+------------------------------------------------------+---+-------------+
| FREE-STANDING PROVISIONS                             |   | P.L.102-573 |
|                                                      |   |             |
| [Note]{.underline}: The Indian Health Care           |   | P.L.102-573 |
| Amendments of 1988, P.L. 100-713 contained a number  |   |             |
| of free-standing provisions. Some of these were      |   | P.L.102-573 |
| noted in the foregoing codification of P.L. 94-437.  |   |             |
| Others that may still have relevance are presented   |   | P.L.102-573 |
| below for your convenience. Citations refer to P.L.  |   |             |
| 100-713 [not]{.underline} P.L. 94-437.               |   | P.L.102-573 |
|                                                      |   |             |
| **REFERENCES**                                       |   | P.L.102-573 |
|                                                      |   |             |
| Sec. 3. Except as otherwise specifically provided,   |   | P.L.102-573 |
| whenever in this Act an amendment or repeal is       |   |             |
| expressed in terms of an amendment to, or a repeal   |   | P.L.102-573 |
| of, a section or other provision, the reference      |   |             |
| shall be considered to be made to a section or other |   | P.L.102-573 |
| provision of the Indian Health Care Improvement Act  |   |             |
| (25 U.S.C. 1601, et seqq.).                          |   | P.L.102-573 |
|                                                      |   |             |
| **APPROPRIATIONS; AVAILABILITY**                     |   | P.L.102-573 |
|                                                      |   |             |
| Sec. 4. Any new spending authority (described in     |   | P.L.102-573 |
| subsection (c)(2) (A) or (B) of section 401 of the   |   |             |
| Congressional Budget Act of 1974) which is provided  |   | P.L.102-573 |
| under this Act shall be effective for any fiscal     |   |             |
| year only to such extent or in such amounts as are   |   | P.L.102-573 |
| provided in appropriation Acts.                      |   |             |
|                                                      |   | P.L.102-573 |
| **PROVISION OF SERVICES IN MONTANA**                 |   |             |
|                                                      |   | P.L.102-573 |
| Sec. 712. (a) The Secretary of Health and Human      |   |             |
| Services, acting through the Indian Health Service,  |   | P.L.102-573 |
| shall provide services and benefits for Indians in   |   |             |
| Montana in a manner consistent with the decision of  |   | P.L.102-573 |
| the United States Court of Appeals for the Ninth     |   |             |
| Circuit in McNabb for McNabb v. Bowen, 829 F.2d 787  |   | P.L.102-573 |
| (9th Cr. 1987).                                      |   |             |
|                                                      |   | P.L.102-573 |
| \(b\) The provisions of subsection (a) shall not be  |   |             |
| construed to be an expression of the sense of the    |   | P.L.102-573 |
| Congress on the application of the decision          |   |             |
| described in subsection (a) with respect to the      |   | P.L.102-573 |
| provision of services or benefits for Indians living |   |             |
| in any State other than Montana.                     |   | P.L.102-573 |
|                                                      |   |             |
| **\[ELIGIBILITY MORATORIUM AND STUDY\]**             |   |             |
|                                                      |   |             |
| Sec. 719. (a) During the period of the moratorium    |   |             |
| imposed by Public Law 100-446 on implementation of   |   |             |
| the final rule published in the Federal Register on  |   |             |
| September 16, 1987, by the Health Resources and      |   |             |
| Services Administration of the Public Health         |   |             |
| Service, relating to eligibility for the health care |   |             |
| services of the Indian Health Service, the Indian    |   |             |
| Health Service shall provide services pursuant to    |   |             |
| the criteria for eligibility for such services that  |   |             |
| were in effect on September 15, 1987, subject to the |   |             |
| provisions of section 709 of the Indian Health Care  |   |             |
| Improvement Act, as amended by this Act.             |   |             |
|                                                      |   |             |
| \(b\) The Secretary of Health and Human Services,    |   |             |
| acting through the Indian Health Service, shall, by  |   |             |
| contract or any other means, conduct a study to      |   |             |
| determine the impact of the final rule described in  |   |             |
| subsection (a) and of any other proposed rules which |   |             |
| would change the eligibility criteria for medical    |   |             |
| services provided by the Indian Health Service.      |   |             |
|                                                      |   |             |
| \(c\) The study conducted under subsection (b) shall |   |             |
| include-                                             |   |             |
|                                                      |   |             |
| \(1\) full participation and consultation with       |   |             |
| Indian and Alaskan Native tribal governments and     |   |             |
| representatives of urban Indian health care          |   |             |
| programs:                                            |   |             |
|                                                      |   |             |
| (2)statistics for each of the service areas of the   |   |             |
| Indian Health Service on the number of Indians who   |   |             |
| are currently eligible for the services of the       |   |             |
| Indian Health Service;                               |   |             |
|                                                      |   |             |
| (3)statistics for each of the service areas of the   |   |             |
| Indian Health Service on the number of Indians who   |   |             |
| would be eligible for such services if the final     |   |             |
| rule described in subsection (a), or any alternative |   |             |
| rule changing eligibility, were implemented;         |   |             |
|                                                      |   |             |
| (4)consideration of the financial impact of such     |   |             |
| final rule or any other proposed rule on the         |   |             |
| contract health care budget and on the clinical      |   |             |
| services budget of the Indian Health Service;        |   |             |
|                                                      |   |             |
| (5)consideration of the health status, cultural,     |   |             |
| social, and economic impact on Indian reservations   |   |             |
| and urban Indian populations of such final rule or   |   |             |
| any other rule changing the eligibility criteria;    |   |             |
|                                                      |   |             |
| (6)consideration of the alternatives, if any, that   |   |             |
| would be available to those Indians who would not be |   |             |
| eligible for such services by reason of any such     |   |             |
| final rule; and                                      |   |             |
|                                                      |   |             |
| (7)consideration of the program changes that the     |   |             |
| Indian Health Service would be required to make if   |   |             |
| the eligibility requirements for such services that  |   |             |
| were in effect on September 15, 1987, were modified. |   |             |
|                                                      |   |             |
| \(d\) The Secretary of Health and Human Services     |   |             |
| shall submit to the Congress a report on the study   |   |             |
| required under subsection (b).                       |   |             |
|                                                      |   |             |
| \(e\) Before submitting to Congress the report on    |   |             |
| the study required under subsection (b), the         |   |             |
| Secretary of Health and Human Services shall provide |   |             |
| Indian tribes, Alaska Native villages and urban      |   |             |
| Indian health care programs an opportunity to        |   |             |
| comment on the report and shall incorporate the      |   |             |
| comments of such Indian groups into the report.      |   |             |
|                                                      |   |             |
| \(f\) There are hereby authorized to be appropriated |   |             |
| such sums as are necessary to carry out the          |   |             |
| provisions of this section.                          |   |             |
|                                                      |   |             |
| SEVERABILITY PROVISIONS                              |   |             |
|                                                      |   |             |
| Sec. 801. If any provision of this Act, any          |   |             |
| amendment made by the Act, or the application of     |   |             |
| such provision or amendment to any person or         |   |             |
| circumstances is held to be invalid, the remainder   |   |             |
| of this Act, the remaining amendments made by this   |   |             |
| Act, and the application of such provisions to       |   |             |
| persons or circumstances other than those to which   |   |             |
| it is held invalid, shall not be affected thereby.   |   |             |
|                                                      |   |             |
| [Note]{.underline}: The Indian Health Amendments of  |   |             |
| 1992, P.L. 102-573 had a number of free-standing     |   |             |
| provisions. Some of these were noted in the          |   |             |
| foregoing codification of P.L. 94-437. Others that   |   |             |
| may still have relevance are presented below for     |   |             |
| your convenience. Citations refer to P.L. 102-573    |   |             |
| [not]{.underline} P.L. 94-437.                       |   |             |
|                                                      |   |             |
| **SEC. 2. AMENDMENTS TO INDIAN HEALTH CARE           |   |             |
| IMPROVEMENT ACT.** Except as otherwise specifically  |   |             |
| provided, whenever in this Act a section or other    |   |             |
| provision is amended or repealed, such amendment or  |   |             |
| repeal shall be considered to be made to that        |   |             |
| section or other provision of the Indian Health Care |   |             |
| Improvement Act (25 U.S.C. 1601 et seq.).            |   |             |
|                                                      |   |             |
| **SEC. 701. REDESIGNATION OF EXISTING TITLE VII.**   |   |             |
|                                                      |   |             |
| > \....                                              |   |             |
| >                                                    |   |             |
| > \(d\) REFERENCES-Any reference in a provision of   |   |             |
| > law other than the Indian Health Care Improvement  |   |             |
| > Act to sections redesignated by subsection (b)     |   |             |
| > shall be deemed to refer to the section as so      |   |             |
| > redesignated.                                      |   |             |
| >                                                    |   |             |
| > \[NOTE: P.L. 102-573, title VIII, also amended     |   |             |
| > title III of the Indian Self-Determination and     |   |             |
| > Education Assistance Act, P.L. 93-638. For your    |   |             |
| > convenience, title III, **Tribal Self-Governance   |   |             |
| > Demonstration Project is printed below.\]**        |   |             |
|                                                      |   |             |
| **TITLE III - TRIBAL SELF-GOVERNANCE DEMONSTRATION   |   |             |
| PROJECTS**                                           |   |             |
|                                                      |   |             |
| > ***Sec. 301. The Secretary of the Interior and the |   |             |
| > Secretary of Health and Human Services             |   |             |
| > (hereinafter in this title referred to as \"the    |   |             |
| > Secretaries\") each shall, for a period not to     |   |             |
| > exceed eight years following enactment of this     |   |             |
| > title, conduct a research and demonstration        |   |             |
| > project to be known as the Tribal Self-Governance  |   |             |
| > Project according to the provisions of this        |   |             |
| > title.***                                          |   |             |
| >                                                    |   |             |
| > ***Sec. 302. (a) The ~~Secretary~~ Secretaries     |   |             |
| > shall select thirty tribes to participate in the   |   |             |
| > demonstration project, as follows:***              |   |             |
| >                                                    |   |             |
| > ***(1) a tribe that successfully completes a       |   |             |
| > Self-Governance Planning Grant authorized by       |   |             |
| > Conference Report 100-498 to accompany H.J.Res.    |   |             |
| > 395, One Hundredth Congress, first session, shall  |   |             |
| > be selected to participate in the demonstration    |   |             |
| > project; and***                                    |   |             |
| >                                                    |   |             |
| > ***(2) the ~~Secretary~~ Secretaries shall select, |   |             |
| > in such a manner as to achieve geographic          |   |             |
| > representation, the remaining tribal participants  |   |             |
| > from the pool of qualified applicants. In order to |   |             |
| > be in the pool of qualified applicants\--***       |   |             |
| >                                                    |   |             |
| > ***(A)the governing body of the tribe shall        |   |             |
| > request participation in the demonstration         |   |             |
| > project;***                                        |   |             |
| >                                                    |   |             |
| > ***(B)such tribe shall have operated two or more   |   |             |
| > mature contracts; and***                           |   |             |
| >                                                    |   |             |
| > ***(C)such tribe shall have demonstrated, for the  |   |             |
| > previous three fiscal years, financial stability   |   |             |
| > and financial management capability as evidence by |   |             |
| > such tribe having no significant and material      |   |             |
| > audit exceptions in the required annual audit of   |   |             |
| > such tribe\'s self-determination contracts.***     |   |             |
| >                                                    |   |             |
| > ***Sec. 303. (a) The ~~Secretary~~ Secretaries is  |   |             |
| > directed to negotiate, and to enter into, an       |   |             |
| > annual written funding agreement with the          |   |             |
| > governing body of a participating tribal           |   |             |
| > government that successfully completes its         |   |             |
| > Self-Governance Planning Grant. Such annual        |   |             |
| > written funding agreement\--***                    |   |             |
| >                                                    |   |             |
| > ***(1)shall authorize the tribe to plan, conduct,  |   |             |
| > consolidate, and administer programs, services and |   |             |
| > functions of the Department of the Interior and    |   |             |
| > the*** ***Indian Health Service of the Department  |   |             |
| > of Health and Human Services that are otherwise    |   |             |
| > available to Indian tribes or Indians, including   |   |             |
| > but not limited to, the Act of April 16, 1934 (48  |   |             |
| > Stat. 596) \[25 U.S.C.S. @@ 455 et seq.\], as      |   |             |
| > amended, and the Act of November 2, 1921 (42 Stat. |   |             |
| > 208) \[25 U.S.C.S. @@ 13 and former 52a\];***      |   |             |
| >                                                    |   |             |
| > ***(2)subject to the terms of the written          |   |             |
| > agreement authorized by this title shall authorize |   |             |
| > the tribe to redesign programs, activities,        |   |             |
| > functions or services and to reallocate funds for  |   |             |
| > such programs, activities, functions or            |   |             |
| > services;***                                       |   |             |
| >                                                    |   |             |
| > ***(3)shall not include funds provided pursuant to |   |             |
| > the Tribally-Controlled Community College          |   |             |
| > Assistance Act (Public Law 95-471 \[25 U.S.C.S. @@ |   |             |
| > 1801 et seq., generally; for full classification,  |   |             |
| > consult U.S.C.S. Tables volumes\]), for elementary |   |             |
| > and secondary schools under the Indian School      |   |             |
| > Equalization Formula pursuant to title XI of the   |   |             |
| > Education Amendments of 1978 (Public Law 95-561    |   |             |
| > \[Act November 1, 1978, P.L. 95-561, title XI, 92  |   |             |
| > Stat. 2313; for full classification, consult       |   |             |
| > U.S.C.S Tables volumes\], as amended), or for      |   |             |
| > either the Flathead Agency Irrigation Division or  |   |             |
| > the Flathead Agency Power Division: Provided, That |   |             |
| > nothing in this section shall affect the           |   |             |
| > contractibility of such divisions under section    |   |             |
| > 102 of this Act \[25 U.S.C.S. @ 450f\];***         |   |             |
| >                                                    |   |             |
| > ***(4)shall specify the services to be provided,   |   |             |
| > the functions to be performed, and the             |   |             |
| > responsibilities of the tribe and the              |   |             |
| > ~~Secretary~~ Secretaries pursuant to this         |   |             |
| > agreement;***                                      |   |             |
| >                                                    |   |             |
| > ***(5)shall specify the authority of the tribe and |   |             |
| > the ~~Secretary~~ Secretaries, and the procedures  |   |             |
| > to be used, to reallocate funds or modify budget   |   |             |
| > allocations within any project year;***            |   |             |
| >                                                    |   |             |
| > ***(6)shall, except as provided in paragraphs (1)  |   |             |
| > and (2), provide for payment by the ~~Secretary~~  |   |             |
| > Secretaries to the tribe of funds from one or more |   |             |
| > programs, services, functions, or activities in an |   |             |
| > amount equal to that which the tribe would have    |   |             |
| > been eligible to receive under contracts and       |   |             |
| > grants under this Act, including direct program    |   |             |
| > costs, and for any funds which are specifically    |   |             |
| > related to the provision by the ~~Secretary~~      |   |             |
| > Secretaries of services and benefits to the tribe  |   |             |
| > and is members: Provided, however, that Funds for  |   |             |
| > trust services to individual Indians are available |   |             |
| > under this written agreement only to the extent    |   |             |
| > that the same services which would have been       |   |             |
| > provided by the ~~Secretary~~ Secretaries are      |   |             |
| > provided to individual Indians by the tribe;***    |   |             |
| >                                                    |   |             |
| > ***(7)shall not allow the ~~Secretary~~            |   |             |
| > Secretaries to waive, modify or diminish in any    |   |             |
| > way the trust responsibility of the United States  |   |             |
| > with respect to Indian tribes and individual       |   |             |
| > Indians which exists under treaties, Executive     |   |             |
| > orders, and Acts of Congress;***                   |   |             |
| >                                                    |   |             |
| > ***(8)shall allow for retrocession of programs or  |   |             |
| > portions thereof pursuant to section 105(e) of     |   |             |
| > this Act \[25 U.S.C.S. @ 450j(e)\]; and***         |   |             |
| >                                                    |   |             |
| > ***(9)shall be submitted by the ~~Secretary~~      |   |             |
| > Secretaries ninety days in advance of the proposed |   |             |
| > effective date of the agreement to each tribe      |   |             |
| > which is served by the agency which is serving the |   |             |
| > tribe which is a party to the*** ***funding        |   |             |
| > agreement and to the Congress for review by the    |   |             |
| > Select Committee on Indian Affairs of the Senate   |   |             |
| > and the Committee on Interior and Insular Affairs  |   |             |
| > of the House of Representatives.***                |   |             |
| >                                                    |   |             |
| > ***(b) For the year for which, and to the extent   |   |             |
| > to which, funding is provided to a tribe pursuant  |   |             |
| > to this title, such tribe\--***                    |   |             |
| >                                                    |   |             |
| > ***(1) shall not be entitled to contract with the  |   |             |
| > ~~Secretary~~ Secretaries for such funds under     |   |             |
| > section 102 \[25 U.S.C.S @ 450f}, except that such |   |             |
| > tribe shall be eligible for new programs on the    |   |             |
| > same basis as other tribes; and***                 |   |             |
| >                                                    |   |             |
| > ***(2) shall be responsible for the administration |   |             |
| > of programs, services and activities pursuant to   |   |             |
| > agreements under this title.***                    |   |             |
| >                                                    |   |             |
| > ***(c) At the request of the governing body of the |   |             |
| > tribe and under the terms of an agreement pursuant |   |             |
| > to subsection (a), the ~~Secretary~~ Secretaries   |   |             |
| > shall provide funding to such tribe to implement   |   |             |
| > the agreement.***                                  |   |             |
| >                                                    |   |             |
| > ***(d) For the purpose of section 110 of this Act  |   |             |
| > \[25 U.S.C.S @ 450m-l\] the term \"contract\"      |   |             |
| > shall also include agreements to authorized by     |   |             |
| > this title except that for the term of the         |   |             |
| > authorized agreements under this title, the        |   |             |
| > provisions of section 2103 of the Revised Statutes |   |             |
| > of the United States (25 U.S.C. 81), and section   |   |             |
| > 16 of the Act of June 18, 1934 (25 U.S.C. 476),    |   |             |
| > shall not apply to attorney and other professional |   |             |
| > contracts by participating Indian tribal           |   |             |
| > governments operating under the provisions of this |   |             |
| > title.***                                          |   |             |
| >                                                    |   |             |
| > ***(e) To the extent feasible, the ~~Secretary~~   |   |             |
| > Secretaries shall interpret Federal laws and       |   |             |
| > regulations in a manner that will facilitate the   |   |             |
| > agreements authorized by this title.***            |   |             |
| >                                                    |   |             |
| > ***(f) To the extent feasible, the ~~Secretary~~   |   |             |
| > Secretaries shall interpret Federal laws and       |   |             |
| > regulations in a manner that will facilitate the   |   |             |
| > inclusion of activities, programs, services, and   |   |             |
| > functions in the agreements authorized by this     |   |             |
| > title.***                                          |   |             |
| >                                                    |   |             |
| > ***Sec.304.The ~~Secretary~~ Secretaries shall     |   |             |
| > identify, in the President\'s annual budget        |   |             |
| > request to the Congress, any funds proposed to be  |   |             |
| > included in the Tribal Self-Governance Project.    |   |             |
| > The use of funds pursuant to this title shall be   |   |             |
| > subject to specific directives or limitations as   |   |             |
| > may be included in applicable appropriations       |   |             |
| > Acts.***                                           |   |             |
| >                                                    |   |             |
| > ***Sec 305. The ~~Secretary~~ Secretaries shall    |   |             |
| > submit to the Congress a written report on July 1  |   |             |
| > and January 1 of each of the five years following  |   |             |
| > the date of enactment of this title on the         |   |             |
| > relative costs and benefits of the Tribal          |   |             |
| > Self-Governance Project.Such report shall be based |   |             |
| > on mutually determined* *baseline measurements     |   |             |
| > jointly developed by the ~~Secretary~~ Secretaries |   |             |
| > and participating tribes, and shall separately     |   |             |
| > include the views of the tribes.***                |   |             |
| >                                                    |   |             |
| > ***Sec. 306. Nothing in this title shall be        |   |             |
| > construed to limit or reduce in any way the        |   |             |
| > services, contracts or funds that any other Indian |   |             |
| > tribe or tribal organization is eligible to        |   |             |
| > receive under section 102 \[25 U.S.C.S. @ 450f\]   |   |             |
| > or any other applicable Federal law and the        |   |             |
| > provisions of section 110 of this Act \[25         |   |             |
| > U.S.C.S. @ 450m-l\] shall be available to any      |   |             |
| > tribe or Indian organization which alleges that a  |   |             |
| > funding agreement is in violation of this          |   |             |
| > section.***                                        |   |             |
| >                                                    |   |             |
| > ***Sec. 307. For the purpose of providing planning |   |             |
| > and negotiation grants to the ten tribes added by  |   |             |
| > section 3 of the Tribal Self-Governance            |   |             |
| > Demonstration Project Act \[Act of December 4,     |   |             |
| > 1991, P.L. 102-184 @ 3, 105 Stat. 1278\] to the    |   |             |
| > number of tribes set forth by section 302 of this  |   |             |
| > Act (as in effect before the date of enactment of  |   |             |
| > this section ), there is authorized to be          |   |             |
| > appropriated \$700,000.***                         |   |             |
| >                                                    |   |             |
| > ***Sec. 308. (a) The Secretary of Health and Human |   |             |
| > Services, in consultation with the Secretary of    |   |             |
| > the Interior and Indian tribal governments         |   |             |
| > participating in the demonstration project under   |   |             |
| > this title, shall conduct a study for the purpose  |   |             |
| > of determining the feasibility of extending the    |   |             |
| > demonstration project under this title to the      |   |             |
| > activities, programs, functions, and services of   |   |             |
| > the Indian Health Service. The Secretary shall     |   |             |
| > report the results of such study, together with    |   |             |
| > his recommendations, to the Congress within the 12 |   |             |
| > month period following the date of the enactment   |   |             |
| > of the Tribal Self-Governance Demonstration        |   |             |
| > Project \[enacted December 4, 1991\].***           |   |             |
| >                                                    |   |             |
| > ***(b) The Secretary of Health and Human Services  |   |             |
| > may establish within the Indian Health Service an  |   |             |
| > office of self-governance to be responsible for    |   |             |
| > coordinating the activities necessary to carry out |   |             |
| > the study required under subsection (a).***        |   |             |
| >                                                    |   |             |
| > ***Sec. 309. The Secretary of the Interior shall   |   |             |
| > conduct a study for the purpose of determining the |   |             |
| > feasibility of including in the demonstration      |   |             |
| > project under this title those programs and        |   |             |
| > activities excluded under section 303(a)(3). The   |   |             |
| > Secretary of the Interior shall report the results |   |             |
| > of such study, together with his recommendations,  |   |             |
| > to the Congress within the 12-month period         |   |             |
| > following the date of the enactment of the Tribal  |   |             |
| > Self-Governance Demonstration Project Act          |   |             |
| > \[enacted December 4, 1991\].***                   |   |             |
| >                                                    |   |             |
| > ***Sec. 310. For the purposes of providing one     |   |             |
| > year planning and negotiations grants to the       |   |             |
| > Indian tribes identified by section 302, with      |   |             |
| > respect to the programs, activities, functions, or |   |             |
| > services of the Indian Health Service, there are   |   |             |
| > authorized to be appropriated such sums as may be  |   |             |
| > necessary to carry out such purposes. Upon         |   |             |
| > completion of an authorized planning activity or a |   |             |
| > comparable planning activity by a tribe, the       |   |             |
| > Secretary is authorized to negotiate and implement |   |             |
| > a Compact of Self‑Governance and Annual Funding    |   |             |
| > Agreement with such tribe.***                      |   |             |
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