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| ~~TITLE VI\--AMERICAN INDIAN SCHOOL OF MEDICINE,     |   | P.L.96-537  |
| FEASIBILITY STUDY~~                                  |   |             |
|                                                      |   | P.L.100-713 |
| ~~FEASIBILITY STUDY~~                                |   |             |
|                                                      |   | P.L.100-713 |
| ~~Sec. 601. The Secretary, in consultation with      |   |             |
| Indian tribes and appropriate Indian organizations,  |   | P.L.102-573 |
| shall conduct a study to determine the need for, and |   |             |
| the feasibility of, establishing a school of         |   | P.L.102-573 |
| medicine to train Indians to provide health services |   |             |
| for Indians. Within one year of the date of the      |   | P.L.102-573 |
| enactment of this Act the Secretary shall complete   |   |             |
| such study and shall report to the Congress findings |   | P.L.102-573 |
| and recommendations based on such study.~~           |   |             |
|                                                      |   | P.L.102-573 |
| TITLE VI\--ORGANIZATIONAL IMPROVEMENTS               |   |             |
|                                                      |   | P.L.102-573 |
| ESTABLISHMENT OF THE INDIAN HEALTH SERVICE           |   |             |
|                                                      |   | P.L.102-573 |
| AS AN AGENCY OF THE PUBLIC HEALTH SERVICE            |   |             |
|                                                      |   | P.L.102-573 |
| Sec. 601. (a) In order to more effectively and       |   |             |
| efficiently carry out the responsibilities,          |   |             |
| authorities, and functions of the United States to   |   |             |
| provide health care services to Indians and Indian   |   |             |
| tribes, as are or may be hereafter provided by the   |   |             |
| Federal statute or treaties, there is established    |   |             |
| within the Public Health Service of the Department   |   |             |
| of Health and Human Services the Indian Health       |   |             |
| Service. The indian Health Service shall be          |   |             |
| administered by a Director, who shall be appointed   |   |             |
| by the ~~Secretary~~ President, by and with advice   |   |             |
| and consent of the Senate. The Director of the       |   |             |
| Indian Health Service shall report to the Secretary  |   |             |
| through the Assistant Secretary for Health of the    |   |             |
| Department of Health and Human Services. Effective   |   |             |
| with respect to an individual appointed by the       |   |             |
| President, by and with the advice and consent of the |   |             |
| Senate, after January 1, 1993, the term of service   |   |             |
| of the Director shall be 4 years. A Director may     |   |             |
| serve more than 1 term.                              |   |             |
|                                                      |   |             |
| \(b\) The Indian Health Service shall be an agency   |   |             |
| within the Public Health Service of the Department   |   |             |
| of Health and Human Services, and shall not be an    |   |             |
| office, component, or unit of any other agency of    |   |             |
| the Department.                                      |   |             |
|                                                      |   |             |
| \(c\) The Secretary shall carry out through the      |   |             |
| Director of the Indian Health Service\--             |   |             |
|                                                      |   |             |
| > \(1\) all functions which were, on the day before  |   |             |
| > the date of enactment of the Indian Health Care    |   |             |
| > Amendments of 1988, carried out by or under the    |   |             |
| > direction of the individual serving as Director of |   |             |
| > the Indian Health Service on such day;             |   |             |
| >                                                    |   |             |
| > \(2\) all functions of the Secretary relating to   |   |             |
| > the maintenance and operation of hospital and      |   |             |
| > health facilities for Indians and the planning     |   |             |
| > for, and provision and utilization of, health      |   |             |
| > services for Indians; ~~and~~                      |   |             |
| >                                                    |   |             |
| > \(3\) all health programs under which health care  |   |             |
| > is provided to Indians based upon their status s   |   |             |
| > Indians which are administered by the Secretary,   |   |             |
| > including (but not limited to programs under\--    |   |             |
| >                                                    |   |             |
| > \(A\) this Act;                                    |   |             |
| >                                                    |   |             |
| > \(B\) the Act of November 2, 1921 (25 U.S.C.13);   |   |             |
| >                                                    |   |             |
| > \(C\) the Act of August 5, 1954 (42 U.S.C. 2001,   |   |             |
| > et seq.);                                          |   |             |
| >                                                    |   |             |
| > \(D\) the Act of August 16, 1957 (~~25 U.S.C.      |   |             |
| > 2005, et seq.~~ 42 U.S.C. et seq.); ~~and~~        |   |             |
| >                                                    |   |             |
| > \(E\) the Indian Self-Determination Act (25 U.S.C. |   |             |
| > 450f, et seq.)~~.~~; and                           |   |             |
|                                                      |   |             |
| \(4\) all scholarship and loan functions carried out |   |             |
| under title I.                                       |   |             |
|                                                      |   |             |
| (d)(1) The Secretary, acting through the Director of |   |             |
| the Indian Health Service, shall have the            |   |             |
| authority\--                                         |   |             |
|                                                      |   |             |
| > \(A\) except to the extent provided in paragraph   |   |             |
| > (2), to appoint and compensate employees for the   |   |             |
| > Service in accordance with title 5, United States  |   |             |
| > Code;                                              |   |             |
| >                                                    |   |             |
| > \(B\) to enter into contracts for the procurement  |   |             |
| > of goods and services to carry out the functions   |   |             |
| > of the Service; and                                |   |             |
| >                                                    |   |             |
| > \(C\) to manage, expend, and obligate all funds    |   |             |
| > appropriated for the Service.                      |   |             |
|                                                      |   |             |
| \(2\) Notwithstanding any other law, the provisions  |   |             |
| of section 12 of the Act of June 18, 1934 (48 Stat.  |   |             |
| 986; 25 U.S.C. 472), shall apply to all personnel    |   |             |
| actions taken with respect to new positions created  |   |             |
| within the Service as a result of its establishment  |   |             |
| under subsection (a).                                |   |             |
|                                                      |   |             |
| > \[NOTE: Sec. 602 of P.L. 102-573 has a number of   |   |             |
| > free-standing provisions that affect but are not   |   |             |
| > part of Sec. 601 of P.L. 94-437 (above). For your  |   |             |
| > convenience these provisions follow.\]             |   |             |
| >                                                    |   |             |
| > {Sec. 602. DIRECTOR OF INDIAN HEALTH SERVICE       |   |             |
|                                                      |   |             |
| {(a) CONFIRMATION BY SENATE                          |   |             |
|                                                      |   |             |
| {\....                                               |   |             |
|                                                      |   |             |
| > \(2\) EFFECTIVE DATE.‑‑The amendment made by       |   |             |
| > paragraph (1) \[requiring President\'s appointment |   |             |
| > and Senate confirmation\] shall take effect        |   |             |
| > January 1, 1993.                                   |   |             |
| >                                                    |   |             |
| > {(b) INTERIM APPOINTMENT.‑‑The President may       |   |             |
| > appoint an individual to serve as Interim Director |   |             |
| > of the Service from January 1, 1993, until such    |   |             |
| > time as a Director is appointed and confirmed as   |   |             |
| > provided in section 601(a) of the Indian Health    |   |             |
| > Care Improvement Act (25 U.S.C. 1601 et            |   |             |
| > seq.)\....\"}                                      |   |             |
| >                                                    |   |             |
| > **\[NOTE: Sec. 601 of P.L. 100-713 has a number of |   |             |
| > free-standing provisions that affect but are not   |   |             |
| > part of Section 601 of P.L. 94-437 (above). For    |   |             |
| > your convenience these provisions follow.\]**      |   |             |
|                                                      |   |             |
| ESTABLISHMENT OF THE INDIAN HEALTH SERVICE AS AN     |   |             |
| AGENCY OF                                            |   |             |
|                                                      |   |             |
| THE PUBLIC HEALTH SERVICE                            |   |             |
|                                                      |   |             |
| > {\"Sec. 601.                                       |   |             |
| >                                                    |   |             |
| > {\....                                             |   |             |
| >                                                    |   |             |
| > {(b) All personnel, records, equipment,            |   |             |
| > facilities, and interests in property that are     |   |             |
| > administered by the Indian Health Service on the   |   |             |
| > day before the date on which the amendments made   |   |             |
| > by this section take effect shall be transfered to |   |             |
| > the Indian Health Service established by the       |   |             |
| > amendment made by subsection (a) of this section.  |   |             |
| > All transfers must be accomplished within 9 months |   |             |
| > of the date of enactment of this section. The      |   |             |
| > Secretary is authorize to waive the Indian         |   |             |
| > preference laws on a case-by-case basis for        |   |             |
| > temporary transfers involved in implementing this  |   |             |
| > section during such 9-month period.                |   |             |
| >                                                    |   |             |
| > {(c)(1) Except as provided in paragraph (2),       |   |             |
| > section 601 of the Indian Health Care Improvement  |   |             |
| > Act added by subsection (a) of this section shall  |   |             |
| > take effect 9 months from the date of the          |   |             |
| > enactment of this section.                         |   |             |
| >                                                    |   |             |
| > \(2\) Nothwithstanding subsections (b) and (c)(1), |   |             |
| > any action which carries out such section 601 that |   |             |
| > is taken by the Secretary before the effective     |   |             |
| > date of such section 601 shall be effective        |   |             |
| > beginning on the date such action was taken.       |   |             |
| >                                                    |   |             |
| > {(d) Section 5316 of title 5, United States Code,  |   |             |
| > is amended by adding at the end thereof the        |   |             |
| > following:                                         |   |             |
| >                                                    |   |             |
| > \"Director, Indian Health Service, Department of   |   |             |
| > Health and Human Services.\".}                     |   |             |
|                                                      |   |             |
| AUTOMATED MANAGEMENT INFORMATION SYSTEM              |   |             |
|                                                      |   |             |
| Sec. 602. (a)(1) The Secretary shall establish an    |   |             |
| automated management information system for the      |   |             |
| Service.                                             |   |             |
|                                                      |   |             |
| \(2\) The information system established under       |   |             |
| paragraph (1) shall include\--                       |   |             |
|                                                      |   |             |
| > \(A\) a financial management system,               |   |             |
| >                                                    |   |             |
| > \(B\) a patient care information system for each   |   |             |
| > area served by the Service,                        |   |             |
| >                                                    |   |             |
| > \(C\) a privacy component that protects the        |   |             |
| > privacy of patient information held by, or on      |   |             |
| > behalf of, the Service, and                        |   |             |
| >                                                    |   |             |
| > \(D\) a services-based cost accounting component   |   |             |
| > that provides estimates of the costs associated    |   |             |
| > with the provision of specific medical treatments  |   |             |
| > or services in each area office of the Service.    |   |             |
|                                                      |   |             |
| ~~(3) By no later than September 30, 1989, the       |   |             |
| Secretary shall submit a report to Congress setting  |   |             |
| forth\--~~                                           |   |             |
|                                                      |   |             |
| > ~~(A) the activities which have been undertaken to |   |             |
| > establish an automated management information      |   |             |
| > system,~~                                          |   |             |
| >                                                    |   |             |
| > ~~(B) the activities, if any, which remain to be   |   |             |
| > undertaken to complete the implementation of an    |   |             |
| > automated management information system, and~~     |   |             |
| >                                                    |   |             |
| > ~~(C) the amount of funds which will be needed to  |   |             |
| > complete the implementation of a management        |   |             |
| > information system in the succeeding fiscal        |   |             |
| > years.~~                                           |   |             |
|                                                      |   |             |
| (b)(1) The Secretary shall provide each Indian tribe |   |             |
| and tribal organization that provides health         |   |             |
| services under a contract entered into with the      |   |             |
| Service under the Indian Self-Determination Act      |   |             |
| automated management information systems which\--    |   |             |
|                                                      |   |             |
| > \(A\) meet the management information needs of     |   |             |
| > such Indian tribe or tribal organization with      |   |             |
| > respect to the treatment by the Indian tribe or    |   |             |
| > tribal organization patients of the Service, and   |   |             |
| >                                                    |   |             |
| > \(B\) meet the management information needs of the |   |             |
| > Service.                                           |   |             |
|                                                      |   |             |
| \(2\) The Secretary shall provide systems under      |   |             |
| paragraph (1) to Indian tribes and tribal            |   |             |
| organizations providing health services in           |   |             |
| California by no later than September 30,1 990.      |   |             |
|                                                      |   |             |
| \(c\) Notwithstanding any other provision of law,    |   |             |
| each patient shall have reasonable access to the     |   |             |
| medical or health records of such patient which are  |   |             |
| held by, or on behalf of, the Service.               |   |             |
|                                                      |   |             |
| AUTHORIZATION OF APPROPRIATIONS                      |   |             |
|                                                      |   |             |
| Sec. 603. There are authorized to be appropriated    |   |             |
| such sums as may be necessary for each fiscal year   |   |             |
| through fiscal year 2000 to carry out this title.    |   |             |
|                                                      |   |             |
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