I have a '98 Toyota Sienna with 54,000 miles on it and I was wondering when I should have the timing belt replaced? Also, I have heard that it is a good idea to replace the water pump with the timing belt. Why is that? Thanks

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Scheduled Maintenance Services, for most Cars, has to be done at 30K, 60K, and 90K. Toyota recommend to replace the timing belt at 90K Service.
If you wait, one of two things could happen: Nothing, or the belt could break and you would be out thousands to repair the engine instead of a $400 hundred to replace just the belt. If it breaks, there will be damage done to the valves and various other internal components, which will not covered under warranty. The problem is that the Dealer would charge you between $700-$800 because they would also replace the water pump at the same time. Or you can buy the timing belt and change it by your self. To do so, you nee the Haynes Repair Manual specific for your car, or another equivalent manual.
To be safe, have the timing belt changed before the 95k mile mark ...... AND have the water pump replaced with a NEW one.