The Need for Reliable Emergency Medical Transportation for the Isolated Community of King Cove, Alaska

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Good Morning Chairman Murkowski, Ranking Member Cantwell, and Members of the Committee. My name is Denise Desiderio and I am the Policy Director for the National Congress of American Indians.

On behalf of the National Congress of American Indians (NCAI), the oldest, largest, and most representative American Indian and Alaska Native organization serving the broad interests of tribal governments and communities, I’d like to thank you for holding this important hearing on the lack of reliable emergency medical transportation for the isolated community of King Cove in Alaska.

Formed in 1944 as a response to termination and assimilation policies that threatened the existence of American Indian and Alaska Native tribes, NCAI has fought to preserve the treaty rights and sovereign status of tribal governments, while improving the quality of life for Native communities and peoples.

NCAI fully supports the need for a safe and dependable road connection between King Cove and the Cold Bay Airport for the Agdaagux Tribe for emergency and routine medical and health care access for its tribal members.

Twice a year NCAI’s membership comes together to meet on issues of importance to all of Indian Country. At those meetings, members submit, review, and pass resolutions that become the voice of NCAI on issues of national importance. These resolutions are passed much like legislation passes in Congress – through subcommittees, committees and ultimately by the full body. This process ensures that NCAI’s resolutions are thoroughly vetted and become the consensus position of Indian Country.

NCAI’s members have shown consistent and long-standing support for road access to King Cove. In 2007, recognizing the nearly 25 year struggle to build a road, our membership passed a resolution supporting land exchange legislation to build a road for the community of King Cove to improve their access to emergency and routine health care access #DEN-07-036 - The Izembek and Alaska Peninsula Refuge and Wilderness Enhancement and King Cove Safe Access Act.

Following the Secretary of the Interior’s December 2013 decision denying road access to King Cove, NCAI’s membership renewed its support for road access by passing resolutions in 2014 and 2015, recognizing the need for this life saving road. #ECWS-14-010 - Supporting Legislation for a Land Exchange between and among the King Cove Corporation, State of Alaska, and United States of America for a Permanent Road between the King Cove and Cold Bay; #MSP-15-033 – Support for Road Access for the Aleut People of King Cove, Alaska to Cold Bay All Weather Airport.

This is first and foremost an issue of public safety. Access to emergency medical assistance is one of the most basic rights afforded to American citizens. Nowhere is this more relevant than in American Indian and Alaska Native communities who ceded millions of acres of land to form the United States. In exchange, Native communities expect the United States to uphold its federal trust responsibility in areas such as education, land management and health care.

In order for the residents of King Cove to receive high level medical services, they must fly more than 600 miles to Anchorage. This already inconvenient trip becomes impossible when weather conditions close the local airport which occurs an average of 100 days per year. Even when the airport is open, 40 percent of flights are cancelled due to weather conditions.

However, this situation changes from inconvenient to life threatening when serious medical emergencies occur and the residents lack any access to reliable medical transport to health facilities. In these cases, the only options for evacuation of residents becomes medevac airlifts to Anchorage. And oftentimes, those services are not immediately available to residents and take hours or days for evacuations.

For the most serious medical emergencies, including heart attack, childbirth, internal bleeding, dislocated joints and other emergencies, the residents of King Cove are not assured the same access to medical facilities that we all take for granted. In addition, when evacuations must occur, those who are conducting the medical rescue are also putting their lives in danger.

Since Secretary Jewell’s decision in December 2013 to deny road access to the airport from King Cove, 23 medevacs have been needed for medical emergencies. That is an average of 1.5 evacuations per month.

The major reason the road has not been approved yet is concern for the beautiful, diverse, and natural habit that exists in the Izembek National Wildlife Refuge. When the Department of the Interior completed the required NEPA process to support this authorization, it focused solely on the natural environment of the Izembek Refuge and not the health and safety needs of the residents of King Cove.

However, there is no other group that has more at stake regarding the protection of the environment than the Aleut Native population which has inhabited the King Cove area for more than 4,000 years. Since time immemorial, the Aleut have hunted, fished, and subsisted off the land and continue to rely on the practice of their traditional and customary lifeways.

This area is their homeland, it’s where their ancestors are buried, and it’s where their children learn their language and culture from their elders. Respect and reliance on the natural environment is paramount in Indian Country and especially here in King Cove. While the road will have a financial cost and some impact to the natural environment, we must ask: what’s the cost of human life?

While this would be the first road built following designation as a wildlife refuge, having a road in a national wildlife refuge is not something unique or out of the ordinary, especially when considering protecting the health, safety, and welfare of the people who live in the area. Many federal lands including Forest Service, Bureau of Land Management, Fish & Wildlife, and others have small access roads built to reach citizens who might be in need or to prevent fires from spreading to vulnerable areas. This is the exact same concept here: providing a 10 mile, gravel, single-lane non-commercial access road would allow the citizens of King Cove the ability to always access medical services in all types of weather.

The Tribe and residents of King Cove have also made great concessions to meet the federal government more than half-way to build this road. This includes transferring more than 56,000 acres of land owned by the State of Alaska and the King Cove Native Corporation in exchange for only 206 acres to build the 13 foot wide gravel road.

In 2009, this Congress passed the Omnibus Public Land Management Act authorizing this land transfer and sanctioning the building of the road connecting King Cove to Cold Bay. The President signed this bill into law but the subsequent Environmental Impact Study led to rejection of Congress’ intent.

NCAI is simply asking the Department of the Interior to fully implement that Act and provide for the health and safety of the residents of King Cove, Alaska