Fast Facts

Tens of thousands of American Indians and Alaska Natives do not have safe drinking water or wastewater disposal in their homes, which may negatively affect their health.

We found that the Indian Health Service (and other federal agencies that fund tribal water projects) spent about $370 million on these projects in 2016. However, they didn't always prioritize projects in areas that lacked safe drinking water or wastewater disposal.

We recommended that IHS and the Department of Agriculture update their processes to prioritize tribal water infrastructure projects in communities that currently lack safe drinking water and wastewater disposal.

Construction of community drinking water and sewer lines in Eek, Alaska (April 2017)

Photograph of construction crew installing drinking water and sewer transmission lines.

Photograph of construction crew installing drinking water and sewer transmission lines.

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Highlights

What GAO Found

Federal agencies have identified several billion dollars in existing and future tribal drinking water and wastewater infrastructure needs. Specifically, the Indian Health Service (IHS) worked with tribes to identify, in fiscal year 2016, an estimated $3.2 billion in water infrastructure projects to address existing sanitation deficiencies in Indian homes, and the Environmental Protection Agency (EPA) identified an additional $2.4 billion in future tribal drinking water infrastructure needs over the next 20 years. However, IHS could enhance the accuracy of its information about the water infrastructure needs of some Indian homes. In February 2018, the database that IHS uses to track Indian homes' sanitation deficiencies showed that about one-third of the homes (138,700) had no deficiency. However, because the database does not provide IHS with a way to record if a home's deficiency has been assessed, IHS could not determine whether these homes had no deficiency or if they had not yet been assessed to identify a deficiency. IHS officials stated that improving the database's accuracy would be beneficial. By implementing a way to indicate in its database whether these homes' deficiencies have been assessed, IHS could also more efficiently address any deficiencies in these homes.

Federal agencies provided about $370 million for tribal drinking water and wastewater infrastructure projects in fiscal year 2016, including some projects to address what the agencies identified as the most severe sanitation deficiencies (i.e., communities that lack safe drinking water or wastewater disposal). IHS and U.S. Department of Agriculture (USDA) policies direct the agencies to fund tribal projects that address these deficiencies. However, agency scoring processes may not always prioritize the projects that address them:

IHS assigns points to projects using eight scoring factors, including sanitation deficiency and cost. Based on GAO's review of IHS documents and interviews with agency officials, IHS's process for selecting projects can discourage funding some projects that address the most severe sanitation deficiencies, especially those with a relatively high cost per home. As a result, some projects to serve homes without water infrastructure can remain unfunded for many years. IHS officials said the scoring factors balance a number of interests, and the agency is looking to improve the extent to which it funds projects that address these deficiencies.

USDA uses a different set of scoring factors to assign points when evaluating project applications for its tribal water program, including rural population and income levels. However, USDA does not have a scoring factor to assign points to a project based on whether it will serve homes that lack safe drinking water or wastewater disposal, as it does with another program with similar goals. Instead, USDA officials said they use discretionary points to score projects on this basis, but these points may not be awarded at all. As a result, USDA may not have reasonable assurance that it consistently evaluates project applications in a way that aligns with agency policy to fund projects that address the most severe sanitation deficiencies.

By IHS reviewing and USDA updating their scoring processes, the agencies could have more assurance that the projects they fund address the most severe sanitation deficiencies in Indian communities.

Why GAO Did This Study

Tens of thousands of American Indians and Alaska Natives do not have safe drinking water or wastewater disposal in their home—referred to as needs arising from a sanitation deficiency—at a higher percentage than the general population, according to IHS. Among other things, IHS assesses homes, either individually or by reviewing public water systems, to determine any deficiencies. Seven agencies, including IHS, EPA, and USDA, have programs that provide drinking water and wastewater infrastructure assistance to Indian tribes.

GAO was asked to review federal efforts to provide water infrastructure assistance to Indian tribes. This report examines, among other objectives, the extent to which selected federal agencies (1) identified tribes' drinking water and wastewater infrastructure needs and (2) funded tribal water infrastructure projects, including tribes' most severe sanitation deficiencies. GAO reviewed agency data on tribal needs, analyzed agency funding data for tribal water infrastructure projects, reviewed agency policy documents, and interviewed agency officials and officials from 22 tribes representing different geographic locations.

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Recommendations

GAO is making 16 recommendations, including that (1) IHS develop a way to indicate in its database if homes' deficiencies have been assessed and (2) IHS and USDA review and update project scoring processes. IHS agreed with these recommendations, and USDA proposed an approach for addressing the recommendation on scoring, as discussed in the report.

Recommendations for Executive Action

Agency Affected Recommendation Status
Indian Health Service 1. The Director of IHS should implement a targeted, resource-efficient method to identify additional eligible Indian homes that may have existing deficiencies to include in IHS's Home Inventory Tracking System (HITS). (Recommendation 1)
Open
In August 2018, IHS's Division of Sanitation Facilities Construction issued a memo to its Area Directors directing them to identify additional eligible Indian homes that may have existing deficiencies to include in HITS. The memo directed Area Offices to use existing staffing resources to leverage their annual efforts to gather sanitation needs data, in collaboration with tribes, to identify any additional homes. In August 2020, IHS officials stated that, as a result of implementing the 2018 memo, Area Directors had increased the number of eligible homes that they identified in 2019, and that Area staff are expected to work with tribes annually to identify additional eligible homes. We will continue to monitor the results of IHS's actions.
Indian Health Service 2. The Director of IHS should implement a mechanism to indicate in HITS whether each home with a deficiency level of 0 has been assessed. (Recommendation 2)
Open
As of August 2020, IHS had developed a mechanism in HITS to indicate whether a home currently classified as deficiency level (DL) 0 had been assessed. IHS stated that it has modified the category of DL 0 in HITS so that it captures just those homes that are pending assessment. IHS also added a field in HITS where staff can assign each DL 0 home to a category that will help the agency prioritize the homes based on their eligibility to receive assistance from IHS. Homes currently in HITS labeled as a DL 0 and that received service through the Sanitation Facilities Construction Program from 2015 through today will be reassigned a DL 1 to indicate the deficiencies are only associated with routine operations and maintenance. IHS stated that the changes to HITS have been implemented and shared screenshots of the new fields. We are awaiting confirmation from IHS that the changes to HITS, and instructions for how to implement them, have been communicated to field staff.
Indian Health Service 3. The Director of IHS should reassess the point distribution across the Sanitation Deficiency System scoring factors as part of its program guidelines update, in light of trade-offs between funding projects that address the most severe sanitation deficiencies and projects that meet other needs. (Recommendation 3)
Closed - Implemented
In November 2019, IHS issued an updated Sanitation Deficiency System (SDS) guide that included a revised point distribution across the SDS scoring factors. The revision increased the weight of the deficiency level scoring factor and decreased the weight of the capital cost factor. According to IHS, the intent of these changes is to elevate projects for funding that address the most severe sanitation deficiencies over projects addressing lower level deficiencies. As part of its reassessment of the point distribution across the scoring factors, IHS consulted with federally-recognized tribes and analyzed various options for changing the point distribution. In light of these actions, we are closing this recommendation as implemented.
Department of Agriculture 4. The Assistant to the Secretary of Agriculture for Rural Development should implement a scoring factor that awards points for proposed Native American program grant projects that address health risks from a lack of access to safe drinking water and wastewater disposal, as it does with the Colonias grant program. (Recommendation 4)
Open
As of January 2020, USDA stated it would prefer to use its discretionary points under its existing regulations to implement this scoring factor instead of making a regulation change to do so. USDA stated that using existing flexibility in the regulations could meet the intent of the recommendation more quickly than by permanently changing the regulation. USDA stated that it has established policy guidance to states that addresses scoring for projects with health and sanitation risks. We will monitor the actions that USDA has taken in response to this recommendation and evaluate them when complete.
Department of Agriculture 5. The Assistant to the Secretary of Agriculture for Rural Development should ensure that all Rural Alaska Village grants are awarded only to recipients authorized by law or seek authority to award grants to municipalities and Alaska Native villages. (Recommendation 5)
Closed - Implemented
In December 2018, section 306D of the Consolidated Farm and Rural Development Act was amended to authorize USDA to award Rural Alaska Village grants to Alaska Native villages. However, the new statutory language did not identify municipalities as eligible recipients. In April 2019, USDA stated that the agency did not intend to award Rural Alaska Village grants to municipalities in the future. The agency provided documentation that it did not award Rural Alaska Village grants to municipalities in fiscal years 2017, 2018, or 2019. In June 2019, USDA's Alaska State Office communicated to its area staff that municipalities are not eligible recipients of Rural Alaska Village grants. We believe USDA's actions sufficiently satisfy this recommendation.
Department of Agriculture 6. The Assistant to the Secretary of Agriculture for Rural Development should amend the Rural Alaska Village Grant program regulations so that they are consistent with USDA's authority. (Recommendation 6)
Closed - Implemented
In December 2018, section 306D of the Consolidated Farm and Rural Development Act was amended to authorize USDA to award Rural Alaska Village grants to Native villages as defined in the Alaska Native Claims Settlement Act (ANCSA). In April 2020, USDA amended the definition of Native villages in the Rural Alaska Village Grant program regulations so that it uses the ANCSA definition of Native village, making the regulatory definition consistent with USDA's authority.
Indian Health Service 7. The Director of IHS, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 7)
Open
As of December 2019, IHS had reviewed the 2011 task force report and summarized actions taken and challenges associated with implementing the remaining recommendations. IHS stated that it anticipated discussing its summary with the other members at a future tribal infrastructure task force meeting. We will evaluate IHS's actions when they are complete.
Environmental Protection Agency 8. The Administrator of EPA, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 8)
Open
As of June 2020, EPA had discussed the 2011 task force report with the other member agencies to identify and implement additional actions to increase collaboration at the national level. EPA published a summary matrix of relevant funding sources on the task force website and compiled a draft document summarizing actions the task force member agencies have taken to implement recommendations from the 2011 report. We will continue to monitor EPA's actions in response to this recommendation.
Department of Agriculture 9. The Assistant to the Secretary of Agriculture for Rural Development, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 9)
Open
In July 2019, the task force member agencies met to discuss the status of the recommendations in the 2011 task force report. The agencies each agreed to compile information about the actions they had taken and consider new actions in 2020. USDA stated in December 2018 that the task force agencies had made progress in developing efficiencies in environmental review processes and with online tribal resources and training, in addition to other areas. We will evaluate USDA's actions after the task force has compiled all actions taken in response to the 2011 report and evaluated what further actions or responses should be conducted.
Department of Housing and Urban Development 10. The Deputy Assistant Secretary of the Department of Housing and Urban Development's Office of Native American Programs, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 10)
Open
As of December 2019, the task force members had agreed to jointly consider the actions they have taken from the 2011 report and to discuss additional actions they could take to increase collaboration at the national level. We will evaluate HUD's actions once they are complete.
Bureau of Reclamation 11. The Commissioner of Reclamation, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 11)
Open
In April 2018, Reclamation met with other members of the task force and the agencies reviewed and discussed the 2011 task force report recommendations. As of December 2019, the task force members had agreed to jointly consider the actions they have taken from the 2011 report and to discuss additional actions they could take to increase collaboration at the national level. We will evaluate the agency's actions once they are complete.
Indian Health Service 12. The Director of IHS, in cooperation with other members of the tribal infrastructure task force, should direct IHS area offices to identify and pursue additional mechanisms to increase their collaboration. (Recommendation 12)
Closed - Implemented
In February 2020, IHS and other task force members signed a memorandum directing their regional and area offices to reach out and work with their counterparts in other agencies to increase the level of collaboration in the provision of safe drinking water and basic sanitation. The memo also included links to online sources of contact information for regional staff to use when identifying their counterparts to facilitate collaboration. In September 2020, IHS distributed the memo to its Sanitation Facilities Construction area directors. In light of these actions, we are closing this recommendation as implemented.
Department of Agriculture 13. The Assistant to the Secretary of Agriculture for Rural Development, in cooperation with other members of the tribal infrastructure task force, should direct USDA state offices to identify and pursue additional mechanisms to increase their collaboration. (Recommendation 13)
Closed - Implemented
In February 2020, USDA and other task force members signed a memorandum directing their regional and state offices to reach out and work with their counterparts in other agencies to increase the level of collaboration in the provision of safe drinking water and basic sanitation. The memo also included links to online sources of contact information for regional staff to use when identifying their counterparts to facilitate collaboration. In August 2020, USDA Rural Development distributed the memo to all state offices that administer its Water and Environmental Programs. In light of these actions, we are closing this recommendation as implemented.
Environmental Protection Agency 14. The Administrator of EPA, in cooperation with other members of the tribal infrastructure task force, should direct EPA regional offices to identify and pursue additional mechanisms to increase their collaboration. (Recommendation 14)
Closed - Implemented
In February 2020, EPA and other task force members signed a memorandum directing their regional offices to reach out and work with their counterparts in other agencies to increase the level of collaboration in the provision of safe drinking water and basic sanitation. The memo also included links to online sources of contact information for regional staff to use when identifying their counterparts to facilitate collaboration. In April 2020, EPA distributed the memo to its regional drinking water program managers. In light of these actions, we are closing this recommendation as implemneted.
Department of Housing and Urban Development 15. The Deputy Assistant Secretary of the Department of Housing and Urban Development's Office of Native American Programs, in cooperation with other members of the tribal infrastructure task force, should direct HUD regional offices to identify and pursue additional mechanisms to increase their collaboration. (Recommendation 15)
Closed - Implemented
In February 2020, HUD and other task force members signed a memorandum directing their regional offices to reach out and work with their counterparts in other agencies to increase the level of collaboration in the provision of safe drinking water and basic sanitation. The memo also included links to online sources of contact information for regional staff to use when identifying their counterparts to facilitate collaboration. In August 2020, HUD distributed the memo to its regional staff in the Office of Native American Programs. In light of these actions, we are closing this recommendation as implemented.
Bureau of Reclamation 16. The Commissioner of Reclamation, in cooperation with other members of the tribal infrastructure task force, should direct Reclamation regional offices to identify and pursue additional mechanisms to increase their collaboration. (Recommendation 16)
Closed - Implemented
In December 2018, the Bureau of Reclamation's Native American and International Affairs Office sent a memo to Reclamation's regional offices encouraging them to work with other agencies and tribal organizations to increase the level of collaboration for needs assessments and specific drinking water and wastewater infrastructure projects. Reclamation provided contact information for other federal agencies and tribal organizations in each region to facilitate the additional collaboration. In light of these actions, we are closing this recommendation as implemented.

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