As far as the institutionalization goes, you ruled out the horrors of the Reservation Schools due to wanting current policies. Can only think of one, but it's a good 'un.
www.amnestyusa.org/our-work/issues/women-s-rights/violence-against-women/maze-of-injustice
Native American communities cannot prosecute non-Natives that commit crimes in the community. Now, they've been given permission (how quaint) to offer lengthier sentences upon Native Americans that commit crimes in their communities.
But if a white American rapes a Native American woman? Suck it up Red.
Also, these provide some rather good perspective.
No emergency services, fuck all telecommunications and internet:
http://www.indian.senate.gov/sites/...ld_hearings/GeoffreyBlackwell&pageid=9339.pdf
Mineral Rights abuses, where US corporations can practice all the cowboy resource extraction they want, and since it's convenient to declare it sovereign, the corporations are held unaccountable and don't have to bother cleaning up contamination in, say, fresh water supplies for affected Native American communities. -
http://www.wavesforwater.org/project/pine-ridge
Edit: Linked the wrong article. First link should have been to Amnesty.