiians begin their story with the Kumulipo 
        which details the creation and inter-relationship of all 
        things, including their evolvement as healthy and well people.
            ``(2) Native Hawaiians are a distinct and unique indigenous 
        peoples with a historical continuity to the original 
        inhabitants of the Hawaiian archipelago within Ke Moananui, the 
        Pacific Ocean, and have a distinct society organized almost 
        2,000 years ago.
            ``(3) The health and well-being of Native Hawaiians are 
        intrinsically tied to their deep feelings and attachment to 
        their lands and seas.
            ``(4) The long-range economic and social changes in Hawaii 
        over the 19th and early 20th centuries have been devastating to 
        the health and well-being of Native Hawaiians.
            ``(5) Native Hawaiians have never directly relinquished to 
        the United States their claims to their inherent sovereignty as 
        a people or over their national territory, either through their 
        monarchy or through a plebiscite or referendum.
            ``(6) The Native Hawaiian people are determined to 
        preserve, develop and transmit to future generations their 
        ancestral territory, and their cultural identity in accordance 
        with their own spiritual and traditional beliefs, customs, 
        practices, language, and social institutions. In referring to 
        themselves, Native Hawaiians use the term `Kanaka Maoli', a 
        term frequently used in the 19th century to describe the native 
        people of Hawaii.
            ``(7) The constitution and statutes of the State of 
        Hawaii--
                    ``(A) acknowledge the distinct land rights of 
                Native Hawaiian people as beneficiaries of the public 
                lands trust; and
                    ``(B) reaffirm and protect the unique right of the 
                Native Hawaiian people to practice and perpetuate their 
                cultural and religious customs, beliefs, practices, and 
                language.
            ``(8) At the time of the arrival of the first nonindigenous 
        peoples in Hawaii in 1778, the Native Hawaiian people lived in 
        a highly organized, self-sufficient, subsistence social system 
        based on communal land tenure with a sophisticated language, 
        culture, and religion.
            ``(9) A unified monarchical government of the Hawaiian 
        Islands was established in 1810 under Kamehameha I, the first 
        King of Hawaii.
            ``(10) Throughout the 19th century and until 1893, the 
        United States--
                    ``(A) recognized the independence of the Hawaiian 
                Nation;
                    ``(B) extended full and complete diplomatic 
                recognition to the Hawaiian Government; and
                    ``(C) entered into treaties and conventions with 
                the Hawaiian monarchs to govern commerce and navigation 
                in 1826, 1842, 1849, 1875 and 1887.
            ``(11) In 1893, John L. Stevens, the United States Minister 
        assigned to the sovereign and independent Kingdom of Hawaii, 
        conspired with a small group of non-Hawaiian residents of the 
        Kingdom, including citizens of the United States, to overthrow 
        the indigenous and lawful government of Hawaii.
            ``(12) In pursuance of that conspiracy, the United States 
        Minister and the naval representative of the United States 
        caused armed naval forces of the United States to invade the 
        sovereign Hawaiian Nation in support of the overthrow of the 
        indigenous and lawful Government of Hawaii and the United 
        States Minister thereupon extended diplomatic recognition of a 
        provisional government formed by the conspirators without the 
        consent of the native people of Hawaii or the lawful Government 
        of Hawaii in violation of treaties between the 2 nations and of 
        international law.
            ``(13) In a message to Congress on December 18, 1893, then 
        President Grover Cleveland reported fully and accurately on 
        these illegal actions, and acknowledged that by these acts, 
        described by the President as acts of war, the government of a 
        peaceful and friendly people was overthrown, and the President 
        concluded that a `substantial wrong has thus been done which a 
        due regard for our national character as well as the rights of 
        the injured people required that we should endeavor to repair'.
            ``(14) Queen Lili`uokalani, the lawful monarch of Hawaii, 
        and the Hawaiian Patriotic League, representing the aboriginal 
        citizens of Hawaii, promptly petitioned the United States for 
        redress of these wrongs and for restoration of the indigenous 
        government of the Hawaiian nation, but this petition was not 
        acted upon.
            ``(15) The United States has acknowledged the significance 
        of these events and has apologized to Native Hawaiians on 
        behalf of the people of the United States for the overthrow of 
        the Kingdom of Hawaii with the participation of agents and 
        citizens of the United States, and the resulting deprivation of 
        the rights of Native Hawaiians to self-determination in 
        legislation enacted into law in 1993 (Public Law 103-150; 107 
        Stat. 1510).
            ``(16) In 1898, the United States annexed Hawaii through 
        the Newlands Resolution without the consent of or compensation 
        to the indigenous peoples of Hawaii or their sovereign 
        government who were thereby denied the mechanism for expression 
        of their inherent sovereignty through self-government and self-
        determination, their lands and ocean resources.
            ``(17) Through the Newlands Resolution and the 1900 Organic 
        Act, the Congress received 1,750,000 acres of lands formerly 
        owned by the Crown and Government of the Hawaiian Kingdom and 
        exempted the lands from then existing public land laws of the 
        United States by mandating that the revenue and proceeds from 
        these lands be `used solely for the benefit of the inhabitants 
        of the Hawaiian Islands for education and other public 
        purposes', thereby establishing a special trust relationship 
        between the United States and the inhabitants of Hawaii.
            ``(18) In 1921, Congress enacted the Hawaiian Homes 
        Commission Act, 1920, which designated 200,000 acres of the 
        ceded public lands for exclusive homesteading by Native 
        Hawaiians, thereby affirming the trust relationship between the 
        United States and the Native Hawaiians, as expressed by then 
        Secretary of the Interior Franklin K. Lane who was cited in the 
        Committee Report of the Committee on Territories of the House 
        of Representatives as stating, `One thing that impressed me . . 
        . was the fact that the natives of the islands . . . for whom 
        in a sense we are trustees, are falling off rapidly in numbers 
        and many of them are in poverty.'.
            ``(19) In 1938, Congress again acknowledged the unique 
        status of the Native Hawaiian people by including in the Act of 
        June 20, 1938 (52 Stat. 781 et seq.), a provision to lease 
        lands within the extension to Native Hawaiians and to permit 
        fishing in the area `only by native Hawaiian residents of said 
        area or of adjacent villages and by visitors under their 
        guidance'.
            ``(20) Under the Act entitled `An Act to provide for the 
        admission of the State of Hawaii into the Union', approved 
        March 18, 1959 (73 Stat. 4), the United States transferred 
        responsibility for the administration of the Hawaiian Home 
        Lands to the State of Hawaii but reaffirmed the trust 
        relationship which existed between the United States and the 
        Native Hawaiian people by retaining the exclusive power to 
        enforce the trust, including the power to approve land 
        exchanges, and legislative amendments affecting the rights of 
        beneficiaries under such Act.
            ``(21) Under the Act entitled `An Act to provide for the 
        admission of the State of Hawaii into the Union', approved 
        March 18, 1959 (73 Stat. 4), the United States transferred 
        responsibility for administration over portions of the ceded 
        public lands trust not retained by the United States to the 
        State of Hawaii but reaffirmed the trust relationship which 
        existed between the United States and the Native Hawaiian 
        people by retaining the legal responsibility of the State for 
        the betterment of the conditions of Native Hawaiians under 
        section 5(f) of such Act.
            ``(22) In 1978, the people of Hawaii amended their 
        Constitution to establish the Office of Hawaiian Affairs and 
        assigned to that body the authority to accept and hold real and 
        personal property transferred from any source in trust for the 
        Native Hawaiian people, to receive payments from the State of 
        Hawaii due to the Native Hawaiian people in satisfaction of the 
        pro rata share of the proceeds of the Public Land Trust created 
        under section 5 of the Admission Act of 1959 (Public Law 83-3), 
        to act as the lead State agency for matters affecting the 
        Native Hawaiian people, and to formulate policy on affairs 
        relating to the Native Hawaiian people.
            ``(23) The authority of the Congress under the Constitution 
        to legislate in matters affecting the aboriginal or indigenous 
        peoples of the United States includes the authority to 
        legislate in matters affecting the native peoples of Alaska and 
        Hawaii.
            ``(24) The United States has recognized the authority of 
        the Native Hawaiian people to continue to work towards an 
        appropriate form of sovereignty as defined by the Native 
        Hawaiian people themselves in provisions set forth in 
        legislation returning the Hawaiian Island of Kaho`olawe to 
        custodial management by the State of Hawaii in 1994.
            ``(25) In furtherance of the trust responsibility for the 
        betterment of the conditions of Native Hawaiians, the United 
        States has established a program for the provision of 
        comprehensive health promotion and disease prevention services 
        to maintain and improve the health status of the Hawaiian 
        people. This program is conducted by the Native Hawaiian Health 
        Care Systems, the Native Hawaiian Health Scholarship Program 
        and Papa Ola Lokahi. Health initiatives from these and other 
        health institutions and agencies using Federal assistance have 
        been responsible for reducing the century-old morbidity and 
        mortality rates of Native Hawaiian people by providing 
        comprehensive disease prevention, health promotion activities 
        and increasing the number of Native Hawaiians in the health and 
        allied health professions. This has been accomplished through 
        the Native Hawaiian Health Care Act of 1988 (Public Law 100-
        579) and its reauthorization in section 9168 of Public Law 102-
        396 (106 Stat. 1948).
            ``(26) This historical and unique legal relationship has 
        been consistently recognized and affirmed by Congress through 
        the enactment of Federal laws which extend to the Native 
        Hawaiian people the same rights and privileges accorded to 
        American Indian, Alaska Native, Eskimo, and Aleut communities, 
        including the Native American Programs Act of 1974 (42 U.S.C. 
        2991 et seq.), the American Indian Religious Freedom Act (42 
        U.S.C. 1996), the National Museum of the American Indian Act 
        (20 U.S.C. 80q et seq.), and the Native American Graves 
        Protection and Repatriation Act (25 U.S.C. 3001 et seq.).
            ``(27) The United States has also recognized and reaffirmed 
        the trust relationship to the Native Hawaiian people through 
        legislation which authorizes the provision of services to 
        Native Hawaiians, specifically, the Older Americans Act of 1965 
        (42 U.S.C. 3001 et seq.), the Developmental Disabilities 
        Assistance and Bill of Rights Act Amendments of 1987, the 
        Veterans' Benefits and Services Act of 1988, the Rehabilitation 
        Act of 1973 (29 U.S.C. 701 et seq.), the Native Hawaiian Health 
        Care Act of 1988 (Public Law 100-579), the Health Professions 
        Reauthorization Act of 1988, the Nursing Shortage Reduction and 
        Education Extension Act of 1988, the Handicapped Programs 
        Technical Amendments Act of 1988, the Indian Health Care 
        Amendments of 1988, and the Disadvantaged Minority Health 
        Improvement Act of 1990.
            ``(28) The United States has also affirmed the historical 
        and unique legal relationship to the Hawaiian people by 
        authorizing the provision of services to Native Hawaiians to 
        address problems of alcohol and drug abuse under the Anti-Drug 
        Abuse Act of 1986 (Public Law 99-570).
            ``(29) Further, the United States has recognized that 
        Native Hawaiians, as aboriginal, indigenous, native peoples of 
        Hawaii, are a unique population group in Hawaii and in the 
        continental United States and has so declared in Office of 
        Management and Budget Circular 15 in 1997 and Presidential 
        Executive Order No. 13125, dated June 7, 1999.
            ``(30) Despite the United States having expressed its 
        commitment to a policy of reconciliation with the Native 
        Hawaiian people for past grievances in Public Law 103-150 (107 
        Stat. 1510) the unmet health needs of the Native Hawaiian 
        people remain severe and their health status continues to be 
        far below that of the general population of the United States.
    ``(b) Unmet Needs and Health Disparities.--Congress finds that the 

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