,,iv #aaf? ,,congress #a/ ,session ,h4 ,,res4 #gce ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,novemb] #bf1 #bjai,ms4 ,haal& 7= h]self1 ,ms4 ,adams1 ,mr4 ,aguil>1 ,mr4 ,cole1 ,ms4 ,davids ( ,kansas1 ,ms4 ,escob>1 ,mr4 ,espaillat1 ,ms4 ,gabb>d1 ,mr4 ,gallego1 ,mr4 ,grijalva1 ,ms4 ,norton1 ,mrs4 ,kirkpatrick1 ,mr4 ,l>s5 ( ,wa%+ton1 ,ms4 ,lee ( ,cali=nia1 ,mr4 ,lujn1 ,ms4 ,mc,collum1 ,ms4 ,moore1 ,mrs4 ,napolitano1 ,mr4 ,o',hall]an1 ,ms4 ,ocasio-,cortez1 ,ms4 ,roybal-,all>d1 ,mr4 ,smi? ( ,wa%+ton1 ,ms4 ,spei]1 ,ms4 ,tlaib1 & ,ms4 ,und]wood7 submitt$ ! foll[+ resolution2 :i* 0 ref]r$ to ! ,committee on ,natural ,res\rces1 & 9 addition to ! ,committee on ,en]gy & ,comm]ce1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,,resolution ,recogniz+ ! mat]nal heal? crisis among indig5\s wom5 9 ! ,unit$ ,/ates1 :i* includes ,am]ican ,indian1 ,alaska ,native1 & ,native ,hawaiian wom51 recogniz+ ! importance ( r$uc+ mortality & morbidity among indig5\s wom51 & call+ = urg5t ,f$]al fund+ *anges to ensure compreh5sive1 high-quality1 & culturally compet5t mat]nal heal? & family plann+ s]vices are available4 ,:]eas ,am]ican ,indian1 ,alaska ,native1 & ,native ,hawaiian wom5 9 ! ,unit$ ,/ates suff] f life-?reat5+ pregnancy complications1 kn[n z sev]e mat]nal morbidities1 twice z (t5 z non-,hispanic ,:ite wom52 ,:]eas ,am]ican ,indian & ,alaska ,native wom5 9 ! ,unit$ ,/ates are m ?an twice z likely to die f pregnancy-relat$ causes z non-,hispanic ,:ite wom52 ,:]eas ,am]ican ,indian1 ,alaska ,native1 & ,native ,hawaiian wom5 are m ?an twice z likely to receive late or no pr5atal c>e comp>$ to non-,hispanic ,:ite wom52 ,:]eas ,am]ican ,indian & ,alaska ,native wom5 9 ! ,unit$ ,/ates exp]i5ce high rates ( bir?s by ,ces>ean section :i* exposes !m to additional risk ( develop+ complications2 ,:]eas ! rate ( pov]ty among ,am]ican ,indian & ,alaska ,native wom5 is ne>ly d\ble ! national av]age = all p2 ,:]eas ! ,f$]al ,gov]nm5t is requir$ to provide heal? c>e s]vices to ,am]ican ,indians & ,alaska ,natives z a result ( promises made 9 hundr$s ( treaties ) ! ,indian ,tribes1 au?oriz$ by ! ,con/itution1 & reaffirm$ by ,unit$ ,/ates ,supreme ,c\rt decisions1 ,f$]al legislation1 ,executive ord]s1 & ,f$]al regulations2 ,:]eas ! a=em5tion$ body ( au?ority makes up ! f\ndation ( ,f$]al ,indian law & explicitly def9es ! ,f$]al tru/ responsibility ow$ ,am]ican ,indians & ,alaska ,natives bas$ on _! political /atus2 ,:]eas ,f$]al ,indian law makes cle> t ,indian ,tribes1 ,am]ican ,indians1 & ,alaska ,natives hold a political /atus1 & are n a racial gr\p2 ,:]eas ,am]ican ,indians & ,alaska ,natives receive heal? c>e s]vices1 9 p>tial fulfilm5t ( ! ,f$]al ,gov]nm5t's tru/ responsibility to ! ,indian ,tribes1 ?r\gh heal? programs adm9i/]$ ?r\gh ! ,indian ,heal? ,s]vice 7,,ihs7 & ,tribes & ,urban ,indian ,organizations 7,u,i,os71 collectively kn[n z ! ,,itu or ,,ihs_/,tribal_/,urban2 ,:]eas indig5\s wom5 b5efit f increas$ res\rces & access to community-bas$ heal? c>e facilities1 includ+ indig5\s midwives1 d\las1 & bir? c5t]s2 ,:]eas ! ,,ihs1 z "p ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 op]ates heal? c>e facilities & adm9i/]s & provides fund+ to heal? programs1 includ+ ,,itu facilities = ,am]ican ,indians & ,alaska ,natives1 b rema9s sev]ely und]fund$ & lacks res\rces to provide adequate heal? c>e s]vices = ,am]ican ,indian & ,alaska ,native wom5 t are culturally compet5t1 includ+ pr5atal c>e1 labor & deliv]y s]vices1 & a full range ( culturally in=m$ family plann+ s]vices2 ,:]eas ! lack ( fund+ & res\rces at ,,ihs sev]ely limits ! ability ( ! ,,itu to provide heal? c>e s]vices & adm9i/] heal? programs to ,am]ican ,indians & ,alaska ,natives2 ,:]eas ! ,unit$ ,/ates ,commission on ,civil ,rights f\nd t ,am]ican ,indian & ,alaska ,native heal? c>e provid$ ?r\gh ,,ihs is inequitable & unequal ) ,f$]al exp5ditures p] capita t rema9 well bel[ o!r ,f$]al heal? c>e programs & only cov] a fraction ( ! heal? c>e ne$s = ,am]ican ,indians & ,alaska ,natives2 ,:]eas1 9 #bjag1 ,,ihs heal? c>e exp5ditures p] p]son 7 #c1ccb1 comp>$ to #i1bjg = ,f$]al heal? c>e sp5d+ nationwide2 ,:]eas hi/orical trauma & g5d] oppression1 c\pl$ ) ! social det]m9ants ( heal? inequities exp]i5c$ by indig5\s wom5 9 ! ,unit$ ,/ates1 is fur!r p]petuat$ by sev]e und]fund+ ( ,,itu facilities t cont9ue to contribute to ! disproportionately high rates ( ,am]ican ,indian & ,alaska ,native mat]nal mortality & morbidity rates2 ,:]eas culturally inadequate & in/itutionaliz$ discrim9ation p]petuat$ by ! ,f$]al ,gov]nm5t's failure to uphold ! tru/ responsibility by adequately fund+ heal? c>e s]vices = ,am]ican ,indians & ,alaska ,natives cont9ues to play a consequ5tial role 9 _! heal? c>e exp]i5ces & outcomes2 ,:]eas fully fund+ ! ,f$]al ,gov]nm5t's tru/ & treaty heal? c>e responsibilities1 especially = reproductive heal? c>e s]vices & mat]nal heal? programm+1 is critical to clos+ ! mat]nal heal? disp>ity gap :5 receiv+ c>e at ,,itu facilities1 & heal? s]vices = indig5\s wom5 g5]ally2 & ,:]eas culturally compet5t models = wom5's heal? s]vices are ne$$ to provide appropriate mat]nal heal?1 family plann+1 & *ild heal? s]vices = ,am]ican ,indian & ,alaska ,native wom5 at ,,ihs1 ,u,i,os1 & non-,,ihs facilities3 ,n[1 !re=e1 be x ,t ! ,h\se ( ,repres5tatives-- 7#a7 ackn[l$ges ! unacceptable mat]nal heal? crisis t indig5\s wom5 disproportionately exp]i5ce result+ 9 ! exce$+ly high rates ( mat]nal mortality & morbidity 9 ! ,unit$ ,/ates2 7#b7 calls = urg5t ,f$]al fund+ increases = ! ,indian ,heal? ,s]vice 7,,ihs71 ,tribally ,op]at$ ,heal? ,c5t]s1 ,urban ,indian ,organizations1 & ,native ,hawaiian heal? c>e programs to ensure ,am]ican ,indians1 ,alaska ,natives1 & ,native ,hawaiians h access to compreh5sive1 high-quality1 & culturally compet5t mat]nal heal?1 pr5atal c>e1 & compreh5sive family plann+ s]vices2 7#c7 recognizes ! ,f$]al ,gov]nm5t's failure to uphold ,tribal treaty rights z x p]ta9s to provid+ adequate heal? c>e s]vices to ,am]ican ,indians & ,alaska ,natives2 & 7#d7 calls ^u ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 ,,ihs1 & ! ,heal? ,res\rces & ,s]vices ,adm9i/ration 7,,hrsa7 to prioritize policy = ,am]ican ,indian1 ,alaska ,native1 & ,native ,hawaiian wom5 to r$uce long-/&+ & well-kn[n b>ri]s to access culturally compet5t mat]nal heal? & compreh5sive family plann+ s]vices4