The Honorable Barack Obama President of the United States of America The White House 1600 Pennsylvania Ave., NW Washington, DC 20500

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The Honorable Barack Obama President of the United States of America The White House 1600 Pennsylvania Ave., NW Washington, DC 20500 Dear President Obama: Re: Pending Indian Health Service Cases for Breach of Contract Over Unpaid Contract Support Costs Due Under the Indian Self- Determination Act The undersigned legal counsel jointly write to request a formal meeting with appropriate representatives of your Administration to discuss the possibility of a negotiated settlement of all claims in our contract support cost cases pending against the Indian Health Service. For over three decades the United States has awarded contracts to Indian Tribes and Tribal organizations so that the Tribes could control the delivery of federal health care services within their own communities. This contracting initiative is the product of the Indian Self- Determination Act, and it reinvented the delivery of health care in many Indian communities. In 1988 Congress mandated the Indian Health Service to include in these contracts the full amount of negotiated contract support costs required to prudently administer the contracts. But, for years the agency failed to do so. The Bureau of Indian Affairs, too, failed to pay the full contract support costs due under its contracts. In the recent Cherokee and Ramah decisions the Supreme Court held the government liable in damages for failing to pay these costs to the Tribes. In the recent Arctic Slope decision, the Federal Circuit reiterated this ruling in connection with IHS contracts. Today, over 100 Tribes and tribal organizations have brought an estimated 700 breach of contract claims against the Indian Health Service, with more claims being filed every month. Some claims go as far back as 1996 and have been pending for nearly a decade. Reportedly, the claims already exceed $1 billion dollars. While most claims are pending before the agency, the claims of some two dozen Tribes are pending in the Civilian Board of Contract Appeals, and a few are pending in court. Past claims of this kind have taken years, even decades, to run their course, and more claims are on the way. According to the agency s own records submitted to Congress, Tribes and tribal organizations have been collectively underpaid on their contracts by some $800 million, just over the past six years. On behalf of our tribal clients from across the country, we jointly request a formal meeting with the Attorney General and other appropriate representatives of your Administration to discuss the possibility of a negotiated settlement of these claims. Our clients listed below constitute the majority of the Tribes possessing such claims and the vast majority of the damages sought by the Tribes. We believe that, with the considerable research and record keeping that has been done to date, a fair and equitable resolution of these claims can be achieved within a few months. Otherwise, settlement of these claims could take years and individual litigation could take a decade or more. Either way, these alternatives will consume enormous federal, tribal and judicial resources with no discernable benefit to either the Government or the Tribes.

Fair resolution of these claims is essential to turning the page on the Government s past failure to honor its contracts with Tribes on the same basis as it honors all other government contracts. More fundamentally, fair resolution of these claims is essential to honoring the policy of Tribal Self-Determination and Self-Governance. You have spoken often and eloquently about the need to honor the principle of Tribal Self-Governance, and we are confident that a just settlement of these long-standing claims will do justice to that principle and strengthen the government to government relationship upon which it is based. We have concluded that time is now of the essence, and that a formal meeting should be convened at the very earliest opportunity. Although we represent many different Tribes, Nations and tribal organizations, we are prepared to designate a team who would serve as spokespersons for purposes of meeting with your Administration generally on this matter. You may respond to our request by contacting one of these attorneys, Lloyd Miller, at the Sonosky Chambers firm. We look forward to hearing from you soon, Sincerely yours, Lloyd B. Miller Sonosky, Chambers, Sachse, Miller & Munson, LLP Suite 600 1425 K Sreet Washington, D.C. 20005 Absentee Shawnee Tribe Aleutian Pribilof Islands Association Alaska Native Tribal Health Consortium Arctic Slope Native Association California Rural Indian Health Board Cherokee Nation Chickasaw Nation Chippewa Cree Tribe Choctaw Nation Chugachmiut Citizen Potawatomi Nation Cook Inlet Tribal Council Copper River Native Association Eastern Aleutian Tribes Eastern Shoshone Tribe Fond du Lac Band of Lake Superior Chippewa Forest County Potawatomi Fort Mojave Indian Tribe Fort Peck Assiniboine and Sioux Tribes Great Lakes Indian Fish and Wildlife Commission Grand Ronde Confederated Tribes Kodiak Area Native Association Kenaitze Indian Tribe Knik Tribe Lac du Flambeau Band of Lake Superior Chippewa Little River Band of Ottawa Indians Narragansett Indian Tribe Native Village of Tanana Monte Mills Southern Ute Indian Tribe P.O Box 737 Ignacio, CO 81137 Southern Ute Indian Tribe Steven Boos Maynes, Bradford, Shipps & Sheftel, LLP P.O Box 2717 Durango, CO 81302 Navajo Nation Fort Defiance Indian Hospital Board

Nez Perce Tribe Pit River Health Service Poarch Band of Creek Indians Port Gamble S'Klallam Tribe Pueblo of Isleta Pueblo of Sandia Pueblo of Zuni Puyallup Tribe Red Lake Band of Band of Chippewa Indians Reno Sparks Indian Colony Riverside-San Bernardino County Indian Health Sault St. Marie Tribe of Chippewa Indians Southcentral Foundation SouthEast Alaska Regional Health Consortium Shoshone-Bannock Tribes Shoshone-Paiute Tribes Skokomish Tribal Nation Sleetmute Village Council Southern Indian Health Council Spirit Lake Nation St. Croix Chippewa Indians Standing Rock Sioux Tribe Tanana Chiefs Conference Tlingit & Haida Indian Tribes Tule River Indian Tribe Wampanoag Tribe of Gay Head Wind River Shoshone & Arapaho Tribes Yukon-Kuskowim Health Corporation cc: Honorable Eric Holder, Attorney General U.S. Department of Justice Honorable Kathleen. Sebelius, Secretary U.S. Department of Health and Human Services

2013 Winter Convention Ground Mound, WA RESOLUTION #13-02 "RECOMMENDATION FOR THE SENATE COMMITTEE ON INDIAN AFFAIRS AND HOUSE RESOURCES SUBCOMMITTEE ON INDIAN AND ALASKA NATIVE AFFAIRS TO CONDUCT OVERSIGHT HEARINGS ON IHS AND BIA CONTRACT SUPPORT COST ISSUES" PREAMBLE We the members of the Affiliated Tribes of Northwest Indians of the United States, invoking the divine blessing of the Creator upon our efforts and purposes, in order to preserve for ourselves and our descendants rights secured under Indian Treaties, Executive Orders, and benefits to which we are entitled under the laws and constitution of the United States and several states, to enlighten the public toward a better understanding of the Indian people, to preserve Indian cultural values, and otherwise to promote the welfare of the Indian people, do hereby establish and submit the following resolution: WHEREAS, the Affiliated Tribes of Northwest Indians (ATNI) are representatives of and advocates for national, regional, and specific tribal concerns; and WHEREAS, ATNI is a regional organization comprised of American Indians/Alaska Natives and tribes in the states of Washington, Idaho, Oregon, Montana, Nevada, Northern California, and Alaska; and WHEREAS, the health, safety, welfare, education, economic and employment opportunity, and preservation of cultural and natural resources are primary goals and objectives of the ATNI; and WHEREAS, the Indian Self-Determination and Education Assistance Act (ISDEAA) allows Tribal governments to assume operation of federal health programs managed by the Indian Health Service (IHS) and Bureau of Indian Affairs (BIA) and to receive contract support

AFFILIATED TRIBES OF NORTHWEST INDIANS RESOLUTION #13-02 costs (CSC) to cover the reasonable costs of activities which must be carried out by Tribes in order to ensure compliance with the terms of the contract and prudent management of the program, but normally are not carried on by the Federal government s direct operation of the program or are provided by other resources than those under the contract; and WHEREAS, due to CSC shortfalls, tribally administered IHS and BIA programs end up with less funding and fewer personnel than non-contracted IHS and BIA programs that provide the same services; and WHEREAS, Tribes have been litigating CSC issues with IHS and BIA for over twenty years; and WHEREAS, the Supreme Court has ruled that the Federal government is liable for these CSC underpayments; in Cherokee Nation v. Leavitt the Supreme Court held the United States liable for IHS s failure to pay full CSCs in 1994-1997; and WHEREAS, in Salazar v. Ramah Navajo Chapter, 132 S. Ct. 2181 (2012), the Supreme Court reached the same conclusion over the BIA s 1994-2001 CSC underpayments, notwithstanding "caps" on aggregate CSC spending in each year's appropriations act, and the Ramah decision was held to apply to IHS in Arctic Slope v. Sebelius, No. 2010-1013 (Fed. Cir. Aug. 22. 2012); and WHEREAS, the Salazar v. Ramah Navajo Chapter case affirmed that Tribes carrying out federal programs under the ISDEAA are entitled to full CSC, the reasonable costs of administering those programs and services, just like any other federal contractor, and are entitled to be paid what the statute and its contract promise; and WHEREAS, while the BIA is involved in productive settlement negotiations, the IHS Director on January 14, 2013, issued a Dear Tribal Leader Letter that proposes a costly settlement framework that would require re-auditing every tribal contractor for every claim year, an approach that threatens to turn the claims resolution process into an expensive and drawn-out legal fight that will waste valuable resources better spent providing health care services; and WHEREAS, the IHS proposal ignores the fact that there is reliable data on past years CSC shortfalls in the agency's annual CSC shortfall reports to Congress, required under the ISDEAA and the IHS Manual and certified by IHS as accurate; and WHEREAS, the CSC shortfall data should be used as the starting point for fair and efficient settlements; and WHEREAS, the IHS has refused to make available CSC distribution data for recent years, data which is necessary to ensure the transparency and accountability of the agency's use of appropriated federal funds; and 2013 WINTER CONVENTION PAGE 2

AFFILIATED TRIBES OF NORTHWEST INDIANS RESOLUTION #13-02 WHEREAS, without access to such CSC data, Tribes are unable to determine if the agency is spending its CSC budget lawfully, and whether IHS is submitting accurate data to Congress; and WHEREAS, the need for transparency was underscored in 2011 when IHS made a major error in the estimate it provided to Congress, misleading Congress into reducing an appropriation which would have been sufficient to fully pay all of the contracts IHS had with the Tribes; now THEREFORE BE IT RESOLVED, that ATNI hereby requests the Senate Committee on Indian Affairs and the House Resources Subcommittee on Indian and Alaska Native Affairs convene oversight hearings on contract support cost issues with the IHS and BIA as early as possible in the 113 th Congress; and BE IT FURTHER RESOLVED, that ATNI recommends that the CSC oversight hearings focus on: (1) addressing future ISDEAA contract support cost funding for BIA and IHS in light of the recent Ramah decision, including the possible removal of the CSC spending "caps"; (2) the IHS's proposed approach to settling past years CSC shortfalls; (3) IHS resistance to using CSC shortfall data to settle past years claims; (4) IHS's refusal to share CSC data required under the ISDEAA and IHS Contract Support Cost Policy, and; (5) removing the CSC cap language in the annual appropriations bills and requiring the agencies to request full CSC funding. CERTIFICATION The foregoing resolution was adopted at the 2013 Winter Convention of the Affiliated Tribes of Northwest Indians, held at Great Wolf Lodge, Grand Mound, Washington, on January 28 31, 2013 with a quorum present. Fawn Sharp, President Norma Jean Louie, Secretary 2013 WINTER CONVENTION PAGE 3