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108th Congress                                            Rept. 108-523
                        HOUSE OF REPRESENTATIVES
 2d Session                                                      Part 1

======================================================================



 
        THREE AFFILIATED TRIBES HEALTH FACILITY COMPENSATION ACT

                                _______
                                

                  June 3, 2004.--Ordered to be printed

                                _______
                                

  Mr. Pombo, from the Committee on Resources, submitted the following

                              R E P O R T

                         [To accompany S. 1146]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Resources, to whom was referred the bill (S. 
1146) to implement the recommendations of the Garrison Unit 
Joint Tribal Advisory Committee by providing authorization for 
the construction of a rural health care facility on the Fort 
Berthold Indian Reservation, North Dakota, having considered 
the same, report favorably thereon without amendment and 
recommend that the bill do pass.

                          Purpose of the Bill

    The purpose of S. 1146 is to implement the recommendations 
of the Garrison Unit Tribal Advisory Committee by providing 
authorization for the construction of a rural health care 
facility on the Fort Berthold Indian Reservation, North Dakota.

                  Background and Need for Legislation

    S. 1146 authorizes appropriations for a $20 million health 
care facility on the Fort Berthold Reservation, the reservation 
for the Mandan, Hadatsa, and Arikara Nations (also known as the 
Three Affiliated Tribes). Construction of the facility would 
fulfill a recommendation by the Garrison Unit Tribal Advisory 
Committee, which was formed to study how to compensate the 
Three Affiliated Tribes for loss of property and infrastructure 
from a flood caused by the federal Garrison Dam and Reservoir 
project in the 1940s. When the dam project was being built, 
hundreds of families representing 80% of the tribe were forced 
to relocate as 150,000 acres of the Fort Berthold Indian 
Reservation were flooded. The flood also destroyed 
infrastructure, including a U.S. Public Health Service 
hospital.
    One of the Advisory Committee's recommendations was to 
replace the health care facility. S. 1146 authorizes the 
construction of, and related expenses for, a rural health care 
facility on the Fort Berthold Reservation.

                            Committee Action

    S. 1146 was introduced on May 23, 2003, by Senator Kent 
Conrad D-ND). The Senate passed S. 1146 with an amendment by 
unanimous consent on October 27, 2003. The bill was referred to 
the Committee on Resources and in addition to the Committee on 
Energy and Commerce. On May 19, 2004, the Full Resources 
Committee met to consider the bill. No amendments were offered 
and the bill was ordered favorably reported to the House of 
Representatives by unanimous consent.

            Committee Oversight Findings and Recommendations

    Regarding clause 2(b)(1) of rule X and clause 3(c)(1) of 
rule XIII of the Rules of the House of Representatives, the 
Committee on Resources' oversight findings and recommendations 
are reflected in the body of this report.

                   Constitutional Authority Statement

    Article I, section 8 of the Constitution of the United 
States grants Congress the authority to enact this bill.

                    Compliance With House Rule XIII

    1. Cost of Legislation. Clause 3(d)(2) of rule XIII of the 
Rules of the House of Representatives requires an estimate and 
a comparison by the Committee of the costs which would be 
incurred in carrying out this bill. However, clause 3(d)(3)(B) 
of that rule provides that this requirement does not apply when 
the Committee has included in its report a timely submitted 
cost estimate of the bill prepared by the Director of the 
Congressional Budget Office under section 402 of the 
Congressional Budget Act of 1974.
    2. Congressional Budget Act. As required by clause 3(c)(2) 
of rule XIII of the Rules of the House of Representatives and 
section 308(a) of the Congressional Budget Act of 1974, this 
bill does not contain any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.
    3. General Performance Goals and Objectives. As required by 
clause 3(c)(4) of rule XIII, the general performance goal or 
objective of this bill is to implement the recommendations of 
the Garrison Unit Joint Tribal Advisory Committee by providing 
authorization for the construction of a rural health care 
facility on the Fort Berthold Indian Reservation, North Dakota.
    4. Congressional Budget Office Cost Estimate. Under clause 
3(c)(3) of rule XIII of the Rules of the House of 
Representatives and section 403 of the Congressional Budget Act 
of 1974, the Committee has received the following cost estimate 
for this bill from the Director of the Congressional Budget 
Office:

                                     U.S. Congress,
                               Congressional Budget Office,
                                      Washington, DC, May 26, 2004.
Hon. Richard W. Pombo,
Chairman, Committee on Resources,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 1146, the Three 
Affiliated Tribes Health Facility Compensation Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Eric Rollins.
            Sincerely,
                                      Elizabeth M. Robinson
                                         (For Douglas Holtz-Eakin).
    Enclosure.

S. 1146--Three Affiliated Tribes Health Facility Compensation Act

    Summary: S. 1146 would authorize the appropriation of $20 
million for the construction of a new hospital on the Fort 
Berthold Indian Reservation in North Dakota. The act also would 
authorize the appropriation of such sums as necessary for other 
expenses--such as operating costs--associated with the new 
facility.
    CBO estimates that implementing S. 1146 would cost $2 
million in 2005 and $57 million over the 2005-2009 period, 
assuming appropriation of the necessary funds. These costs 
would be borne by the Indian Health Service (IHS), which would 
construct and operate the new hospital. The act would have no 
effect on direct spending or revenues.
    S. 1146 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would impose no costs on state, local, or tribal 
governments.
    Estimated cost to the Federal Government: The estimated 
budgetary impact of S. 1146 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health). For this estimate, CBO assumes that S. 1146 would be 
enacted by the end of the fiscal year 2004.

------------------------------------------------------------------------
                                         By fiscal year, in millions of
                                                   dollars--
                                      ----------------------------------
                                        2005   2006   2007   2008   2009
------------------------------------------------------------------------
              CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Construction of new hospital:
    Estimated authorization level....      1      1     12      6      0
    Estimated outlays................      1      1     12      6      0
Construction of staff quarters:
    Estimated authorization level....      1      1     12      5      0
    Estimated outlays................      1      1     12      5      0
Equipment and furnishings:
    Estimated authorization level....      0      0      0      3      0
    Estimated outlays................      0      0      0      3      0
Operating costs:
    Estimated authorization level....      0      0      0      5     10
    Estimated outlays................      0      0      0      5     10
Total spending under S. 1146:
    Estimated authorization level....      2      2     24     19     10
    Estimated outlays................      2      2     24     19     10
------------------------------------------------------------------------

    Basis of estimate: CBO estimates that implementing S. 1146 
would cost a total of $57 million over the 2005-2009 period, 
assuming appropriation of the necessary funds. Construction of 
the new hospital would cost $20 million over that period, while 
related costs would total $37 million.
            Construction of new hospital
    S. 1146 would authorize the appropriation of $20 million 
for a new hospital on the Fort Berthold Indian Reservation in 
North Dakota. Based on the Indian Health Service's experience 
in building other hospitals, CBO assumes that planning and 
design for the new hospital would take place during 2005 and 
2006, and that construction would begin in 2007 and be 
completed in 2008. CBO estimates that costs for these 
activities would be $1 million in both 2005 and 2006, $12 
million in 2007, and $6 million in 2008.
            Construction of staff quarters
    In addition to the hospital itself, IHS also would have to 
build living quarters for hospital staff. Based on information 
from IHS, CBO estimates that the cost of these quarters would 
total about $19 million, CBO assumes that these quarters would 
be built at the same time as the hospital, with costs of $1 
million in both 2005 and 2006, $12 million in 2007, and $5 
million in 2008.
            Equipment and furnishings
    Based on information from IHS, CBO estimates that the 
purchase of medical equipment and furnishings for the new 
hospital would cost $3 million in 2008.
            Operating costs
    Based on information from IHS, CBO estimates that staffing 
and maintenance costs for the new hospital would total $5 
million in 2008 and $10 million in 2009. Costs in 2008 would be 
lower because CBO assumes that the new hospital would be open 
for only part of the year.
    Intergovernmental and Private-Sector Impact: S. 1146 
contains no intergovernmental or private-sector mandates as 
defined in UMRA and would impose no costs on state, local, or 
tribal governments.
    Previous CBO estimate: On September 22, 2003, CBO 
transmitted a cost estimate for S. 1146 as ordered reported by 
the Senate Committee on Indian Affairs on July 16, 2003. The 
two versions of the legislation and their estimated costs are 
identical, except that CBO's estimate for the version approved 
by the House Committee on Resources reflects a later assumed 
enactment date, with likely costs over the 2005-2009 period 
(while the earlier estimate showed costs over the 2004-2008 
period).
    Estimate prepared by: Federal Costs: Eric Rollins. Impact 
on state, Local, and Tribal governments: Leo Lex. Impact on the 
Private Sector: Selena Caldera.
    Estimate approved by: Peter H. Fontaine, Deputy Assistant 
Director for Budget Analysis.

                    Compliance With Public Law 104-4

    This bill contains no unfunded mandates.

                Preemption of State, Local or Tribal Law

    This bill is not intended to preempt any state, local or 
tribal law.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

    THREE AFFILIATED TRIBES AND STANDING ROCK SIOUX TRIBE EQUITABLE 
                            COMPENSATION ACT


   TITLE XXXV--THREE AFFILIATED TRIBES AND STANDING ROCK SIOUX TRIBE 
              EQUITABLE COMPENSATION PROGRAM, NORTH DAKOTA


SEC. 3501. SHORT TITLE.

  This title may be cited as the ``Three Affiliated Tribes and 
Standing Rock Sioux Tribe Equitable Compensation Act''.

           *       *       *       *       *       *       *


SEC. 3504. FUNDS.

  (a) * * *

           *       *       *       *       *       *       *

  (c) Authorization of Appropriations.--There are authorized to 
be appropriated such sums as are necessary to carry out this 
section.

           *       *       *       *       *       *       *


[SEC. 3511. AUTHORIZATION.

  [There are authorized to be appropriated such sums as may be 
necessary to carry out the provisions of section 3504 of this 
title.]

SEC. 3511. RURAL HEALTH CARE FACILITY, FORT BERTHOLD INDIAN 
                    RESERVATION, NORTH DAKOTA.

  There are authorized to be appropriated to the Secretary of 
Health and Human Services $20,000,000 for the construction of, 
and such sums as are necessary for other expenses relating to, 
a rural health care facility on the Fort Berthold Indian 
Reservation of the Three Affiliated Tribes, North Dakota.