-CITE-
    25 USC CHAPTER 18 - INDIAN HEALTH CARE                      01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE

-HEAD-
                      CHAPTER 18 - INDIAN HEALTH CARE                  

-MISC1-
                            GENERAL PROVISIONS                        
    Sec.                                                     
    1601.       Congressional findings.                               
    1602.       Declaration of health objectives.                     
    1603.       Definitions.                                          

            SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL        
    1611.       Congressional statement of purpose.                   
    1612.       Health professions recruitment program for Indians.   
    1613.       Health professions preparatory scholarship program for
                 Indians.                                             
    1613a.      Indian health professions scholarships.               
    1614.       Indian health service extern programs.                
    1615.       Continuing education allowances.                      
    1616.       Community Health Representative Program.              
    1616a.      Indian Health Service Loan Repayment Program.         
    1616a-1.    Scholarship and Loan Repayment Recovery Fund.         
    1616b.      Recruitment activities.                               
    1616c.      Tribal recruitment and retention program.             
    1616d.      Advanced training and research.                       
    1616e.      Nursing program.                                      
    1616e-1.    Nursing school clinics.                               
    1616f.      Tribal culture and history.                           
    1616g.      INMED program.                                        
    1616h.      Health training programs of community colleges.       
    1616i.      Additional incentives for health professionals.       
    1616j.      Retention bonus.                                      
    1616k.      Nursing residency program.                            
    1616l.      Community Health Aide Program for Alaska.             
    1616m.      Matching grants to tribes for scholarship programs.   
    1616n.      Tribal health program administration.                 
    1616o.      University of South Dakota pilot program.             
    1616p.      Authorization of appropriations.                      

                      SUBCHAPTER II - HEALTH SERVICES                  
    1621.       Indian Health Care Improvement Fund.                  
    1621a.      Catastrophic Health Emergency Fund.                   
    1621b.      Health promotion and disease prevention services.     
    1621c.      Diabetes prevention, treatment, and control.          
    1621d.      Hospice care feasibility study.                       
    1621e.      Reimbursement from certain third parties of costs of
                 health services.                                     
    1621f.      Crediting of reimbursements.                          
    1621g.      Health services research.                             
    1621h.      Mental health prevention and treatment services.      
    1621i.      Managed care feasibility study.                       
    1621j.      California contract health services demonstration
                 program.                                             
    1621k.      Coverage of screening mammography.                    
    1621l.      Patient travel costs.                                 
    1621m.      Epidemiology centers.                                 
    1621n.      Comprehensive school health education programs.       
    1621o.      Indian youth grant program.                           
    1621p.      American Indians Into Psychology Program.             
    1621q.      Prevention, control, and elimination of tuberculosis. 
    1621r.      Contract health services payment study.               
    1621s.      Prompt action on payment of claims.                   
    1621t.      Demonstration of electronic claims processing.        
    1621u.      Liability for payment.                                
    1621v.      Office of Indian Women's Health Care.                 
    1621w.      Authorization of appropriations.                      
    1621x.      Limitation on use of funds.                           
    1622.       Transferred.                                          

                    SUBCHAPTER III - HEALTH FACILITIES                
    1631.       Consultation; closure of facilities; reports.         
    1632.       Safe water and sanitary waste disposal facilities.    
    1633.       Preferences to Indians and Indian firms.              
    1634.       Expenditure of non-Service funds for renovation.      
    1635.       Repealed.                                             
    1636.       Grant program for construction, expansion, and
                 modernization of small ambulatory care facilities.   
    1637.       Indian health care delivery demonstration project.    
    1638.       Land transfer.                                        
    1638a.      Authorization of appropriations.                      
    1638b.      Applicability of Buy American requirement.            
    1638c.      Contracts for personal services in Indian Health
                 Service facilities.                                  
    1638d.      Credit to appropriations of money collected for meals
                 at Indian Health Service facilities.                 

               SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES           
    1641.       Treatment of payments under medicare program.         
    1642.       Treatment of payments under medicaid program.         
    1643.       Amount and use of funds reimbursed through medicare
                 and medicaid available to Indian Health Service.     
    1644.       Grants to and contracts with tribal organizations.    
    1645.       Direct billing of medicare, medicaid, and other third
                 party payors.                                        
    1646.       Authorization for emergency contract health services. 
    1647.       Authorization of appropriations.                      

             SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS         
    1651.       Purpose.                                              
    1652.       Contracts with, and grants to, urban Indian
                 organizations.                                       
    1653.       Contracts and grants for provision of health care and
                 referral services.                                   
    1654.       Contracts and grants for determination of unmet health
                 care needs.                                          
    1655.       Evaluations; renewals.                                
    1656.       Other contract and grant requirements.                
    1657.       Reports and records.                                  
    1658.       Limitation on contract authority.                     
    1659.       Facilities renovation.                                
    1660.       Urban Health Programs Branch.                         
    1660a.      Grants for alcohol and substance abuse related
                 services.                                            
    1660b.      Treatment of certain demonstration projects.          
    1660c.      Urban NIAAA transferred programs.                     
    1660d.      Authorization of appropriations.                      

                SUBCHAPTER V - ORGANIZATIONAL IMPROVEMENTS            
    1661.       Establishment of Indian Health Service as an agency of
                 Public Health Service.                               
    1662.       Automated management information system.              
    1663.       Authorization of appropriations.                      

                 SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS             
    1665.       Indian Health Service responsibilities.               
    1665a.      Indian Health Service program.                        
    1665b.      Indian women treatment programs.                      
    1665c.      Indian Health Service youth program.                  
    1665d.      Training and community education.                     
    1665e.      Gallup alcohol and substance abuse treatment center.  
    1665f.      Reports.                                              
    1665g.      Fetal alcohol syndrome and fetal alcohol effect
                 grants.                                              
    1665h.      Pueblo substance abuse treatment project for San Juan
                 Pueblo, New Mexico.                                  
    1665i.      Thunder Child Treatment Center.                       
    1665j.      Substance abuse counselor education demonstration
                 project.                                             
    1665k.      Gila River alcohol and substance abuse treatment
                 facility.                                            
    1665l.      Alaska Native drug and alcohol abuse demonstration
                 project.                                             
    1665m.      Authorization of appropriations.                      

                       SUBCHAPTER VI - MISCELLANEOUS                   
    1671.       Reports.                                              
    1672.       Regulations.                                          
    1673.       Repealed.                                             
    1674.       Leases with Indian tribes.                            
    1675.       Availability of funds.                                
    1676.       Limitation on use of funds appropriated to Indian
                 Health Service.                                      
    1677.       Nuclear resource development health hazards.          
    1678.       Arizona as a contract health service delivery area.   
    1679.       Eligibility of California Indians.                    
    1680.       California as a contract health service delivery area.
    1680a.      Contract health facilities.                           
    1680b.      National Health Service Corps.                        
    1680c.      Health services for ineligible persons.               
    1680d.      Infant and maternal mortality; fetal alcohol syndrome.
    1680e.      Contract health services for the Trenton Service Area.
    1680f.      Indian Health Service and Department of Veterans
                 Affairs health facilities and services sharing.      
    1680g.      Reallocation of base resources.                       
    1680h.      Demonstration projects for tribal management of health
                 care services.                                       
    1680i.      Child sexual abuse treatment programs.                
    1680j.      Tribal leasing.                                       
    1680k.      Home- and community-based care demonstration project. 
    1680l.      Shared services demonstration project.                
    1680m.      Results of demonstration projects.                    
    1680n.      Priority for Indian reservations.                     
    1680o.      Authorization of appropriations.                      
    1681.       Omitted.                                              
    1682.       Subrogation of claims by Indian Health Service.       
    1683.       Indian Catastrophic Health Emergency Fund.            

-End-


-CITE-
    25 USC GENERAL PROVISIONS                                   01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    GENERAL PROVISIONS

-HEAD-
                            GENERAL PROVISIONS                        

-End-



-CITE-
    25 USC Sec. 1601                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    GENERAL PROVISIONS

-HEAD-
    Sec. 1601. Congressional findings

-STATUTE-
      The Congress finds the following:
      (a) Federal health services to maintain and improve the health of
    the Indians are consonant with and required by the Federal
    Government's historical and unique legal relationship with, and
    resulting responsibility to, the American Indian people.
      (b) A major national goal of the United States is to provide the
    quantity and quality of health services which will permit the
    health status of Indians to be raised to the highest possible level
    and to encourage the maximum participation of Indians in the
    planning and management of those services.
      (c) Federal health services to Indians have resulted in a
    reduction in the prevalence and incidence of preventable illnesses
    among, and unnecessary and premature deaths of, Indians.
      (d) Despite such services, the unmet health needs of the American
    Indian people are severe and the health status of the Indians is
    far below that of the general population of the United States.

-SOURCE-
    (Pub. L. 94-437, Sec. 2, Sept. 30, 1976, 90 Stat. 1400; Pub. L. 102-
    573, Sec. 3(a), Oct. 29, 1992, 106 Stat. 4526.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573 substituted "finds the following:" for
    "finds that - " in introductory provisions and struck out last
    sentence of subsec. (d) which compared death rates of Indians to
    those of all Americans for tuberculosis, influenza and pneumonia,
    and compared death rates for infants, subsec. (e) which related to
    threat to fulfillment of Federal responsibility to Indians posed by
    low health status of American Indian people, subsec. (f) which
    enumerated causes imperiling improvements in Indian health, and
    subsec. (g) which related to confidence of Indian people in Federal
    Indian health services.

                       SHORT TITLE OF 2000 AMENDMENT                   
      Pub. L. 106-417, Sec. 1, Nov. 1, 2000, 114 Stat. 1812, provided
    that: "This Act [enacting and amending section 1645 of this title,
    amending sections 1395qq and 1396j of Title 42, The Public Health
    and Welfare, and enacting provisions set out as notes under section
    1645 of this title] may be cited as the 'Alaska Native and American
    Indian Direct Reimbursement Act of 2000'."

                       SHORT TITLE OF 1996 AMENDMENT                   
      Pub. L. 104-313, Sec. 1(a), Oct. 19, 1996, 110 Stat. 3820,
    provided that: "This Act [amending sections 1603, 1613a, 1621j,
    1645, 1665e, 1665j, and 1680k of this title] may be cited as the
    'Indian Health Care Improvement Technical Corrections Act of
    1996'."

                       SHORT TITLE OF 1992 AMENDMENT                   
      Section 1 of Pub. L. 102-573 provided that: "This Act [see Tables
    for classification] may be cited as the 'Indian Health Amendments
    of 1992'."

                       SHORT TITLE OF 1990 AMENDMENT                   
      Pub. L. 101-630, title V, Sec. 501, Nov. 28, 1990, 104 Stat.
    4556, provided that: "This title [enacting sections 1621h, 1637,
    1659, and 1660 of this title, amending sections 1653, 1657, and
    2474 of this title, and enacting provisions set out as notes under
    sections 1621h, 1653, and 2415 of this title] may be cited as the
    'Indian Health Care Amendments of 1990'."

                       SHORT TITLE OF 1988 AMENDMENT                   
      Pub. L. 100-713, Sec. 1, Nov. 23, 1988, 102 Stat. 4784, provided
    that: "This Act [enacting sections 1616 to 1616j, 1621a to 1621g,
    1636, 1651 to 1658, 1661, 1662, and 1680a to 1680j of this title
    and sections 254s and 295j of Title 42, The Public Health and
    Welfare, amending sections 1603, 1612 to 1613a, 1614, 1615, 1621,
    1631, 1632, 1634, 1674, 1676, and 1678 to 1680 of this title and
    section 5316 of Title 5, Government Organization and Employees,
    repealing section 1635 of this title and section 254r of Title 42,
    enacting provisions set out as notes under this section and
    sections 1611, 1621b, 1661, and 1677 of this title and sections
    254r, 1395qq, and 1396j of Title 42, amending provisions set out as
    a note under section 1396j of Title 42, and repealing provisions
    set out as a note under section 1396j of Title 42] may be cited as
    the 'Indian Health Care Amendments of 1988'."

                       SHORT TITLE OF 1980 AMENDMENT                   
      Pub. L. 96-537, Sec. 1(a), Dec. 17, 1980, 94 Stat. 3173, provided
    that: "this Act [enacting sections 1622, 1634, and 1676 to 1680 of
    this title, amending sections 1603, 1612 to 1614, 1621, 1651 to
    1657, and 1674 of this title and section 294y-1 of Title 42, The
    Public Health and Welfare, and repealing section 1658 of this
    title] may be cited as the 'Indian Health Care Amendments of
    1980'."

                                SHORT TITLE                            
      Section 1 of Pub. L. 94-437 provided: "That this Act [enacting
    this chapter and sections 1395qq and 1396j of Title 42, The Public
    Health and Welfare, amending sections 234, 1395f, 1395n, and 1396d
    of Title 42, and enacting provisions set out as notes under section
    1671 of this title and sections 1395qq and 1396j of Title 42] may
    be cited as the 'Indian Health Care Improvement Act'."

                               SEPARABILITY                           
      Pub. L. 100-713, title VIII, Sec. 801, Nov. 23, 1988, 102 Stat.
    4839, provided that: "If any provision of this Act, any amendment
    made by this Act [see Short Title of 1988 Amendment note above], 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
    provision or amendment to persons or circumstances other than those
    to which it is held invalid, shall not be affected thereby."

                      AVAILABILITY OF APPROPRIATIONS                  
      Pub. L. 100-713, Sec. 4, Nov. 23, 1988, 102 Stat. 4785, provided
    that: "Any new spending authority (described in subsection
    (c)(2)(A) or (B) of section 401 of the Congressional Budget Act of
    1974 [2 U.S.C. 651(c)(2)(A), (B)]) which is provided under this Act
    [see Short Title of 1988 Amendment note above] shall be effective
    for any fiscal year only to such extent or in such amounts as are
    provided in appropriation Acts."

-End-



-CITE-
    25 USC Sec. 1602                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    GENERAL PROVISIONS

-HEAD-
    Sec. 1602. Declaration of health objectives

-STATUTE-
      (a) The Congress hereby declares that it is the policy of this
    Nation, in fulfillment of its special responsibilities and legal
    obligation to the American Indian people, to assure the highest
    possible health status for Indians and urban Indians and to provide
    all resources necessary to effect that policy.
      (b) It is the intent of the Congress that the Nation meet the
    following health status objectives with respect to Indians and
    urban Indians by the year 2000:
        (1) Reduce coronary heart disease deaths to a level of no more
      than 100 per 100,000.
        (2) Reduce the prevalence of overweight individuals to no more
      than 30 percent.
        (3) Reduce the prevalence of anemia to less than 10 percent
      among children aged 1 through 5.
        (4) Reduce the level of cancer deaths to a rate of no more than
      130 per 100,000.
        (5) Reduce the level of lung cancer deaths to a rate of no more
      than 42 per 100,000.
        (6) Reduce the level of chronic obstructive pulmonary disease
      related deaths to a rate of no more than 25 per 100,000.
        (7) Reduce deaths among men caused by alcohol-related motor
      vehicle crashes to no more than 44.8 per 100,000.
        (8) Reduce cirrhosis deaths to no more than 13 per 100,000.
        (9) Reduce drug-related deaths to no more than 3 per 100,000.
        (10) Reduce pregnancies among girls aged 17 and younger to no
      more than 50 per 1,000 adolescents.
        (11) Reduce suicide among men to no more than 12.8 per 100,000.
        (12) Reduce by 15 percent the incidence of injurious suicide
      attempts among adolescents aged 14 through 17.
        (13) Reduce to less than 10 percent the prevalence of mental
      disorders among children and adolescents.
        (14) Reduce the incidence of child abuse or neglect to less
      than 25.2 per 1,000 children under age 18.
        (15) Reduce physical abuse directed at women by male partners
      to no more than 27 per 1,000 couples.
        (16) Increase years of healthy life to at least 65 years.
        (17) Reduce deaths caused by unintentional injuries to no more
      than 66.1 per 100,000.
        (18) Reduce deaths caused by motor vehicle crashes to no more
      than 39.2 per 100,000.
        (19) Among children aged 6 months through 5 years, reduce the
      prevalence of blood lead levels exceeding 15 ug/dl and reduce to
      zero the prevalence of blood lead levels exceeding 25 ug/dl.
        (20) Reduce dental caries (cavities) so that the proportion of
      children with one or more caries (in permanent or primary teeth)
      is no more than 45 percent among children aged 6 through 8 and no
      more than 60 percent among adolescents aged 15.
        (21) Reduce untreated dental caries so that the proportion of
      children with untreated caries (in permanent or primary teeth) is
      no more than 20 percent among children aged 6 through 8 and no
      more than 40 percent among adolescents aged 15.
        (22) Reduce to no more than 20 percent the proportion of
      individuals aged 65 and older who have lost all of their natural
      teeth.
        (23) Increase to at least 45 percent the proportion of
      individuals aged 35 to 44 who have never lost a permanent tooth
      due to dental caries or periodontal disease.
        (24) Reduce destructive periodontal disease to a prevalence of
      no more than 15 percent among individuals aged 35 to 44.
        (25) Increase to at least 50 percent the proportion of children
      who have received protective sealants on the occlusal (chewing)
      surfaces of permanent molar teeth.
        (26) Reduce the prevalence of gingivitis among individuals aged
      35 to 44 to no more than 50 percent.
        (27) Reduce the infant mortality rate to no more than 8.5 per
      1,000 live births.
        (28) Reduce the fetal death rate (20 or more weeks of
      gestation) to no more than 4 per 1,000 live births plus fetal
      deaths.
        (29) Reduce the maternal mortality rate to no more than 3.3 per
      100,000 live births.
        (30) Reduce the incidence of fetal alcohol syndrome to no more
      than 2 per 1,000 live births.
        (31) Reduce stroke deaths to no more than 20 per 100,000.
        (32) Reverse the increase in end-stage renal disease (requiring
      maintenance dialysis or transplantation) to attain an incidence
      of no more than 13 per 100,000.
        (33) Reduce breast cancer deaths to no more than 20.6 per
      100,000 women.
        (34) Reduce deaths from cancer of the uterine cervix to no more
      than 1.3 per 100,000 women.
        (35) Reduce colorectal cancer deaths to no more than 13.2 per
      100,000.
        (36) Reduce to no more than 11 percent the proportion of
      individuals who experience a limitation in major activity due to
      chronic conditions.
        (37) Reduce significant hearing impairment to a prevalence of
      no more than 82 per 1,000.
        (38) Reduce significant visual impairment to a prevalence of no
      more than 30 per 1,000.
        (39) Reduce diabetes-related deaths to no more than 48 per
      100,000.
        (40) Reduce diabetes to an incidence of no more than 2.5 per
      1,000 and a prevalence of no more than 62 per 1,000.
        (41) Reduce the most severe complications of diabetes as
      follows:
          (A) End-stage renal disease, 1.9 per 1,000.
          (B) Blindness, 1.4 per 1,000.
          (C) Lower extremity amputation, 4.9 per 1,000.
          (D) Perinatal mortality, 2 percent.
          (E) Major congenital malformations, 4 percent.

        (42) Confine annual incidence of diagnosed AIDS cases to no
      more than 1,000 cases.
        (43) Confine the prevalence of HIV infection to no more than
      100 per 100,000.
        (44) Reduce gonorrhea to an incidence of no more than 225 cases
      per 100,000.
        (45) Reduce chlamydia trachomatis infections, as measured by a
      decrease in the incidence of nongonococcal urethritis to no more
      than 170 cases per 100,000.
        (46) Reduce primary and secondary syphilis to an incidence of
      no more than 10 cases per 100,000.
        (47) Reduce the incidence of pelvic inflammatory disease, as
      measured by a reduction in hospitalization for pelvic
      inflammatory disease to no more than 250 per 100,000 women aged
      15 through 44.
        (48) Reduce viral hepatitis B infection to no more than 40 per
      100,000 cases.
        (49) Reduce indigenous cases of vaccine-preventable diseases as
      follows:
          (A) Diphtheria among individuals aged 25 and younger, 0.
          (B) Tetanus among individuals aged 25 and younger, 0.
          (C) Polio (wild-type virus), 0.
          (D) Measles, 0.
          (E) Rubella, 0.
          (F) Congenital Rubella Syndrome, 0.
          (G) Mumps, 500.
          (H) Pertussis, 1,000.

        (50) Reduce epidemic-related pneumonia and influenza deaths
      among individuals aged 65 and older to no more than 7.3 per
      100,000.
        (51) Reduce the number of new carriers of viral hepatitis B
      among Alaska Natives to no more than 1 case.
        (52) Reduce tuberculosis to an incidence of no more than 5
      cases per 100,000.
        (53) Reduce bacterial meningitis to no more than 8 cases per
      100,000.
        (54) Reduce infectious diarrhea by at least 25 percent among
      children.
        (55) Reduce acute middle ear infections among children aged 4
      and younger, as measured by days of restricted activity or school
      absenteeism, to no more than 105 days per 100 children.
        (56) Reduce cigarette smoking to a prevalence of no more than
      20 percent.
        (57) Reduce smokeless tobacco use by youth to a prevalence of
      no more than 10 percent.
        (58) Increase to at least 65 percent the proportion of parents
      and caregivers who use feeding practices that prevent baby bottle
      tooth decay.
        (59) Increase to at least 75 percent the proportion of mothers
      who breast feed their babies in the early postpartum period, and
      to at least 50 percent the proportion who continue breast feeding
      until their babies are 5 to 6 months old.
        (60) Increase to at least 90 percent the proportion of pregnant
      women who receive prenatal care in the first trimester of
      pregnancy.
        (61) Increase to at least 70 percent the proportion of
      individuals who have received, as a minimum within the
      appropriate interval, all of the screening and immunization
      services and at least one of the counseling services appropriate
      for their age and gender as recommended by the United States
      Preventive Services Task Force.

      (c) It is the intent of the Congress that the Nation increase the
    proportion of all degrees in the health professions and allied and
    associated health profession fields awarded to Indians to 0.6
    percent.
      (d) The Secretary shall submit to the President, for inclusion in
    each report required to be transmitted to the Congress under
    section 1671 of this title, a report on the progress made in each
    area of the Service toward meeting each of the objectives described
    in subsection (b) of this section.

-SOURCE-
    (Pub. L. 94-437, Sec. 3, Sept. 30, 1976, 90 Stat. 1401; Pub. L. 102-
    573, Sec. 3(b), Oct. 29, 1992, 106 Stat. 4526.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573 amended section generally. Prior to
    amendment, section read as follows: "The Congress hereby declares
    that it is the policy of this Nation, in fulfillment of its special
    responsibilities and legal obligation to the American Indian
    people, to meet the national goal of providing the highest possible
    health status to Indians and to provide existing Indian health
    services with all resources necessary to effect that policy."

-End-



-CITE-
    25 USC Sec. 1603                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    GENERAL PROVISIONS

-HEAD-
    Sec. 1603. Definitions

-STATUTE-
      For purposes of this chapter - 
      (a) "Secretary", unless otherwise designated, means the Secretary
    of Health and Human Services.
      (b) "Service" means the Indian Health Service.
      (c) "Indians" or "Indian", unless otherwise designated, means any
    person who is a member of an Indian tribe, as defined in subsection
    (d) of this section, except that, for the purpose of sections 1612
    and 1613 of this title, such terms shall mean any individual who
    (1), irrespective of whether he or she lives on or near a
    reservation, is a member of a tribe, band, or other organized group
    of Indians, including those tribes, bands, or groups terminated
    since 1940 and those recognized now or in the future by the State
    in which they reside, or who is a descendant, in the first or
    second degree, of any such member, or (2) is an Eskimo or Aleut or
    other Alaska Native, or (3) is considered by the Secretary of the
    Interior to be an Indian for any purpose, or (4) is determined to
    be an Indian under regulations promulgated by the Secretary.
      (d) "Indian tribe" means any Indian tribe, band, nation, or other
    organized group or community, including any Alaska Native village
    or group or regional or village corporation as defined in or
    established pursuant to the Alaska Native Claims Settlement Act (85
    Stat. 688) [43 U.S.C. 1601 et seq.], which is recognized as
    eligible for the special programs and services provided by the
    United States to Indians because of their status as Indians.
      (e) "Tribal organization" means the elected governing body of any
    Indian tribe or any legally established organization of Indians
    which is controlled by one or more such bodies or by a board of
    directors elected or selected by one or more such bodies (or
    elected by the Indian population to be served by such organization)
    and which includes the maximum participation of Indians in all
    phases of its activities.
      (f) "Urban Indian" means any individual who resides in an urban
    center, as defined in subsection (g) of this section, and who meets
    one or more of the four criteria in subsection (c)(1) through (4)
    of this section.
      (g) "Urban center" means any community which has a sufficient
    urban Indian population with unmet health needs to warrant
    assistance under subchapter IV of this chapter, as determined by
    the Secretary.
      (h) "Urban Indian organization" means a nonprofit corporate body
    situated in an urban center, governed by an urban Indian controlled
    board of directors, and providing for the maximum participation of
    all interested Indian groups and individuals, which body is capable
    of legally cooperating with other public and private entities for
    the purpose of performing the activities described in section
    1653(a) of this title.
      (i) "Area office" means an administrative entity including a
    program office, within the Indian Health Service through which
    services and funds are provided to the service units within a
    defined geographic area.
      (j) "Service unit" means - 
        (1) an administrative entity within the Indian Health Service,
      or
        (2) a tribe or tribal organization operating health care
      programs or facilities with funds from the Service under the
      Indian Self-Determination Act [25 U.S.C. 450f et seq.],

    through which services are provided, directly or by contract, to
    the eligible Indian population within a defined geographic area.
      (k) "Health promotion" includes - 
        (1) cessation of tobacco smoking,
        (2) reduction in the misuse of alcohol and drugs,
        (3) improvement of nutrition,
        (4) improvement in physical fitness,
        (5) family planning,
        (6) control of stress, and
        (7) pregnancy and infant care (including prevention of fetal
      alcohol syndrome).

      (l) "Disease prevention" includes - 
        (1) immunizations,
        (2) control of high blood pressure,
        (3) control of sexually transmittable diseases,
        (4) prevention and control of diabetes,
        (5) control of toxic agents,
        (6) occupational safety and health,
        (7) accident prevention,
        (8) fluoridation of water, and
        (9) control of infectious agents.

      (m) "Service area" means the geographical area served by each
    area office.
      (n) "Health profession" means allopathic medicine, family
    medicine, internal medicine, pediatrics, geriatric medicine,
    obstetrics and gynecology, podiatric medicine, nursing, public
    health nursing, dentistry, psychiatry, osteopathy, optometry,
    pharmacy, psychology, public health, social work, marriage and
    family therapy, chiropractic medicine, environmental health and
    engineering, an allied health profession, or any other health
    profession.
      (o) "Substance abuse" includes inhalant abuse.
      (p) "FAE" means fetal alcohol effect.
      (q) "FAS" means fetal alcohol syndrome.

-SOURCE-
    (Pub. L. 94-437, Sec. 4, Sept. 30, 1976, 90 Stat. 1401; Pub. L. 96-
    537, Sec. 2, Dec. 17, 1980, 94 Stat. 3173; Pub. L. 100-713, title
    II, Secs. 201(b), 203(b), title V, Sec. 502, Nov. 23, 1988, 102
    Stat. 4803, 4804, 4824; Pub. L. 102-573, Sec. 3(c), title IX, Sec.
    902(1), Oct. 29, 1992, 106 Stat. 4529, 4591; Pub. L. 104-313, Sec.
    2(a), Oct. 19, 1996, 110 Stat. 3820.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Alaska Native Claims Settlement Act, referred to in subsec.
    (d), is Pub. L. 92-203, Dec. 18, 1971, 85 Stat. 688, as amended,
    which is classified generally to chapter 33 (Sec. 1601 et seq.) of
    Title 43, Public Lands. For complete classification of this Act to
    the Code, see Short Title note set out under section 1601 of Title
    43, and Tables.
      The Indian Self-Determination Act, referred to in subsec. (j)(2),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1996 - Subsec. (n). Pub. L. 104-313 inserted "allopathic
    medicine," before "family medicine" and substituted "an allied
    health profession, or any other health profession" for "and allied
    health professions".
      1992 - Subsec. (c). Pub. L. 102-573, Sec. 902(1), substituted
    "sections 1612 and 1613 of this title" for "sections 1612, 1613,
    and 1621(c)(5) of this title".
      Subsecs. (m) to (q). Pub. L. 102-573, Sec. 3(c), added subsecs.
    (m) to (q).
      1988 - Subsec. (h). Pub. L. 100-713, Sec. 502, inserted "urban"
    after "governed by an".
      Subsec. (i). Pub. L. 100-713, Sec. 201(b), added subsec. (i) and
    struck out former subsec. (i) which defined "rural Indian".
      Subsec. (j). Pub. L. 100-713, Sec. 201(b), added subsec. (j) and
    struck out former subsec. (j) which defined "rural community".
      Subsec. (k). Pub. L. 100-713, Secs. 201(b), 203(b), added subsec.
    (k) and struck out former subsec. (k) which defined "rural Indian
    organization".
      Subsec. (l). Pub. L. 100-713, Sec. 203(b), added subsec. (l).
      1980 - Subsec. (a). Pub. L. 96-537, Sec. 2(a), substituted
    "Secretary of Health and Human Services" for "Secretary of Health,
    Education, and Welfare".
      Subsec. (h). Pub. L. 96-537, Sec. 2(b), substituted "governed by
    an Indian controlled board of directors" for "composed of urban
    Indians".
      Subsecs. (i) to (k). Pub. L. 96-537, Sec. 2(c), added subsecs.
    (i) to (k).

-End-


-CITE-
    25 USC SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL
           PERSONNEL                                       01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
            SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL        

-End-



-CITE-
    25 USC Sec. 1611                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1611. Congressional statement of purpose

-STATUTE-
      The purpose of this subchapter is to increase the number of
    Indians entering the health professions and to assure an adequate
    supply of health professionals to the Service, Indian tribes,
    tribal organizations, and urban Indian organizations involved in
    the provision of health care to Indian people.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 101, Sept. 30, 1976, 90 Stat. 1402;
    Pub. L. 102-573, title I, Sec. 101, Oct. 29, 1992, 106 Stat. 4530.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573 amended section generally. Prior to
    amendment, section read as follows: "The purpose of this subchapter
    is to augment the inadequate number of health professionals serving
    Indians and remove the multiple barriers to the entrance of health
    professionals into the Service and private practice among Indians."

          ADVISORY PANEL AND REPORT ON RECRUITMENT AND RETENTION      
      Pub. L. 100-713, title I, Sec. 110, Nov. 23, 1988, 102 Stat.
    4800, directed Secretary of Health and Human Services to establish
    an advisory panel composed of 10 physicians or other health
    professionals who are employees of, or assigned to, the Indian
    Health Service, 3 representatives of tribal health boards, and 1
    representative of an urban health care organization, such advisory
    panel to conduct an investigation of (1) administrative policies
    and regulatory procedures which impede recruitment or retention of
    physicians and other health professionals by Indian Health Service,
    and (2) regulatory changes necessary to establish pay grades for
    health professionals employed by, or assigned to, the Service that
    correspond to the pay grades established for positions provided
    under 38 U.S.C. 4103 and 4104 and costs associated with
    establishing such pay grades, and, no later than the date that is
    18 months after Nov. 23, 1988, to submit to Congress a report on
    the investigation, together with any recommendations for
    administrative or legislative changes in existing law, practices,
    or procedures.

-End-



-CITE-
    25 USC Sec. 1612                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1612. Health professions recruitment program for Indians

-STATUTE-
    (a) Grants for education and training
      The Secretary, acting through the Service, shall make grants to
    public or nonprofit private health or educational entities or
    Indian tribes or tribal organizations to assist such entities in
    meeting the costs of - 
        (1) identifying Indians with a potential for education or
      training in the health professions and encouraging and assisting
      them - 
          (A) to enroll in courses of study in such health professions;
        or
          (B) if they are not qualified to enroll in any such courses
        of study, to undertake such postsecondary education or training
        as may be required to qualify them for enrollment;

        (2) publicizing existing sources of financial aid available to
      Indians enrolled in any course of study referred to in paragraph
      (1) of this subsection or who are undertaking training necessary
      to qualify them to enroll in any such course of study; or
        (3) establishing other programs which the Secretary determines
      will enhance and facilitate the enrollment of Indians in, and the
      subsequent pursuit and completion by them of, courses of study
      referred to in paragraph (1) of this subsection.
    (b) Application for grant; submittal and approval; preference;
      payment
      (1) No grant may be made under this section unless an application
    therefor has been submitted to, and approved by, the Secretary.
    Such application shall be in such form, submitted in such manner,
    and contain such information, as the Secretary shall by regulation
    prescribe. The Secretary shall give a preference to applications
    submitted by Indian tribes or tribal organizations.
      (2) The amount of any grant under this section shall be
    determined by the Secretary. Payments pursuant to grants under this
    section may be made in advance or by way of reimbursement, and at
    such intervals and on such conditions as the Secretary finds
    necessary.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 102, Sept. 30, 1976, 90 Stat. 1402;
    Pub. L. 96-537, Sec. 3(a), Dec. 17, 1980, 94 Stat. 3173; Pub. L.
    100-713, title I, Sec. 101, Nov. 23, 1988, 102 Stat. 4785; Pub. L.
    102-573, title I, Secs. 102(a), 117(b)(1), title IX, Sec.
    902(2)(A), Oct. 29, 1992, 106 Stat. 4530, 4544, 4591.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a)(1). Pub. L. 102-573, Sec. 102(a)(1), amended
    par. (1) generally. Prior to amendment, par. (1) read as follows:
    "identifying Indians with a potential for education or training in
    the health professions and encouraging and assisting them (A) to
    enroll in schools of medicine, osteopathy, dentistry, veterinary
    medicine, optometry, podiatry, pharmacy, public health, nursing, or
    allied health professions; or (B), if they are not qualified to
    enroll in any such school, to undertake such post-secondary
    education or training as may be required to qualify them for
    enrollment;".
      Subsec. (a)(2). Pub. L. 102-573, Sec. 102(a)(2), substituted
    "course of study" for "school" in two places and "paragraph (1)"
    for "clause (1)(A)".
      Subsec. (a)(3). Pub. L. 102-573, Sec. 102(a)(3), substituted
    "enrollment of Indians in, and the subsequent pursuit and
    completion by them of, courses of study referred to in paragraph
    (1) of this subsection" for "enrollment of Indians, and the
    subsequent pursuit and completion by them of courses of study, in
    any school referred to in clause (1)(A) of this subsection".
      Subsec. (b)(1). Pub. L. 102-573, Sec. 902(2)(A), substituted
    "prescribe. The Secretary shall" for ": Provided, That the
    Secretary shall".
      Subsec. (c). Pub. L. 102-573, Sec. 117(b)(1), struck out subsec.
    (c) which authorized appropriations for fiscal years 1989 to 1992.
      1988 - Subsec. (c). Pub. L. 100-713 amended subsec. (c)
    generally. Prior to amendment, subsec. (c) read as follows: "For
    the purpose of making payments pursuant to grants under this
    section, there are authorized to be appropriated $900,000 for
    fiscal year 1978, $1,500,000 for fiscal year 1979, and $1,800,000
    for fiscal year 1980. There are authorized to be appropriated to
    carry out this section $2,300,000 for the fiscal year ending
    September 30, 1981, $2,600,000 for the fiscal year ending September
    30, 1982, $3,000,000 for the fiscal year ending September 30, 1983,
    and $3,500,000 for the fiscal year ending September 30, 1984."
      1980 - Subsec. (c). Pub. L. 96-537 substituted provisions
    authorizing appropriation of specific amounts for fiscal years
    ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept.
    30, 1984, for provisions authorizing appropriation of such amounts
    as may be specifically authorized by an act enacted after Sept. 30,
    1976.

-End-



-CITE-
    25 USC Sec. 1613                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1613. Health professions preparatory scholarship program for
      Indians

-STATUTE-
    (a) Requirements
      The Secretary, acting through the Service, shall make scholarship
    grants to Indians who - 
        (1) have successfully completed their high school education or
      high school equivalency; and
        (2) have demonstrated the capability to successfully complete
      courses of study in the health professions.
    (b) Purposes and duration of grants; preprofessional and
      pregraduate education
      Scholarship grants made pursuant to this section shall be for the
    following purposes:
        (1) Compensatory preprofessional education of any grantee, such
      scholarship not to exceed two years on a full-time basis (or the
      part-time equivalent thereof, as determined by the Secretary).
        (2) Pregraduate education of any grantee leading to a
      baccalaureate degree in an approved course of study preparatory
      to a field of study in a health profession, such scholarship not
      to exceed 4 years (or the part-time equivalent thereof, as
      determined by the Secretary).
    (c) Covered expenses
      Scholarship grants made under this section may cover costs of
    tuition, books, transportation, board, and other necessary related
    expenses of a grantee while attending school.
    (d) Basis for denial of assistance
      The Secretary shall not deny scholarship assistance to an
    eligible applicant under this section solely on the basis of the
    applicant's scholastic achievement if such applicant has been
    admitted to, or maintained good standing at, an accredited
    institution.
    (e) Eligibility for assistance under other Federal programs
      The Secretary shall not deny scholarship assistance to an
    eligible applicant under this section solely by reason of such
    applicant's eligibility for assistance or benefits under any other
    Federal program.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 103, Sept. 30, 1976, 90 Stat. 1403;
    Pub. L. 96-537, Sec. 3(b), Dec. 17, 1980, 94 Stat. 3174; Pub. L.
    100-713, title I, Sec. 102, Nov. 23, 1988, 102 Stat. 4785; Pub. L.
    102-573, title I, Sec. 102(b), Oct. 29, 1992, 106 Stat. 4530.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a)(2). Pub. L. 102-573, Sec. 102(b)(1), amended
    par. (2) generally. Prior to amendment, par. (2) read as follows:
    "have demonstrated the capability to successfully complete courses
    of study in schools of medicine, osteopathy, dentistry, veterinary
    medicine, optometry, podiatry, pharmacy, public health, nursing, or
    allied health professions."
      Subsec. (b)(1). Pub. L. 102-573, Sec. 102(b)(2), inserted before
    period at end "on a full-time basis (or the part-time equivalent
    thereof, as determined by the Secretary)".
      Subsec. (b)(2). Pub. L. 102-573, Sec. 102(b)(3), amended par. (2)
    generally. Prior to amendment, par. (2) read as follows:
    "Pregraduate education of any grantee leading to a baccalaureate
    degree in an approved premedicine, predentistry, preosteopathy,
    preveterinary medicine, preoptometry, or prepodiatry curriculum,
    such scholarship not to exceed four years."
      Subsec. (c). Pub. L. 102-573, Sec. 102(b)(4), struck out "full
    time" after "while attending school".
      Subsec. (e). Pub. L. 102-573, Sec. 102(b)(5), amended subsec. (e)
    generally. Prior to amendment, subsec. (e) read as follows: "There
    are authorized to be appropriated for the purpose of carrying out
    the provisions of this section - 
        "(1) $3,000,000 for fiscal year 1989,
        "(2) $3,700,000 for fiscal year 1990,
        "(3) $4,400,000 for fiscal year 1991, and
        "(4) $5,100,000 for fiscal year 1992."
      1988 - Subsec. (c). Pub. L. 100-713, Sec. 102(b), inserted "of a
    grantee while attending school full time" after "expenses".
      Subsecs. (d), (e). Pub. L. 100-713, Sec. 102(a), added subsecs.
    (d) and (e) and struck out former subsec. (d) which read as
    follows: "There are authorized to be appropriated for the purpose
    of this section: $800,000 for fiscal year 1978, $1,000,000 for
    fiscal year 1979, and $1,300,000 for fiscal year 1980. There are
    authorized to be appropriated to carry out this section $3,510,000
    for the fiscal year ending September 30, 1981, $4,000,000 for the
    fiscal year ending September 30, 1982, $4,620,000 for the fiscal
    year ending September 30, 1983, and $5,300,000 for the fiscal year
    ending September 30, 1984."
      1980 - Subsec. (b). Pub. L. 96-537, Sec. 3(b)(1), substituted
    provisions specifying in pars. (1) and (2), purposes for which
    scholarship grants could be made, for provisions that the
    scholarship grant shall be for a period not to exceed two academic
    years, which years shall be for compensatory preprofessional
    education of the grantee.
      Subsec. (d). Pub. L. 96-537, Sec. 3(b)(2), substituted provisions
    authorizing appropriation of specific amounts for fiscal years
    ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept.
    30, 1984, for provisions authorizing appropriations of such amounts
    as may be specifically authorized by an act enacted after Sept. 30,
    1976.

-End-



-CITE-
    25 USC Sec. 1613a                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1613a. Indian health professions scholarships

-STATUTE-
    (a) General authority
      In order to provide health professionals to Indians, Indian
    tribes, tribal organizations, and urban Indian organizations, the
    Secretary, acting through the Service and in accordance with this
    section, shall make scholarship grants to Indians who are enrolled
    full or part time in appropriately accredited schools and pursuing
    courses of study in the health professions. Such scholarships shall
    be designated Indian Health Scholarships and shall be made in
    accordance with section 254l of title 42, except as provided in
    subsection (b) of this section.
    (b) Recipients; active duty service obligation
      (1) The Secretary, acting through the Service, shall determine
    who shall receive scholarships under subsection (a) of this section
    and shall determine the distribution of such scholarships among
    such health professions on the basis of the relative needs of
    Indians for additional service in such health professions.
      (2) An individual shall be eligible for a scholarship under
    subsection (a) of this section in any year in which such individual
    is enrolled full or part time in a course of study referred to in
    subsection (a) of this section.
      (3)(A) The active duty service obligation under a written
    contract with the Secretary under section 254l of title 42 that an
    individual has entered into under that section shall, if that
    individual is a recipient of an Indian Health Scholarship, be met
    in full-time practice, by service - 
        (i) in the Indian Health Service;
        (ii) in a program conducted under a contract entered into under
      the Indian Self-Determination Act [25 U.S.C. 450f et seq.];
        (iii) in a program assisted under subchapter IV of this
      chapter; (!1)

        (iv) in the private practice of the applicable profession if,
      as determined by the Secretary, in accordance with guidelines
      promulgated by the Secretary, such practice is situated in a
      physician or other health professional shortage area and
      addresses the health care needs of a substantial number of
      Indians; or (!2)


      (B) At the request of any individual who has entered into a
    contract referred to in subparagraph (A) and who receives a degree
    in medicine (including osteopathic or allopathic medicine),
    dentistry, optometry, podiatry, or pharmacy, the Secretary shall
    defer the active duty service obligation of that individual under
    that contract, in order that such individual may complete any
    internship, residency, or other advanced clinical training that is
    required for the practice of that health profession, for an
    appropriate period (in years, as determined by the Secretary),
    subject to the following conditions:
        (i) No period of internship, residency, or other advanced
      clinical training shall be counted as satisfying any period of
      obligated service that is required under this section.
        (ii) The active duty service obligation of that individual
      shall commence not later than 90 days after the completion of
      that advanced clinical training (or by a date specified by the
      Secretary).
        (iii) The active duty service obligation will be served in the
      health profession of that individual, in a manner consistent with
      clauses (i) through (v) of subparagraph (A).

      (C) A recipient of an Indian Health Scholarship may, at the
    election of the recipient, meet the active duty service obligation
    described in subparagraph (A) by service in a program specified in
    that subparagraph that - 
        (i) is located on the reservation of the tribe in which the
      recipient is enrolled; or
        (ii) serves the tribe in which the recipient is enrolled.

      (D) Subject to subparagraph (C), the Secretary, in making
    assignments of Indian Health Scholarship recipients required to
    meet the active duty service obligation described in subparagraph
    (A), shall give priority to assigning individuals to service in
    those programs specified in subparagraph (A) that have a need for
    health professionals to provide health care services as a result of
    individuals having breached contracts entered into under this
    section.
      (4) In the case of an individual receiving a scholarship under
    this section who is enrolled part time in an approved course of
    study - 
        (A) such scholarship shall be for a period of years not to
      exceed the part-time equivalent of 4 years, as determined by the
      Secretary;
        (B) the period of obligated service described in paragraph
      (3)(A) shall be equal to the greater of - 
          (i) the part-time equivalent of one year for each year for
        which the individual was provided a scholarship (as determined
        by the Secretary); or
          (ii) two years; and

        (C) the amount of the monthly stipend specified in section
      254l(g)(1)(B) of title 42 shall be reduced pro rata (as
      determined by the Secretary) based on the number of hours such
      student is enrolled.

      (5)(A) An individual who has, on or after October 29, 1992,
    entered into a written contract with the Secretary under this
    section and who - 
        (i) fails to maintain an acceptable level of academic standing
      in the educational institution in which he is enrolled (such
      level determined by the educational institution under regulations
      of the Secretary),
        (ii) is dismissed from such educational institution for
      disciplinary reasons,
        (iii) voluntarily terminates the training in such an
      educational institution for which he is provided a scholarship
      under such contract before the completion of such training, or
        (iv) fails to accept payment, or instructs the educational
      institution in which he is enrolled not to accept payment, in
      whole or in part, of a scholarship under such contract,

    in lieu of any service obligation arising under such contract,
    shall be liable to the United States for the amount which has been
    paid to him, or on his behalf, under the contract.
      (B) If for any reason not specified in subparagraph (A) an
    individual breaches his written contract by failing either to begin
    such individual's service obligation under this section or to
    complete such service obligation, the United States shall be
    entitled to recover from the individual an amount determined in
    accordance with the formula specified in subsection (l) of section
    1616a of this title in the manner provided for in such subsection.
      (C) Upon the death of an individual who receives an Indian Health
    Scholarship, any obligation of that individual for service or
    payment that relates to that scholarship shall be canceled.
      (D) The Secretary shall provide for the partial or total waiver
    or suspension of any obligation of service or payment of a
    recipient of an Indian Health Scholarship if the Secretary
    determines that - 
        (i) it is not possible for the recipient to meet that
      obligation or make that payment;
        (ii) requiring that recipient to meet that obligation or make
      that payment would result in extreme hardship to the recipient;
      or
        (iii) the enforcement of the requirement to meet the obligation
      or make the payment would be unconscionable.

      (E) Notwithstanding any other provision of law, in any case of
    extreme hardship or for other good cause shown, the Secretary may
    waive, in whole or in part, the right of the United States to
    recover funds made available under this section.
      (F) Notwithstanding any other provision of law, with respect to a
    recipient of an Indian Health Scholarship, no obligation for
    payment may be released by a discharge in bankruptcy under title
    11, unless that discharge is granted after the expiration of the 5-
    year period beginning on the initial date on which that payment is
    due, and only if the bankruptcy court finds that the nondischarge
    of the obligation would be unconscionable.
    (c) Placement Office
      The Secretary shall, acting through the Service, establish a
    Placement Office to develop and implement a national policy for the
    placement, to available vacancies within the Service, of Indian
    Health Scholarship recipients required to meet the active duty
    service obligation prescribed under section 254m of title 42
    without regard to any competitive personnel system, agency
    personnel limitation, or Indian preference policy.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 104, as added Pub. L. 100-713, title
    I, Sec. 104(a), Nov. 23, 1988, 102 Stat. 4786; amended Pub. L. 102-
    573, title I, Secs. 102(c), 103, Oct. 29, 1992, 106 Stat. 4531,
    4532; Pub. L. 104-313, Sec. 2(b), Oct. 19, 1996, 110 Stat. 3820.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec.
    (b)(3)(A)(ii), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat.
    2206, as amended, which is classified principally to part A (Sec.
    450f et seq.) of subchapter II of chapter 14 of this title. For
    complete classification of this Act to the Code, see Short Title
    note set out under section 450 of this title and Tables.


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 104 of Pub. L. 94-437, title I, Sept. 30, 1976,
    90 Stat. 1403, amended former section 234 of Title 42, The Public
    Health and Welfare.

                                AMENDMENTS                            
      1996 - Subsec. (b)(3)(A). Pub. L. 104-313, Sec. 2(b)(1)(A),
    substituted "The active duty service obligation under a written
    contract with the Secretary under section 254l of title 42 that an
    individual has entered into under that section shall, if that
    individual is a recipient of an Indian Health Scholarship, be met
    in full-time practice, by service - " for "The active duty service
    obligation prescribed under section 254m of title 42 shall be met
    by a  recipient  of  an  Indian  Health  Scholarship  by service -
    " in introductory provisions, struck out "or" at end of cl. (iii),
    and substituted "; or" for period at end of cl. (iv).
      Subsec. (b)(3)(B). Pub. L. 104-313, Sec. 2(b)(1)(C), added
    subpar. (B). Former subpar. (B) redesignated (C).
      Subsec. (b)(3)(C). Pub. L. 104-313, Sec. 2(b)(1)(D), substituted
    "described in subparagraph (A) by service in a program specified in
    that subparagraph" for "prescribed under section 254m of title 42
    by service in a program specified in subparagraph (A)".
      Pub. L. 104-313, Sec. 2(b)(1)(B), redesignated subpar. (B) as
    (C). Former subpar. (C) redesignated (D).
      Subsec. (b)(3)(D). Pub. L. 104-313, Sec. 2(b)(1)(E), substituted
    "Subject to subparagraph (C)," for "Subject to subparagraph (B),"
    and "described in subparagraph (A)" for "prescribed under section
    254m of title 42".
      Pub. L. 104-313, Sec. 2(b)(1)(B), redesignated subpar. (C) as
    (D).
      Subsec. (b)(4)(B). Pub. L. 104-313, Sec. 2(b)(2)(A), substituted
    "the period of obligated service described in paragraph (3)(A)
    shall be equal to the greater of - " for "the period of obligated
    service specified in section 254l(f)(1)(B)(iv) of title 42 shall be
    equal to the greater of - " in introductory provisions.
      Subsec. (b)(4)(C). Pub. L. 104-313, Sec. 2(b)(2)(B), made
    technical amendment to reference in original act which appears in
    text as reference to section 254l(g)(1)(B) of title 42.
      Subsec. (b)(5)(C) to (F). Pub. L. 104-313, Sec. 2(b)(3), added
    subpars. (C) to (F).
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 102(c)(1)(C),
    substituted "accredited schools and pursuing courses of study in
    the health professions" for "accredited schools of medicine,
    osteopathy, podiatry, psychology, dentistry, environmental health
    and engineering, nursing, optometry, public health, allied health
    professions, and social work".
      Pub. L. 102-573, Sec. 102(c)(1)(A), (B), substituted "Indians,
    Indian tribes, tribal organizations, and urban Indian
    organizations" for "Indian communities" and "full or part time" for
    "full time".
      Subsec. (b)(2). Pub. L. 102-573, Sec. 102(c)(2)(A), substituted
    "full or part time" for "full time" and "course of study" for
    "health profession school".
      Subsec. (b)(3). Pub. L. 102-573, Sec. 102(c)(2)(B), designated
    existing provisions as subpar. (A), redesignated former subpars.
    (A) to (D) as cls. (i) to (iv), respectively, and added subpars.
    (B) and (C).
      Subsec. (b)(4). Pub. L. 102-573, Sec. 102(c)(2)(C), added par.
    (4).
      Subsec. (b)(5). Pub. L. 102-573, Sec. 103, added par. (5).
      Subsec. (c). Pub. L. 102-573, Sec. 102(c)(3), amended subsec. (c)
    generally. Prior to amendment, subsec. (c) read as follows: "For
    purposes of this section, the term 'Indian' has the same meaning
    given that term by subsection (c) of section 1603 of this title,
    including all individuals described in clauses (1) through (4) of
    that subsection."
      Subsec. (d). Pub. L. 102-573, Sec. 102(c)(4), struck out subsec.
    (d) which authorized appropriations for fiscal years 1989 to 1992.

                     EFFECTIVE DATE OF 1992 AMENDMENT                 
      Section 102(d) of Pub. L. 102-573 provided that: "The amendments
    made by subsection (c)(1)(C) and subsection (c)(2)(B) [amending
    this section] shall apply with respect to scholarships granted
    under section 104 of the Indian Health Care Improvement Act [this
    section] after the date of the enactment of this Act [Oct. 29,
    1992]."

-FOOTNOTE-               

    (!1) So in original. Probably should be followed by "or".

               

    (!2) So in original. The "; or" probably should be a period.


-End-



-CITE-
    25 USC Sec. 1614                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1614. Indian health service extern programs

-STATUTE-
    (a) Employment of scholarship grantees during nonacademic periods
      Any individual who receives a scholarship grant pursuant to
    section 1613a of this title shall be entitled to employment in the
    Service during any nonacademic period of the year. Periods of
    employment pursuant to this subsection shall not be counted in
    determining the fulfillment of the service obligation incurred as a
    condition of the scholarship grant.
    (b) Employment of medical and other students during nonacademic
      periods
      Any individual enrolled in a course of study in the health
    professions may be employed by the Service during any nonacademic
    period of the year. Any such employment shall not exceed one
    hundred and twenty days during any calendar year.
    (c) Employment without regard to competitive personnel system or
      agency personnel limitation; compensation
      Any employment pursuant to this section shall be made without
    regard to any competitive personnel system or agency personnel
    limitation and to a position which will enable the individual so
    employed to receive practical experience in the health profession
    in which he or she is engaged in study. Any individual so employed
    shall receive payment for his or her services comparable to the
    salary he or she would receive if he or she were employed in the
    competitive system. Any individual so employed shall not be counted
    against any employment ceiling affecting the Service or the
    Department of Health and Human Services.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 105, Sept. 30, 1976, 90 Stat. 1404;
    Pub. L. 95-83, title III, Sec. 307(n)(2), Aug. 1, 1977, 91 Stat.
    393; Pub. L. 96-537, Sec. 3(c), Dec. 17, 1980, 94 Stat. 3174; Pub.
    L. 100-713, title I, Sec. 103, Nov. 23, 1988, 102 Stat. 4786; Pub.
    L. 102-573, title I, Secs. 102(e), 117(b)(2), title IX, Sec.
    902(2)(B), Oct. 29, 1992, 106 Stat. 4532, 4544, 4591.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 102(e)(1), substituted
    "section 1613a of this title" for "section 254r of title 42".
      Subsec. (b). Pub. L. 102-573, Sec. 102(e)(2), substituted "course
    of study in the health professions" for "school of medicine,
    osteopathy, dentistry, veterinary medicine, optometry, podiatry,
    pharmacy, public health, nursing, or allied health professions".
      Subsec. (c). Pub. L. 102-573, Sec. 902(2)(B), substituted
    "Department of Health and Human Services" for "Department of
    Health, Education, and Welfare".
      Subsec. (d). Pub. L. 102-573, Sec. 117(b)(2), struck out subsec.
    (d) which authorized appropriations for fiscal years 1989 to 1992.
      1988 - Subsec. (d). Pub. L. 100-713 amended subsec. (d)
    generally. Prior to amendment, subsec. (d) read as follows: "There
    are authorized to be appropriated for the purpose of this section:
    $600,000 for fiscal year 1978, $800,000 for fiscal year 1979, and
    $1,000,000 for fiscal year 1980. There are authorized to be
    appropriated to carry out this section $990,000 for the fiscal year
    ending September 30, 1981, $1,140,000 for the fiscal year ending
    September 30, 1982, $1,310,000 for the fiscal year ending September
    30, 1983, and $1,510,000 for the fiscal year ending September 30,
    1984."
      1980 - Subsec. (d). Pub. L. 96-537 substituted provisions
    authorizing appropriations of specific amounts for fiscal years
    ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept.
    30, 1984, for provisions authorizing appropriation of such amounts
    as may be specifically authorized by an act enacted after Sept. 30,
    1976.
      1977 - Subsec. (a). Pub. L. 95-83 substituted reference to
    "section 294y-1 of title 42" for reference to "section 104" meaning
    section 104 of Pub. L. 94-437, which added section 234(i)(2) of
    Title 42, The Public Health and Welfare.

-End-



-CITE-
    25 USC Sec. 1615                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1615. Continuing education allowances

-STATUTE-
    (a) Discretionary authority; scope of activities
      In order to encourage physicians, dentists, nurses, and other
    health professionals to join or continue in the Service and to
    provide their services in the rural and remote areas where a
    significant portion of the Indian people resides, the Secretary,
    acting through the Service, may provide allowances to health
    professionals employed in the Service to enable them for a period
    of time each year prescribed by regulation of the Secretary to take
    leave of their duty stations for professional consultation and
    refresher training courses.
    (b) Limitation
      Of amounts appropriated under the authority of this subchapter
    for each fiscal year to be used to carry out this section, not more
    than $1,000,000 may be used to establish postdoctoral training
    programs for health professionals.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 106, Sept. 30, 1976, 90 Stat. 1404;
    Pub. L. 100-713, title I, Sec. 105, Nov. 23, 1988, 102 Stat. 4787;
    Pub. L. 102-573, title I, Secs. 104(a), 115, Oct. 29, 1992, 106
    Stat. 4533, 4543.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 104(a), inserted
    "nurses," after "physicians, dentists,".
      Subsec. (b). Pub. L. 102-573, Sec. 115, amended subsec. (b)
    generally. Prior to amendment, subsec. (b) read as follows: "There
    are authorized to be appropriated for the purpose of carrying out
    the provisions of this section - 
        "(1) $500,000 for fiscal year 1989,
        "(2) $526,300 for fiscal year 1990,
        "(3) $553,800 for fiscal year 1991, and
        "(4) $582,500 for fiscal year 1992."
      1988 - Subsec. (b). Pub. L. 100-713 amended subsec. (b)
    generally. Prior to amendment, subsec. (b) read as follows: "There
    are authorized to be appropriated for the purpose of this section:
    $100,000 for fiscal year 1978, $200,000 for fiscal year 1979, and
    $250,000 for fiscal year 1980. For fiscal years 1981, 1982, 1983,
    and 1984 there are authorized to be appropriated for the purpose of
    this section such sums as may be specifically authorized by an Act
    enacted after this chapter."

-End-



-CITE-
    25 USC Sec. 1616                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616. Community Health Representative Program

-STATUTE-
      (a) Under the authority of section 13 of this title, the
    Secretary shall maintain a Community Health Representative Program
    under which the Service - 
        (1) provides for the training of Indians as health
      paraprofessionals, and
        (2) uses such paraprofessionals in the provision of health
      care, health promotion, and disease prevention services to Indian
      communities.

      (b) The Secretary, acting through the Community Health
    Representative Program of the Service, shall - 
        (1) provide a high standard of training for paraprofessionals
      to Community Health Representatives to ensure that the Community
      Health Representatives provide quality health care, health
      promotion, and disease prevention services to the Indian
      communities served by such Program,
        (2) in order to provide such training, develop and maintain a
      curriculum that - 
          (A) combines education in the theory of health care with
        supervised practical experience in the provision of health
        care, and
          (B) provides instruction and practical experience in health
        promotion and disease prevention activities, with appropriate
        consideration given to lifestyle factors that have an impact on
        Indian health status, such as alcoholism, family dysfunction,
        and poverty,

        (3) maintain a system which identifies the needs of Community
      Health Representatives for continuing education in health care,
      health promotion, and disease prevention and maintain programs
      that meet the needs for such continuing education,
        (4) maintain a system that provides close supervision of
      Community Health Representatives,
        (5) maintain a system under which the work of Community Health
      Representatives is reviewed and evaluated, and
        (6) promote traditional health care practices of the Indian
      tribes served consistent with the Service standards for the
      provision of health care, health promotion, and disease
      prevention.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 107, as added Pub. L. 100-713, title
    I, Sec. 107, Nov. 23, 1988, 102 Stat. 4788; amended Pub. L. 102-
    573, title I, Sec. 105, Oct. 29, 1992, 106 Stat. 4535.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (b)(2). Pub. L. 102-573, Sec. 105(1), inserted
    "and maintain" in introductory provisions.
      Subsec. (b)(2)(B). Pub. L. 102-573, Sec. 105(2), inserted at end
    "with appropriate consideration given to lifestyle factors that
    have an impact on Indian health status, such as alcoholism, family
    dysfunction, and poverty,".
      Subsec. (b)(3). Pub. L. 102-573, Sec. 105(3), substituted
    "maintain" for "develop" in two places.
      Subsec. (b)(4). Pub. L. 102-573, Sec. 105(4), struck out "develop
    and" before "maintain".
      Subsec. (b)(5). Pub. L. 102-573, Sec. 105(3), substituted
    "maintain" for "develop".

-End-



-CITE-
    25 USC Sec. 1616a                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616a. Indian Health Service Loan Repayment Program

-STATUTE-
    (a) Establishment
      (1) The Secretary, acting through the Service, shall establish a
    program to be known as the Indian Health Service Loan Repayment
    Program (hereinafter referred to as the "Loan Repayment Program")
    in order to assure an adequate supply of trained health
    professionals necessary to maintain accreditation of, and provide
    health care services to Indians through, Indian health programs.
      (2) For the purposes of this section - 
        (A) the term "Indian health program" means any health program
      or facility funded, in whole or part, by the Service for the
      benefit of Indians and administered - 
          (i) directly by the Service;
          (ii) by any Indian tribe or tribal or Indian organization
        pursuant to a contract under - 
            (I) the Indian Self-Determination Act [25 U.S.C. 450f et
          seq.], or
            (II) section 23 of the Act of April 30, 1908 (!1) (25
          U.S.C. 47), popularly known as the "Buy-Indian" Act; or


          (iii) by an urban Indian organization pursuant to subchapter
        IV of this chapter; and

        (B) the term "State" has the same meaning given such term in
      section 254d(i)(4) (!1) of title 42.
    (b) Eligibility
      To be eligible to participate in the Loan Repayment Program, an
    individual must - 
        (1)(A) be enrolled - 
          (i) in a course of study or program in an accredited
        institution, as determined by the Secretary, within any State
        and be scheduled to complete such course of study in the same
        year such individual applies to participate in such program; or
          (ii) in an approved graduate training program in a health
        profession; or

        (B) have - 
          (i) a degree in a health profession; and
          (ii) a license to practice a health profession in a State;

        (2)(A) be eligible for, or hold, an appointment as a
      commissioned officer in the Regular or Reserve Corps of the
      Public Health Service;
        (B) be eligible for selection for civilian service in the
      Regular or Reserve Corps of the Public Health Service;
        (C) meet the professional standards for civil service
      employment in the Indian Health Service; or
        (D) be employed in an Indian health program without a service
      obligation; and
        (3) submit to the Secretary an application for a contract
      described in subsection (f) of this section.
    (c) Application and contract forms
      (1) In disseminating application forms and contract forms to
    individuals desiring to participate in the Loan Repayment Program,
    the Secretary shall include with such forms a fair summary of the
    rights and liabilities of an individual whose application is
    approved (and whose contract is accepted) by the Secretary,
    including in the summary a clear explanation of the damages to
    which the United States is entitled under subsection (l) of this
    section in the case of the individual's breach of the contract. The
    Secretary shall provide such individuals with sufficient
    information regarding the advantages and disadvantages of service
    as a commissioned officer in the Regular or Reserve Corps of the
    Public Health Service or a civilian employee of the Indian Health
    Service to enable the individual to make a decision on an informed
    basis.
      (2) The application form, contract form, and all other
    information furnished by the Secretary under this section shall be
    written in a manner calculated to be understood by the average
    individual applying to participate in the Loan Repayment Program.
      (3) The Secretary shall make such application forms, contract
    forms, and other information available to individuals desiring to
    participate in the Loan Repayment Program on a date sufficiently
    early to ensure that such individuals have adequate time to
    carefully review and evaluate such forms and information.
    (d) Vacancies; priority
      (1) Consistent with paragraph (3), the Secretary, acting through
    the Service and in accordance with subsection (k) of this section,
    shall annually - 
        (A) identify the positions in each Indian health program for
      which there is a need or a vacancy, and
        (B) rank those positions in order of priority.

      (2) Consistent with the priority determined under paragraph (1),
    the Secretary, in determining which applications under the Loan
    Repayment Program to approve (and which contracts to accept), shall
    give priority to applications made by - 
        (A) Indians; and
        (B) individuals recruited through the efforts of Indian tribes
      or tribal or Indian organizations.

      (3)(A) Subject to subparagraph (B), of the total amounts
    appropriated for each of the fiscal years 1993, 1994, and 1995 for
    loan repayment contracts under this section, the Secretary shall
    provide that - 
        (i) not less than 25 percent be provided to applicants who are
      nurses, nurse practitioners, or nurse midwives; and
        (ii) not less than 10 percent be provided to applicants who are
      mental health professionals (other than applicants described in
      clause (i)).

      (B) The requirements specified in clause (i) or clause (ii) of
    subparagraph (A) shall not apply if the Secretary does not receive
    the number of applications from the individuals described in clause
    (i) or clause (ii), respectively, necessary to meet such
    requirements.
    (e) Approval
      (1) An individual becomes a participant in the Loan Repayment
    Program only upon the Secretary and the individual entering into a
    written contract described in subsection (f) of this section.
      (2) The Secretary shall provide written notice to an individual
    promptly on - 
        (A) the Secretary's approving, under paragraph (1), of the
      individual's participation in the Loan Repayment Program,
      including extensions resulting in an aggregate period of
      obligated service in excess of 4 years; or
        (B) the Secretary's disapproving an individual's participation
      in such Program.
    (f) Contract terms
      The written contract referred to in this section between the
    Secretary and an individual shall contain - 
        (1) an agreement under which - 
          (A) subject to paragraph (3), the Secretary agrees - 
            (i) to pay loans on behalf of the individual in accordance
          with the provisions of this section, and
            (ii) to accept (subject to the availability of appropriated
          funds for carrying out this section) the individual into the
          Service or place the individual with a tribe or Indian
          organization as provided in subparagraph (B)(iii), and

          (B) subject to paragraph (3), the individual agrees - 
            (i) to accept loan payments on behalf of the individual;
            (ii) in the case of an individual described in subsection
          (b)(1) of this section - 
              (I) to maintain enrollment in a course of study or
            training described in subsection (b)(1)(A) of this section
            until the individual completes the course of study or
            training, and
              (II) while enrolled in such course of study or training,
            to maintain an acceptable level of academic standing (as
            determined under regulations of the Secretary by the
            educational institution offering such course of study or
            training);

            (iii) to serve for a time period (hereinafter in this
          section referred to as the "period of obligated service")
          equal to 2 years or such longer period as the individual may
          agree to serve in the full-time clinical practice of such
          individual's profession in an Indian health program to which
          the individual may be assigned by the Secretary;

        (2) a provision permitting the Secretary to extend for such
      longer additional periods, as the individual may agree to, the
      period of obligated service agreed to by the individual under
      paragraph (1)(B)(iii);
        (3) a provision that any financial obligation of the United
      States arising out of a contract entered into under this section
      and any obligation of the individual which is conditioned thereon
      is contingent upon funds being appropriated for loan repayments
      under this section;
        (4) a statement of the damages to which the United States is
      entitled under subsection (l) of this section for the
      individual's breach of the contract; and
        (5) such other statements of the rights and liabilities of the
      Secretary and of the individual, not inconsistent with this
      section.
    (g) Loan repayment purposes; maximum amount; tax liability
      reimbursement; schedule of payments
      (1) A loan repayment provided for an individual under a written
    contract under the Loan Repayment Program shall consist of payment,
    in accordance with paragraph (2), on behalf of the individual of
    the principal, interest, and related expenses on government and
    commercial loans received by the individual regarding the
    undergraduate or graduate education of the individual (or both),
    which loans were made for - 
        (A) tuition expenses;
        (B) all other reasonable educational expenses, including fees,
      books, and laboratory expenses, incurred by the individual; and
        (C) reasonable living expenses as determined by the Secretary.

      (2)(A) For each year of obligated service that an individual
    contracts to serve under subsection (f) of this section the
    Secretary may pay up to $35,000 (or an amount equal to the amount
    specified in section 254l-1(g)(2)(A) of title 42) on behalf of the
    individual for loans described in paragraph (1). In making a
    determination of the amount to pay for a year of such service by an
    individual, the Secretary shall consider the extent to which each
    such determination - 
        (i) affects the ability of the Secretary to maximize the number
      of contracts that can be provided under the Loan Repayment
      Program from the amounts appropriated for such contracts;
        (ii) provides an incentive to serve in Indian health programs
      with the greatest shortages of health professionals; and
        (iii) provides an incentive with respect to the health
      professional involved remaining in an Indian health program with
      such a health professional shortage, and continuing to provide
      primary health services, after the completion of the period of
      obligated service under the Loan Repayment Program.

      (B) Any arrangement made by the Secretary for the making of loan
    repayments in accordance with this subsection shall provide that
    any repayments for a year of obligated service shall be made no
    later than the end of the fiscal year in which the individual
    completes such year of service.
      (3) For the purpose of providing reimbursements for tax liability
    resulting from payments under paragraph (2) on behalf of an
    individual, the Secretary - 
        (A) in addition to such payments, may make payments to the
      individual in an amount not less than 20 percent and not more
      than 39 percent of the total amount of loan repayments made for
      the taxable year involved; and
        (B) may make such additional payments as the Secretary
      determines to be appropriate with respect to such purpose.

      (4) The Secretary may enter into an agreement with the holder of
    any loan for which payments are made under the Loan Repayment
    Program to establish a schedule for the making of such payments.
    (h) Effect on employment ceiling of Department of Health and Human
      Services
      Notwithstanding any other provision of law, individuals who have
    entered into written contracts with the Secretary under this
    section, while undergoing academic training, shall not be counted
    against any employment ceiling affecting the Department of Health
    and Human Services.
    (i) Recruiting programs
      The Secretary shall conduct recruiting programs for the Loan
    Repayment Program and other health professional programs of the
    Service at educational institutions training health professionals
    or specialists identified in subsection (a) of this section.
    (j) Prohibition of assignment to other government departments
      Section 215 of title 42 shall not apply to individuals during
    their period of obligated service under the Loan Repayment Program.
    (k) Staff needs of health programs administered by Indian tribes
      The Secretary, in assigning individuals to serve in Indian health
    programs pursuant to contracts entered into under this section,
    shall - 
        (1) ensure that the staffing needs of Indian health programs
      administered by an Indian tribe or tribal or health organization
      receive consideration on an equal basis with programs that are
      administered directly by the Service; and
        (2) give priority to assigning individuals to Indian health
      programs that have a need for health professionals to provide
      health care services as a result of individuals having breached
      contracts entered into under this section.
    (l) Voluntary termination of study or dismissal from educational
      institution; collection of damages
      (1) An individual who has entered into a written contract with
    the Secretary under this section and who - 
        (A) is enrolled in the final year of a course of study and who -
       
          (i) fails to maintain an acceptable level of academic
        standing in the educational institution in which he is enrolled
        (such level determined by the educational institution under
        regulations of the Secretary);
          (ii) voluntarily terminates such enrollment; or
          (iii) is dismissed from such educational institution before
        completion of such course of study; or

        (B) is enrolled in a graduate training program, fails to
      complete such training program, and does not receive a waiver
      from the Secretary under subsection (b)(1)(B)(ii) of this
      section,

    shall be liable, in lieu of any service obligation arising under
    such contract, to the United States for the amount which has been
    paid on such individual's behalf under the contract.
      (2) If, for any reason not specified in paragraph (1), an
    individual breaches his written contract under this section by
    failing either to begin, or complete, such individual's period of
    obligated service in accordance with subsection (f) of this
    section, the United States shall be entitled to recover from such
    individual an amount to be determined in accordance with the
    following formula:

                                A=3Z(T-S/T)                            
    in which - 
        (A) "A" is the amount the United States is entitled to recover;
        (B) "Z" is the sum of the amounts paid under this section to,
      or on behalf of, the individual and the interest on such amounts
      which would be payable if, at the time the amounts were paid,
      they were loans bearing interest at the maximum legal prevailing
      rate, as determined by the Treasurer of the United States;
        (C) "t" is the total number of months in the individual's
      period of obligated service in accordance with subsection (f) of
      this section; and
        (D) "s" is the number of months of such period served by such
      individual in accordance with this section.

    Amounts not paid within such period shall be subject to collection
    through deductions in Medicare payments pursuant to section 1395ccc
    of title 42.
      (3)(A) Any amount of damages which the United States is entitled
    to recover under this subsection shall be paid to the United States
    within the 1-year period beginning on the date of the breach or
    such longer period beginning on such date as shall be specified by
    the Secretary.
      (B) If damages described in subparagraph (A) are delinquent for 3
    months, the Secretary shall, for the purpose of recovering such
    damages - 
        (i) utilize collection agencies contracted with by the
      Administrator of the General Services Administration; or
        (ii) enter into contracts for the recovery of such damages with
      collection agencies selected by the Secretary.

      (C) Each contract for recovering damages pursuant to this
    subsection shall provide that the contractor will, not less than
    once each 6 months, submit to the Secretary a status report on the
    success of the contractor in collecting such damages. Section 3718
    of title 31 shall apply to any such contract to the extent not
    inconsistent with this subsection.
    (m) Cancellation or waiver of obligations; bankruptcy discharge
      (1) Any obligation of an individual under the Loan Repayment
    Program for service or payment of damages shall be canceled upon
    the death of the individual.
      (2) The Secretary shall by regulation provide for the partial or
    total waiver or suspension of any obligation of service or payment
    by an individual under the Loan Repayment Program whenever
    compliance by the individual is impossible or would involve extreme
    hardship to the individual and if enforcement of such obligation
    with respect to any individual would be unconscionable.
      (3) The Secretary may waive, in whole or in part, the rights of
    the United States to recover amounts under this section in any case
    of extreme hardship or other good cause shown, as determined by the
    Secretary.
      (4) Any obligation of an individual under the Loan Repayment
    Program for payment of damages may be released by a discharge in
    bankruptcy under title 11 only if such discharge is granted after
    the expiration of the 5-year period beginning on the first date
    that payment of such damages is required, and only if the
    bankruptcy court finds that nondischarge of the obligation would be
    unconscionable.
    (n) Annual report
      The Secretary shall submit to the President, for inclusion in
    each report required to be submitted to the Congress under section
    1671 of this title, a report concerning the previous fiscal year
    which sets forth - 
        (1) the health professional positions maintained by the Service
      or by tribal or Indian organizations for which recruitment or
      retention is difficult;
        (2) the number of Loan Repayment Program applications filed
      with respect to each type of health profession;
        (3) the number of contracts described in subsection (f) of this
      section that are entered into with respect to each health
      profession;
        (4) the amount of loan payments made under this section, in
      total and by health profession;
        (5) the number of scholarship grants that are provided under
      section 1613a of this title with respect to each health
      profession;
        (6) the amount of scholarship grants provided under section
      1613a of this title, in total and by health profession;
        (7) the number of providers of health care that will be needed
      by Indian health programs, by location and profession, during the
      three fiscal years beginning after the date the report is filed;
      and
        (8) the measures the Secretary plans to take to fill the health
      professional positions maintained by the Service or by tribes or
      tribal or Indian organizations for which recruitment or retention
      is difficult.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 108, as added Pub. L. 100-713, title
    I, Sec. 108, Nov. 23, 1988, 102 Stat. 4789; amended Pub. L. 102-
    573, title I, Secs. 106(a)-(g)(1), (h), (i), 117(b)(3), title IX,
    Sec. 902(2)(C), (D), Oct. 29, 1992, 106 Stat. 4535-4537, 4544,
    4591.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec.
    (a)(2)(A)(ii)(I), is title I of Pub. L. 93-638, Jan. 4, 1975, 88
    Stat. 2206, as amended, which is classified principally to part A
    (Sec. 450f et seq.) of subchapter II of chapter 14 of this title.
    For complete classification of this Act to the Code, see Short
    Title note set out under section 450 of this title and Tables.
      Section 23 of the Act of April 30, 1908, referred to in subsec.
    (a)(2)(A)(ii)(II), probably should be a reference to section 23 of
    act June 25, 1910, ch. 431, 36 Stat. 861, which is popularly known
    as the "Buy Indian Act", and is classified to section 47 of this
    title. Act Apr. 30, 1908, ch. 153, 35 Stat. 70, does not contain a
    section 23 but does have provisions (at 35 Stat. 71) similar to
    those in section 23 of act June 25, 1910, ch. 431, 36 Stat. 861.
      Section 254d(i)(4) of title 42, referred to in subsec. (a)(2)(B),
    was redesignated section 254d(j)(4) of title 42 by Pub. L. 107-251,
    title III, Sec. 310(b)(1), Oct. 26, 2002, 116 Stat. 1643.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a)(1). Pub. L. 102-573, Sec. 106(a)(1),
    substituted "health professionals" for "physicians, dentists,
    nurses, nurse practitioners, physician assistants, clinical and
    counseling psychologists, graduates of schools of public health,
    graduates of schools of social work, and other health
    professionals".
      Subsec. (b)(1)(A)(i). Pub. L. 102-573, Sec. 106(a)(2)(A)(i),
    amended cl. (i) generally. Prior to amendment, cl. (i) read as
    follows: "as a full-time student in the final year of a course of
    study or program in an accredited institution, as determined by the
    Secretary, within any State; or".
      Subsec. (b)(1)(A)(ii). Pub. L. 102-573, Sec. 106(a)(2)(A)(ii),
    substituted "a health profession" for "medicine, osteopathy,
    dentistry, or other health profession".
      Subsec. (b)(1)(B). Pub. L. 102-573, Sec. 106(a)(2)(B), in cl.
    (i), substituted "a degree in a health profession; and" for "a
    degree in medicine, osteopathy, dentistry, or other health
    profession;", redesignated cl. (iii) as (ii) and substituted "a
    health profession" for "medicine, osteopathy, dentistry, or other
    health profession", and struck out former cl. (ii) which read as
    follows: "completed an approved graduate training program in
    medicine, osteopathy, dentistry, or other health profession in a
    State, except that the Secretary may waive the completion
    requirement of this clause for good cause; and".
      Subsec. (b)(2) to (4). Pub. L. 102-573, Sec. 106(a)(2)(C),
    inserted "and" at end of par. (2)(D), added par. (3), and struck
    out former pars. (3) and (4) which read as follows:
      "(3) submit an application to participate in the Loan Repayment
    Program; and
      "(4) sign and submit to the Secretary, at the time of submission
    of such application, a written contract (described in subsection
    (f) of this section) to accept repayment of educational loans and
    to serve (in accordance with this section) for the applicable
    period of obligated service in an Indian health program."
      Subsec. (d)(1). Pub. L. 102-573, Sec. 106(b)(1), substituted
    "Consistent with paragraph (3), the" for "The".
      Subsec. (d)(1)(A). Pub. L. 102-573, Sec. 902(2)(C), substituted
    "Indian health" for "Indian Health".
      Subsec. (d)(3). Pub. L. 102-573, Sec. 106(b)(2), added par. (3).
      Subsec. (e)(1). Pub. L. 102-573, Sec. 106(c), amended par. (1)
    generally. Prior to amendment, par. (1) read as follows: "An
    individual becomes a participant in the Loan Repayment Program only
    on the Secretary's approval of the individual's application
    submitted under subsection (b)(3) of this section and the
    Secretary's acceptance of the contract submitted by the individual
    under subsection (b)(4) of this section."
      Subsec. (e)(2)(A). Pub. L. 102-573, Sec. 106(d), inserted ",
    including extensions resulting in an aggregate period of obligated
    service in excess of 4 years" before "; or".
      Subsec. (g)(1). Pub. L. 102-573, Sec. 106(e), in introductory
    provisions, substituted "loans received by the individual regarding
    the undergraduate or graduate education of the individual (or
    both), which loans were made for" for "loans received by the
    individual for".
      Subsec. (g)(2)(A). Pub. L. 102-573, Sec. 106(f), amended subpar.
    (A) generally. Prior to amendment, subpar. (A) read as follows:
    "Except as provided in subparagraph (B) and paragraph (3), for each
    year of obligated service for which an individual contracts to
    serve under subsection (f) of this section, the Secretary may pay
    up to $25,000 on behalf of the individual for loans described in
    paragraph (1)."
      Subsec. (g)(3). Pub. L. 102-573, Sec. 106(g)(1), amended par. (3)
    generally. Prior to amendment, par. (3) read as follows: "In
    addition to payments made under paragraph (2), in any case in which
    payments on behalf of an individual under the Loan Repayment
    Program result in an increase in Federal, State, or local income
    tax liability for such individual, the Secretary may, on the
    request of such individual, make payments to such individual in a
    reasonable amount, as determined by the Secretary, to reimburse
    such individual for all or part of the increased tax liability of
    the individual."
      Subsec. (i). Pub. L. 102-573, Sec. 902(2)(D), substituted "health
    professional programs of the Service" for "Service manpower
    programs".
      Subsec. (k). Pub. L. 102-573, Sec. 106(h), amended subsec. (k)
    generally. Prior to amendment, subsec. (k) read as follows: "The
    Secretary shall ensure that the staffing needs of Indian health
    programs administered by any Indian tribe or tribal or Indian
    organization receive consideration on an equal basis with programs
    that are administered directly by the Service."
      Subsec. (n). Pub. L. 102-573, Sec. 106(i), amended subsec. (n)
    generally. Prior to amendment, subsec. (n) consisted of pars. (1)
    and (2) requiring submission of annual reports to Congress by the
    first of March and the first of July of each year.
      Subsec. (o). Pub. L. 102-573, Sec. 117(b)(3), struck out subsec.
    (o) which read as follows: "There are authorized to be appropriated
    such sums as may be necessary for each fiscal year to carry out the
    provisions of this section."

                     EFFECTIVE DATE OF 1992 AMENDMENT                 
      Section 106(g)(2) of Pub. L. 102-573 provided that: "The
    amendment made by paragraph (1) [amending this section] shall apply
    only with respect to contracts under section 108 of the Indian
    Health Care Improvement Act [this section] entered into on or after
    the date of enactment of this Act [Oct. 29, 1992]."

-FOOTNOTE-
    (!1) See References in Text note below.


-End-



-CITE-
    25 USC Sec. 1616a-1                                         01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616a-1. Scholarship and Loan Repayment Recovery Fund

-STATUTE-
    (a) Establishment
      There is established in the Treasury of the United States a fund
    to be known as the Indian Health Scholarship and Loan Repayment
    Recovery Fund (hereafter in this section referred to as the
    "Fund"). The Fund shall consist of such amounts as may be
    appropriated to the Fund under subsection (b) of this section.
    Amounts appropriated for the Fund shall remain available until
    expended.
    (b) Authorization of appropriations
      For each fiscal year, there is authorized to be appropriated to
    the Fund an amount equal to the sum of - 
        (1) the amount collected during the preceding fiscal year by
      the Federal Government pursuant to - 
          (A) the liability of individuals under subparagraph (A) or
        (B) of section 1613a(b)(5) of this title for the breach of
        contracts entered into under section 1613a of this title; and
          (B) the liability of individuals under section 1616a(l) of
        this title for the breach of contracts entered into under
        section 1616a of this title; and

        (2) the aggregate amount of interest accruing during the
      preceding fiscal year on obligations held in the Fund pursuant to
      subsection (d) of this section and the amount of proceeds from
      the sale or redemption of such obligations during such fiscal
      year.
    (c) Use of funds
      (1) Amounts in the Fund and available pursuant to appropriation
    Acts may be expended by the Secretary, acting through the Service,
    to make payments to an Indian tribe or tribal organization
    administering a health care program pursuant to a contract entered
    into under the Indian Self-Determination Act [25 U.S.C. 450f et
    seq.] - 
        (A) to which a scholarship recipient under section 1613a of
      this title or a loan repayment program participant under section
      1616a of this title has been assigned to meet the obligated
      service requirements pursuant to (!1) sections; and

        (B) that has a need for a health professional to provide health
      care services as a result of such recipient or participant having
      breached the contract entered into under section 1613a of this
      title or section 1616a of this title.

      (2) An Indian tribe or tribal organization receiving payments
    pursuant to paragraph (1) may expend the payments to recruit and
    employ, directly or by contract, health professionals to provide
    health care services.
    (d) Investment of excess funds
      (1) The Secretary of the Treasury shall invest such amounts of
    the Fund as such Secretary determines are not required to meet
    current withdrawals from the Fund. Such investments may be made
    only in interest-bearing obligations of the United States. For such
    purpose, such obligations may be acquired on original issue at the
    issue price, or by purchase of outstanding obligations at the
    market price.
      (2) Any obligation acquired by the Fund may be sold by the
    Secretary of the Treasury at the market price.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 108A, as added Pub. L. 102-573,
    title I, Sec. 110, Oct. 29, 1992, 106 Stat. 4538.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (c)(1),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-FOOTNOTE-
    (!1) So in original. Probably should be "to such".


-End-



-CITE-
    25 USC Sec. 1616b                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616b. Recruitment activities

-STATUTE-
      (a) The Secretary may reimburse health professionals seeking
    positions in the Service, including individuals considering
    entering into a contract under section 1616a of this title, and
    their spouses, for actual and reasonable expenses incurred in
    traveling to and from their places of residence to an area in which
    they may be assigned for the purpose of evaluating such area with
    respect to such assignment.
      (b) The Secretary, acting through the Service, shall assign one
    individual in each area office to be responsible on a full-time
    basis for recruitment activities.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 109, as added Pub. L. 100-713, title
    I, Sec. 108, Nov. 23, 1988, 102 Stat. 4794; amended Pub. L. 102-
    573, title I, Sec. 107, Oct. 29, 1992, 106 Stat. 4538.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 107(1), substituted "Recruitment
    activities" for "Travel expenses for recruitment" in section
    catchline.
      Subsec. (b). Pub. L. 102-573, Sec. 107(2), amended subsec. (b)
    generally. Prior to amendment, subsec. (b) read as follows: "There
    are authorized to be appropriated $100,000 for each of the fiscal
    years 1990, 1991, and 1992, for the purpose of carrying out the
    provisions of this section."

-End-



-CITE-
    25 USC Sec. 1616c                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616c. Tribal recruitment and retention program

-STATUTE-
    (a) Projects funded on competitive basis
      The Secretary, acting through the Service, shall fund, on a
    competitive basis, projects to enable Indian tribes and tribal and
    Indian organizations to recruit, place, and retain health
    professionals to meet the staffing needs of Indian health programs
    (as defined in section 1616a(a)(2) of this title).
    (b) Eligibility
      (1) Any Indian tribe or tribal or Indian organization may submit
    an application for funding of a project pursuant to this section.
      (2) Indian tribes and tribal and Indian organizations under the
    authority of the Indian Self-Determination Act [25 U.S.C. 450f et
    seq.] shall be given an equal opportunity with programs that are
    administered directly by the Service to compete for, and receive,
    grants under subsection (a) of this section for such projects.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 110, as added Pub. L. 100-713, title
    I, Sec. 108, Nov. 23, 1988, 102 Stat. 4794; amended Pub. L. 102-
    573, title I, Sec. 117(b)(4), Oct. 29, 1992, 106 Stat. 4544.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (b)(2),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (c). Pub. L. 102-573 struck out subsec. (c) which
    authorized appropriations for fiscal years 1990 to 1992.

-End-



-CITE-
    25 USC Sec. 1616d                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616d. Advanced training and research

-STATUTE-
    (a) Establishment of program
      The Secretary, acting through the Service, shall establish a
    program to enable health professionals to pursue advanced training
    or research in areas of study for which the Secretary determines a
    need exists. In selecting participants for a program established
    under this subsection, the Secretary, acting through the Service,
    shall give priority to applicants who are employed by the Indian
    Health Service, Indian tribes, tribal organizations, and urban
    Indian organizations, at the time of the submission of the
    applications.
    (b) Obligated service
      An individual who participates in a program under subsection (a)
    of this section, where the educational costs are borne by the
    Service, shall incur an obligation to serve in an Indian health
    program (as defined in section 1616a(a)(2) of this title) for a
    period of obligated service equal to at least the period of time
    during which the individual participates in such program. In the
    event that the individual fails to complete such obligated service,
    the individual shall be liable to the United States for the period
    of service remaining. In such event, with respect to individuals
    entering the program after October 29, 1992, the United States
    shall be entitled to recover from such individual an amount to be
    determined in accordance with the formula specified in subsection
    (l) of section 1616a of this title in the manner provided for in
    such subsection.
    (c) Eligibility
      Health professionals from Indian tribes and tribal and Indian
    organizations under the authority of the Indian Self-Determination
    Act [25 U.S.C. 450f et seq.] shall be given an equal opportunity to
    participate in the program under subsection (a) of this section.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 111, as added Pub. L. 100-713, title
    I, Sec. 108, Nov. 23, 1988, 102 Stat. 4795; amended Pub. L. 102-
    573, title I, Sec. 108, Oct. 29, 1992, 106 Stat. 4538; Pub. L. 103-
    435, Sec. 16(a), Nov. 2, 1994, 108 Stat. 4573.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (c), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1994 - Subsec. (a). Pub. L. 103-435, Sec. 16(a)(1), struck out
    "who have worked in an Indian health program (as defined in section
    1616a(a)(2) of this title) for a substantial period of time" after
    "health professionals" and inserted at end "In selecting
    participants for a program established under this subsection, the
    Secretary, acting through the Service, shall give priority to
    applicants who are employed by the Indian Health Service, Indian
    tribes, tribal organizations, and urban Indian organizations, at
    the time of the submission of the applications."
      Subsec. (b). Pub. L. 103-435, Sec. 16(a)(2), inserted "(as
    defined in section 1616a(a)(2) of this title)" after "Indian health
    program".
      1992 - Subsec. (b). Pub. L. 102-573, Sec. 108(1), amended last
    sentence generally. Prior to amendment, last sentence read as
    follows: "The Secretary shall develop standards for appropriate
    recoupment for such remaining service."
      Subsec. (d). Pub. L. 102-573, Sec. 108(2), struck out subsec. (d)
    which directed Secretary to prescribe regulations to carry out this
    section.

-End-



-CITE-
    25 USC Sec. 1616e                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616e. Nursing program

-STATUTE-
    (a) Grants
      The Secretary, acting through the Service, shall provide grants
    to - 
        (1) public or private schools of nursing,
        (2) tribally controlled community colleges and tribally
      controlled postsecondary vocational institutions (as defined in
      section 2397h(2) (!1) of title 20), and

        (3) nurse midwife programs, and nurse practitioner programs,
      that are provided by any public or private institution,

    for the purpose of increasing the number of nurses, nurse midwives,
    and nurse practitioners who deliver health care services to
    Indians.
    (b) Purposes
      Grants provided under subsection (a) of this section may be used
    to - 
        (1) recruit individuals for programs which train individuals to
      be nurses, nurse midwives, or nurse practitioners,
        (2) provide scholarships to individuals enrolled in such
      programs that may pay the tuition charged for such program and
      other expenses incurred in connection with such program,
      including books, fees, room and board, and stipends for living
      expenses,
        (3) provide a program that encourages nurses, nurse midwives,
      and nurse practitioners to provide, or continue to provide,
      health care services to Indians,
        (4) provide a program that increases the skills of, and
      provides continuing education to, nurses, nurse midwives, and
      nurse practitioners, or
        (5) provide any program that is designed to achieve the purpose
      described in subsection (a) of this section.
    (c) Application
      Each application for a grant under subsection (a) of this section
    shall include such information as the Secretary may require to
    establish the connection between the program of the applicant and a
    health care facility that primarily serves Indians.
    (d) Preference
      In providing grants under subsection (a) of this section, the
    Secretary shall extend a preference to - 
        (1) programs that provide a preference to Indians,
        (2) programs that train nurse midwives or nurse practitioners,
        (3) programs that are interdisciplinary, and
        (4) programs that are conducted in cooperation with a center
      for gifted and talented Indian students established under section
      2624(a) (!1) of this title.
    (e) Quentin N. Burdick American Indians Into Nursing Program
      The Secretary shall provide one of the grants authorized under
    subsection (a) of this section to establish and maintain a program
    at the University of North Dakota to be known as the "Quentin N.
    Burdick American Indians Into Nursing Program". Such program shall,
    to the maximum extent feasible, coordinate with the Quentin N.
    Burdick Indian Health Programs established under section 1616g(b)
    of this title and the Quentin N. Burdick American Indians Into
    Psychology Program established under section 1621p(b) of this
    title.
    (f) Service obligation
      The active duty service obligation prescribed under section 254m
    of title 42 shall be met by each individual who receives training
    or assistance described in paragraph (1) or (2) of subsection (b)
    of this section that is funded by a grant provided under subsection
    (a) of this section. Such obligation shall be met by service - 
        (A) in the Indian Health Service;
        (B) in a program conducted under a contract entered into under
      the Indian Self-Determination Act [25 U.S.C. 450f et seq.];
        (C) in a program assisted under subchapter IV of this chapter;
      or
        (D) in the private practice of nursing if, as determined by the
      Secretary, in accordance with guidelines promulgated by the
      Secretary, such practice is situated in a physician or other
      health professional shortage area and addresses the health care
      needs of a substantial number of Indians.
    (g) Authorization of appropriations
      Beginning with fiscal year 1993, of the amounts appropriated
    under the authority of this subchapter for each fiscal year to be
    used to carry out this section, not less than $1,000,000 shall be
    used to provide grants under subsection (a) of this section for the
    training of nurse midwives, nurse anesthetists, and nurse
    practitioners.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 112, as added Pub. L. 100-713, title
    I, Sec. 108, Nov. 23, 1988, 102 Stat. 4795; amended Pub. L. 102-
    573, title I, Secs. 104(b), (c), 114(a), Oct. 29, 1992, 106 Stat.
    4533, 4543.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      Section 2397h of title 20, referred to in subsec. (a)(2), was
    omitted in the general amendment of chapter 44 (Sec. 2301 et seq.)
    of Title 20, Education, by Pub. L. 105-332, Sec. 1(b), Oct. 31,
    1998, 112 Stat. 3076.
      Section 2624 of this title, referred to in subsec. (d)(4), was
    repealed by Pub. L. 103-382, title III, Sec. 367, Oct. 20, 1994,
    108 Stat. 3976. See section 7454 of Title 20, Education.
      The Indian Self-Determination Act, referred to in subsec. (f)(B),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a)(2). Pub. L. 102-573, Sec. 114(a), inserted
    "and tribally controlled postsecondary vocational institutions (as
    defined in section 2397h(2) of title 20)" after "community
    colleges".
      Subsecs. (e), (f). Pub. L. 102-573, Sec. 104(b), added subsec.
    (e) and redesignated former subsec. (e) as (f). Former subsec. (f)
    redesignated (g).
      Subsec. (g). Pub. L. 102-573, Sec. 104(c), amended subsec. (g)
    generally. Prior to amendment, subsec. (g) read as follows:
      "(1) There are authorized to be appropriated for each of the
    fiscal years 1990, 1991, and 1992, $5,000,000 for the purpose of
    carrying out the provisions of this section.
      "(2) Of the amounts appropriated under the authority of paragraph
    (1) for each fiscal year, the Secretary shall use at least
    $1,000,000 to provide grants under subsection (a) of this section
    for the training of nurse midwives."
      Pub. L. 102-573, Sec. 104(b)(1), redesignated subsec. (f) as (g).

-FOOTNOTE-
    (!1) See References in Text note below.


-End-



-CITE-
    25 USC Sec. 1616e-1                                         01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616e-1. Nursing school clinics

-STATUTE-
    (a) Grants
      In addition to the authority of the Secretary under section
    1616e(a)(1) of this title, the Secretary, acting through the
    Service, is authorized to provide grants to public or private
    schools of nursing for the purpose of establishing, developing,
    operating, and administering clinics to address the health care
    needs of Indians, and to provide primary health care services to
    Indians who reside on or within 50 miles of Indian country, as
    defined in section 1151 of title 18.
    (b) Purposes
      Grants provided under subsection (a) of this section may be used
    to - 
        (1) establish clinics, to be run and staffed by the faculty and
      students of a grantee school, to provide primary care services in
      areas in or within 50 miles of Indian country (as defined in
      section 1151 of title 18);
        (2) provide clinical training, program development, faculty
      enhancement, and student scholarships in a manner that would
      benefit such clinics; and
        (3) carry out any other activities determined appropriate by
      the Secretary.
    (c) Amount and conditions
      The Secretary may award grants under this section in such amounts
    and subject to such conditions as the Secretary deems appropriate.
    (d) Design
      The clinics established under this section shall be designed to
    provide nursing students with a structured clinical experience that
    is similar in nature to that provided by residency training
    programs for physicians.
    (e) Regulations
      The Secretary shall prescribe such regulations as may be
    necessary to carry out the provisions of this section.
    (f) Authorization to use amounts
      Out of amounts appropriated to carry out this subchapter for each
    of the fiscal years 1993 through 2000 not more than $5,000,000 may
    be used to carry out this section.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 112A, as added Pub. L. 102-573,
    title I, Sec. 104(f), Oct. 29, 1992, 106 Stat. 4534.)

-End-



-CITE-
    25 USC Sec. 1616f                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616f. Tribal culture and history

-STATUTE-
    (a) Program established
      The Secretary, acting through the Service, shall establish a
    program under which appropriate employees of the Service who serve
    particular Indian tribes shall receive educational instruction in
    the history and culture of such tribes and in the history of the
    Service.
    (b) Tribally-controlled community colleges
      To the extent feasible, the program established under subsection
    (a) of this section shall - 
        (1) be carried out through tribally-controlled community
      colleges (within the meaning of section 1801(4) (!1) of this
      title) and tribally controlled postsecondary vocational
      institutions (as defined in section 2397h(2) (!1) of title 20),

        (2) be developed in consultation with the affected tribal
      government, and
        (3) include instruction in Native American studies.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 113, as added Pub. L. 100-713, title
    I, Sec. 109, Nov. 23, 1988, 102 Stat. 4796; amended Pub. L. 102-
    573, title I, Secs. 114(b), 117(b)(5), Oct. 29, 1992, 106 Stat.
    4543, 4544; Pub. L. 105-244, title IX, Sec. 901(d), Oct. 7, 1998,
    112 Stat. 1828.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      Section 1801 of this title, referred to in subsec. (b)(1), was
    amended by Pub. L. 98-192, Sec. 1(1), Dec. 1, 1983, 97 Stat. 1335,
    to designate par. (4) as subsec. (a)(4), and was amended by Pub. L.
    105-244, title IX, Sec. 901(b)(5), Oct. 7, 1998, 112 Stat. 1828, so
    that it no longer defines the term "tribally controlled community
    college".
      Section 2397h of title 20, referred to in subsec. (b)(1), was
    omitted in the general amendment of chapter 44 (Sec. 2301 et seq.)
    of Title 20, Education, by Pub. L. 105-332, Sec. 1(b), Oct. 31,
    1998, 112 Stat. 3076.


-MISC1-
                                AMENDMENTS                            
      1998 - Subsec. (b)(1). Pub. L. 105-244 made technical amendment
    to reference in original act which appears in text as reference to
    section 1801(4) of this title.
      1992 - Subsec. (b)(1). Pub. L. 102-573, Sec. 114(b), inserted
    before comma at end "and tribally controlled postsecondary
    vocational institutions (as defined in section 2397h(2) of title
    20)".
      Subsec. (c). Pub. L. 102-573, Sec. 117(b)(5), struck out subsec.
    (c) which authorized appropriations for fiscal years 1990 to 1992.

                     EFFECTIVE DATE OF 1998 AMENDMENT                 
      Amendment by Pub. L. 105-244 effective Oct. 1, 1998, except as
    otherwise provided in Pub. L. 105-244, see section 3 of Pub. L. 105-
    244, set out as a note under section 1001 of Title 20, Education.

-FOOTNOTE-
    (!1) See References in Text note below.


-End-



-CITE-
    25 USC Sec. 1616g                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616g. INMED program

-STATUTE-
    (a) Grants
      The Secretary is authorized to provide grants to at least 3
    colleges and universities for the purpose of maintaining and
    expanding the Native American health careers recruitment program
    known as the "Indians into Medicine Program" (hereinafter in this
    section referred to as "INMED") as a means of encouraging Indians
    to enter the health professions.
    (b) University of North Dakota
      The Secretary shall provide one of the grants authorized under
    subsection (a) of this section to maintain the INMED program at the
    University of North Dakota, to be known as the "Quentin N. Burdick
    Indian Health Programs", unless the Secretary makes a
    determination, based upon program reviews, that the program is not
    meeting the purposes of this section. Such program shall, to the
    maximum extent feasible, coordinate with the Quentin N. Burdick
    American Indians Into Psychology Program established under section
    1621p(b) of this title and the Quentin N. Burdick American Indians
    Into Nursing Program established under section 1616e(e) of this
    title.
    (c) Regulations; contents of recruitment program
      (1) The Secretary shall develop regulations for the competitive
    awarding of the grants provided under this section.
      (2) Applicants for grants provided under this section shall agree
    to provide a program which - 
        (A) provides outreach and recruitment for health professions to
      Indian communities including elementary, secondary and community
      colleges located on Indian reservations which will be served by
      the program,
        (B) incorporates a program advisory board comprised of
      representatives from the tribes and communities which will be
      served by the program,
        (C) provides summer preparatory programs for Indian students
      who need enrichment in the subjects of math and science in order
      to pursue training in the health professions,
        (D) provides tutoring, counseling and support to students who
      are enrolled in a health career program of study at the
      respective college or university, and
        (E) to the maximum extent feasible, employs qualified Indians
      in the program.
    (d) Report to Congress
      By no later than the date that is 3 years after November 23,
    1988, the Secretary shall submit a report to the Congress on the
    program established under this section including recommendations
    for expansion or changes to the program.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 114, as added Pub. L. 100-713, title
    I, Sec. 109, Nov. 23, 1988, 102 Stat. 4796; amended Pub. L. 102-
    573, title I, Secs. 109, 117(b)(6), Oct. 29, 1992, 106 Stat. 4538,
    4544.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (b). Pub. L. 102-573, Sec. 109, inserted "to be
    known as the 'Quentin N. Burdick Indian Health Programs'," after
    "North Dakota," and "Such program shall, to the maximum extent
    feasible, coordinate with the Quentin N. Burdick American Indians
    Into Psychology Program established under section 1621p(b) of this
    title and the Quentin N. Burdick American Indians Into Nursing
    Program established under section 1616e(e) of this title." at end.
      Subsec. (e). Pub. L. 102-573, Sec. 117(b)(6), struck out subsec.
    (e) which authorized appropriations for fiscal years 1990 to 1992.

-End-



-CITE-
    25 USC Sec. 1616h                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616h. Health training programs of community colleges

-STATUTE-
    (a) Grants
      (1) The Secretary, acting through the Service, shall award grants
    to community colleges for the purpose of assisting the community
    college in the establishment of programs which provide education in
    a health profession leading to a degree or diploma in a health
    profession for individuals who desire to practice such profession
    on an Indian reservation or in a tribal clinic.
      (2) The amount of any grant awarded to a community college under
    paragraph (1) for the first year in which such a grant is provided
    to the community college shall not exceed $100,000.
    (b) Eligibility
      (1) The Secretary, acting through the Service, shall award grants
    to community colleges that have established a program described in
    subsection (a)(1) of this section for the purpose of maintaining
    the program and recruiting students for the program.
      (2) Grants may only be made under this section to a community
    college which - 
        (A) is accredited,
        (B) has access to a hospital facility, Service facility, or
      hospital that could provide training of nurses or health
      professionals,
        (C) has entered into an agreement with an accredited college or
      university medical school, the terms of which - 
          (i) provide a program that enhances the transition and
        recruitment of students into advanced baccalaureate or graduate
        programs which train health professionals, and
          (ii) stipulate certifications necessary to approve internship
        and field placement opportunities at service unit facilities of
        the Service or at tribal health facilities,

        (D) has a qualified staff which has the appropriate
      certifications, and
        (E) is capable of obtaining State or regional accreditation of
      the program described in subsection (a)(1) of this section.
    (c) Agreements and technical assistance
      The Secretary shall encourage community colleges described in
    subsection (b)(2) of this section to establish and maintain
    programs described in subsection (a)(1) of this section by - 
        (1) entering into agreements with such colleges for the
      provision of qualified personnel of the Service to teach courses
      of study in such programs, and
        (2) providing technical assistance and support to such
      colleges.
    (d) Advanced training
      Any program receiving assistance under this section that is
    conducted with respect to a health profession shall also offer
    courses of study which provide advanced training for any health
    professional who - 
        (1) has already received a degree or diploma in such health
      profession, and
        (2) provides clinical services on an Indian reservation, at a
      Service facility, or at a tribal clinic.

    Such courses of study may be offered in conjunction with the
    college or university with which the community college has entered
    into the agreement required under subsection (b)(2)(C) of this
    section.
    (e) Definitions
      For purposes of this section - 
        (1) The term "community college" means - 
          (A) a tribally controlled community college, or
          (B) a junior or community college.

        (2) The term "tribally controlled community college" has the
      meaning given to such term by section 1801(4) (!1) of this title.

        (3) The term "junior or community college" has the meaning
      given to such term by section 1058(e) (!1) of title 20.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 115, as added Pub. L. 100-713, title
    I, Sec. 109, Nov. 23, 1988, 102 Stat. 4797; amended Pub. L. 102-
    573, title I, Sec. 117(b)(7), Oct. 29, 1992, 106 Stat. 4544; Pub.
    L. 105-244, title IX, Sec. 901(d), Oct. 7, 1998, 112 Stat. 1828.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      Section 1801 of this title, referred to in subsec. (e)(2), was
    amended by Pub. L. 98-192, Sec. 1(1), Dec. 1, 1983, 97 Stat. 1335,
    to designate par. (4) as subsec. (a)(4), and was amended by Pub. L.
    105-244, title IX, Sec. 901(b)(5), Oct. 7, 1998, 112 Stat. 1828, so
    that it no longer defines the term "tribally controlled community
    college".
      Section 1058 of title 20, referred to in subsec. (e)(3), was
    amended by Pub. L. 105-244, title III, Sec. 303(b)(1), Oct. 7,
    1998, 112 Stat. 1639, which redesignated subsecs. (d) and (e) as
    (e) and (f), respectively.


-MISC1-
                                AMENDMENTS                            
      1998 - Subsec. (e)(2). Pub. L. 105-244 made technical amendment
    to reference in original act which appears in text as reference to
    section 1801(4) of this title.
      1992 - Subsec. (f). Pub. L. 102-573 struck out subsec. (f) which
    authorized appropriations for fiscal years 1990 to 1992.

                     EFFECTIVE DATE OF 1998 AMENDMENT                 
      Amendment by Pub. L. 105-244 effective Oct. 1, 1998, except as
    otherwise provided in Pub. L. 105-244, see section 3 of Pub. L. 105-
    244, set out as a note under section 1001 of Title 20, Education.

-FOOTNOTE-
    (!1) See References in Text note below.


-End-



-CITE-
    25 USC Sec. 1616i                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616i. Additional incentives for health professionals

-STATUTE-
    (a) Incentive special pay
      The Secretary may provide the incentive special pay authorized
    under section 302(b) of title 37 to civilian medical officers of
    the Indian Health Service who are assigned to, and serving in,
    positions included in the list established under subsection (b)(1)
    of this section for which recruitment or retention of personnel is
    difficult.
    (b) List of positions; bonus pay
      (1) The Secretary shall establish and update on an annual basis a
    list of positions of health care professionals employed by, or
    assigned to, the Service for which recruitment or retention is
    difficult.
      (2)(A) The Secretary may pay a bonus to any commissioned officer
    or civil service employee, other than a commissioned medical
    officer, dental officer, optometrist, and veterinarian, who is
    employed in or assigned to, and serving in, a position in the
    Service included in the list established by the Secretary under
    paragraph (1).
      (B) The total amount of bonus payments made by the Secretary
    under this paragraph to any employee during any 1-year period shall
    not exceed $2,000.
    (c) Work schedules
      The Secretary may establish programs to allow the use of flexible
    work schedules, and compressed work schedules, in accordance with
    the provisions of subchapter II of chapter 61 of title 5, for
    health professionals employed by, or assigned to, the Service.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 116, as added Pub. L. 100-713, title
    I, Sec. 109, Nov. 23, 1988, 102 Stat. 4798; amended Pub. L. 102-
    573, title I, Sec. 117(b)(8), title IX, Sec. 901(1), Oct. 29,
    1992, 106 Stat. 4544, 4590.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (d). Pub. L. 102-573, Sec. 901(1), struck out
    subsec. (d) which required a report to Congress by the Secretary no
    later than 6 months after Nov. 23, 1988, relating to overtime pay
    for individuals employed by the Service.
      Subsec. (e). Pub. L. 102-573, Sec. 117(b)(8), struck out subsec.
    (e) which authorized appropriations for fiscal years 1990 to 1992.

-End-



-CITE-
    25 USC Sec. 1616j                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616j. Retention bonus

-STATUTE-
    (a) Eligibility
      The Secretary may pay a retention bonus to any physician or nurse
    employed by, or assigned to, and serving in, the Service either as
    a civilian employee or as a commissioned officer in the Regular or
    Reserve Corps of the Public Health Service who - 
        (1) is assigned to, and serving in, a position included in the
      list established under section 1616i(b)(1) of this title for
      which recruitment or retention of personnel is difficult,
        (2) the Secretary determines is needed by the Service,
        (3) has - 
          (A) completed 3 years of employment with the Service, or
          (B) completed any service obligations incurred as a
        requirement of - 
            (i) any Federal scholarship program, or
            (ii) any Federal education loan repayment program, and

        (4) enters into an agreement with the Service for continued
      employment for a period of not less than 1 year.
    (b) Minimum award percentage to nurses
      Beginning with fiscal year 1993, not less than 25 percent of the
    retention bonuses awarded each year under subsection (a) of this
    section shall be awarded to nurses.
    (c) Rates; maximum rate
      The Secretary may establish rates for the retention bonus which
    shall provide for a higher annual rate for multiyear agreements
    than for single year agreements referred to in subsection (a)(4) of
    this section, but in no event shall the annual rate be more than
    $25,000 per annum.
    (d) Time of payment
      The retention bonus for the entire period covered by the
    agreement described in subsection (a)(4) of this section shall be
    paid at the beginning of the agreed upon term of service.
    (e) Refund; interest
      Any physician or nurse failing to complete the agreed upon term
    of service, except where such failure is through no fault of the
    individual, shall be obligated to refund to the Government the full
    amount of the retention bonus for the period covered by the
    agreement, plus interest as determined by the Secretary in
    accordance with section 1616a(l)(2)(B) of this title.
    (f) Physicians and nurses employed under Indian Self-Determination
      Act
      The Secretary may pay a retention bonus to any physician or nurse
    employed by an organization providing health care services to
    Indians pursuant to a contract under the Indian Self-Determination
    Act [25 U.S.C. 450f et seq.] if such physician or nurse is serving
    in a position which the Secretary determines is - 
        (1) a position for which recruitment or retention is difficult;
      and
        (2) necessary for providing health care services to Indians.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 117, as added Pub. L. 100-713, title
    I, Sec. 109, Nov. 23, 1988, 102 Stat. 4799; amended Pub. L. 102-
    573, title I, Sec. 104(d), Oct. 29, 1992, 106 Stat. 4533.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (f), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsecs. (b) to (f). Pub. L. 102-573 added subsec. (b),
    redesignated former subsecs. (b) to (e) as (c) to (f),
    respectively, and amended subsec. (f) generally, substituting
    provisions relating to physicians and nurses employed under the
    Indian Self-Determination Act for provisions which authorized
    appropriations for fiscal years 1990 to 1992.

-End-



-CITE-
    25 USC Sec. 1616k                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616k. Nursing residency program

-STATUTE-
    (a) Establishment
      The Secretary, acting through the Service, shall establish a
    program to enable licensed practical nurses, licensed vocational
    nurses, and registered nurses who are working in an Indian health
    program (as defined in section 1616a(a)(2)(A) of this title), and
    have done so for a period of not less than one year, to pursue
    advanced training.
    (b) Program components
      Such program shall include a combination of education and work
    study in an Indian health program (as defined in section
    1616a(a)(2)(A) of this title) leading to an associate or bachelor's
    degree (in the case of a licensed practical nurse or licensed
    vocational nurse) or a bachelor's degree (in the case of a
    registered nurse) or a Master's degree.
    (c) Service obligation of program participant
      An individual who participates in a program under subsection (a)
    of this section, where the educational costs are paid by the
    Service, shall incur an obligation to serve in an Indian health
    program for a period of obligated service equal to at least three
    times the period of time during which the individual participates
    in such program. In the event that the individual fails to complete
    such obligated service, the United States shall be entitled to
    recover from such individual an amount determined in accordance
    with the formula specified in subsection (l) of section 1616a of
    this title in the manner provided for in such subsection.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 118, as added Pub. L. 102-573, title
    I, Sec. 104(e), Oct. 29, 1992, 106 Stat. 4534; amended Pub. L. 103-
    435, Sec. 16(b), Nov. 2, 1994, 108 Stat. 4573.)


-MISC1-
                                AMENDMENTS                            
      1994 - Subsec. (b). Pub. L. 103-435 inserted before period at end
    "or a Master's degree".

-End-



-CITE-
    25 USC Sec. 1616l                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616l. Community Health Aide Program for Alaska

-STATUTE-
    (a) Maintenance of Program
      Under the authority of section 13 of this title, the Secretary
    shall maintain a Community Health Aide Program in Alaska under
    which the Service - 
        (1) provides for the training of Alaska Natives as health aides
      or community health practitioners;
        (2) uses such aides or practitioners in the provision of health
      care, health promotion, and disease prevention services to Alaska
      Natives living in villages in rural Alaska; and
        (3) provides for the establishment of teleconferencing capacity
      in health clinics located in or near such villages for use by
      community health aides or community health practitioners.
    (b) Training; curriculum; Certification Board
      The Secretary, acting through the Community Health Aide Program
    of the Service, shall - 
        (1) using trainers accredited by the Program, provide a high
      standard of training to community health aides and community
      health practitioners to ensure that such aides and practitioners
      provide quality health care, health promotion, and disease
      prevention services to the villages served by the Program;
        (2) in order to provide such training, develop a curriculum
      that - 
          (A) combines education in the theory of health care with
        supervised practical experience in the provision of health
        care;
          (B) provides instruction and practical experience in the
        provision of acute care, emergency care, health promotion,
        disease prevention, and the efficient and effective management
        of clinic pharmacies, supplies, equipment, and facilities; and
          (C) promotes the achievement of the health status objectives
        specified in section 1602(b) of this title;

        (3) establish and maintain a Community Health Aide
      Certification Board to certify as community health aides or
      community health practitioners individuals who have successfully
      completed the training described in paragraph (1) or can
      demonstrate equivalent experience;
        (4) develop and maintain a system which identifies the needs of
      community health aides and community health practitioners for
      continuing education in the provision of health care, including
      the areas described in paragraph (2)(B), and develop programs
      that meet the needs for such continuing education;
        (5) develop and maintain a system that provides close
      supervision of community health aides and community health
      practitioners; and
        (6) develop a system under which the work of community health
      aides and community health practitioners is reviewed and
      evaluated to assure the provision of quality health care, health
      promotion, and disease prevention services.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 119, as added Pub. L. 102-573, title
    I, Sec. 111, Oct. 29, 1992, 106 Stat. 4539.)

-End-



-CITE-
    25 USC Sec. 1616m                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616m. Matching grants to tribes for scholarship programs

-STATUTE-
    (a) In general
      (1) The Secretary shall make grants to Indian tribes and tribal
    organizations for the purpose of assisting such tribes and tribal
    organizations in educating Indians to serve as health professionals
    in Indian communities.
      (2) Amounts available for grants under paragraph (1) for any
    fiscal year shall not exceed 5 percent of amounts available for
    such fiscal year for Indian Health Scholarships under section 1613a
    of this title.
      (3) An application for a grant under paragraph (1) shall be in
    such form and contain such agreements, assurances, and information
    as the Secretary determines are necessary to carry out this
    section.
    (b) Compliance with requirements
      (1) An Indian tribe or tribal organization receiving a grant
    under subsection (a) of this section shall agree to provide
    scholarships to Indians pursuing education in the health
    professions in accordance with the requirements of this section.
      (2) With respect to the costs of providing any scholarship
    pursuant to paragraph (1) - 
        (A) 80 percent of the costs of the scholarship shall be paid
      from the grant made under subsection (a) of this section to the
      Indian tribe or tribal organization; and
        (B) 20 percent of such costs shall be paid from non-Federal
      contributions by the Indian tribe or tribal organization through
      which the scholarship is provided.

      (3) In determining the amount of non-Federal contributions that
    have been provided for purposes of subparagraph (B) of paragraph
    (2), any amounts provided by the Federal Government to the Indian
    tribe or tribal organization involved or to any other entity shall
    not be included.
      (4) Non-Federal contributions required by subparagraph (B) of
    paragraph (2) may be provided directly by the Indian tribe or
    tribal organization involved or through donations from public and
    private entities.
    (c) Course of study in health professions
      An Indian tribe or tribal organization shall provide scholarships
    under subsection (b) of this section only to Indians enrolled or
    accepted for enrollment in a course of study (approved by the
    Secretary) in one of the health professions described in section
    1613a(a) of this title.
    (d) Contract requirements
      In providing scholarships under subsection (b) of this section,
    the Secretary and the Indian tribe or tribal organization shall
    enter into a written contract with each recipient of such
    scholarship. Such contract shall - 
        (1) obligate such recipient to provide service in an Indian
      health program (as defined in section 1616a(a)(2)(A) of this
      title), in the same service area where the Indian tribe or tribal
      organization providing the scholarship is located, for - 
          (A) a number of years equal to the number of years for which
        the scholarship is provided (or the part-time equivalent
        thereof, as determined by the Secretary), or for a period of 2
        years, whichever period is greater; or
          (B) such greater period of time as the recipient and the
        Indian tribe or tribal organization may agree;

        (2) provide that the amount of such scholarship - 
          (A) may be expended only for - 
            (i) tuition expenses, other reasonable educational
          expenses, and reasonable living expenses incurred in
          attendance at the educational institution; and
            (ii) payment to the recipient of a monthly stipend of not
          more than the amount authorized by section 254l(g)(1)(B) of
          title 42, such amount to be reduced pro rata (as determined
          by the Secretary) based on the number of hours such student
          is enrolled; and

          (B) may not exceed, for any year of attendance for which the
        scholarship is provided, the total amount required for the year
        for the purposes authorized in subparagraph (A);

        (3) require the recipient of such scholarship to maintain an
      acceptable level of academic standing (as determined by the
      educational institution in accordance with regulations issued by
      the Secretary); and
        (4) require the recipient of such scholarship to meet the
      educational and licensure requirements necessary to be a
      physician, certified nurse practitioner, certified nurse midwife,
      or physician assistant.
    (e) Breach of contract
      (1) An individual who has entered into a written contract with
    the Secretary and an Indian tribe or tribal organization under
    subsection (d) of this section and who - 
        (A) fails to maintain an acceptable level of academic standing
      in the educational institution in which he is enrolled (such
      level determined by the educational institution under regulations
      of the Secretary),
        (B) is dismissed from such educational institution for
      disciplinary reasons,
        (C) voluntarily terminates the training in such an educational
      institution for which he is provided a scholarship under such
      contract before the completion of such training, or
        (D) fails to accept payment, or instructs the educational
      institution in which he is enrolled not to accept payment, in
      whole or in part, of a scholarship under such contract,

    in lieu of any service obligation arising under such contract,
    shall be liable to the United States for the Federal share of the
    amount which has been paid to him, or on his behalf, under the
    contract.
      (2) If for any reason not specified in paragraph (1), an
    individual breaches his written contract by failing either to begin
    such individual's service obligation required under such contract
    or to complete such service obligation, the United States shall be
    entitled to recover from the individual an amount determined in
    accordance with the formula specified in subsection (l) of section
    1616a of this title in the manner provided for in such subsection.
      (3) The Secretary may carry out this subsection on the basis of
    information submitted by the tribes or tribal organizations
    involved, or on the basis of information collected through such
    other means as the Secretary determines to be appropriate.
    (f) Nondiscriminatory practice
      The recipient of a scholarship under subsection (b) of this
    section shall agree, in providing health care pursuant to the
    requirements of subsection (d)(1) of this section - 
        (1) not to discriminate against an individual seeking such care
      on the basis of the ability of the individual to pay for such
      care or on the basis that payment for such care will be made
      pursuant to the program established in title XVIII of the Social
      Security Act [42 U.S.C. 1395 et seq.] or pursuant to the program
      established in title XIX of such Act [42 U.S.C. 1396 et seq.];
      and
        (2) to accept assignment under section 1842(b)(3)(B)(ii) of the
      Social Security Act [42 U.S.C. 1395u(b)(3)(B)(ii)] for all
      services for which payment may be made under part B of title
      XVIII of such Act [42 U.S.C. 1395j et seq.], and to enter into an
      appropriate agreement with the State agency that administers the
      State plan for medical assistance under title XIX of such Act [42
      U.S.C. 1396 et seq.] to provide service to individuals entitled
      to medical assistance under the plan.
    (g) Payments for subsequent fiscal years
      The Secretary may not make any payments under subsection (a) of
    this section to an Indian tribe or tribal organization for any
    fiscal year subsequent to the first fiscal year of such payments
    unless the Secretary determines that, for the immediately preceding
    fiscal year, the Indian tribe or tribal organization has complied
    with requirements of this section.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 120, as added Pub. L. 102-573, title
    I, Sec. 112, Oct. 29, 1992, 106 Stat. 4540.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Social Security Act, referred to in subsec. (f), is act Aug.
    14, 1935, ch. 531, 49 Stat. 620, as amended. Titles XVIII and XIX
    of the Act are classified generally to subchapters XVIII (Sec. 1395
    et seq.) and XIX (Sec. 1396 et seq.) of chapter 7 of Title 42, The
    Public Health and Welfare, respectively. Part B of title XVIII of
    the Act is classified generally to part B (Sec. 1395j et seq.) of
    subchapter XVIII of chapter 7 of Title 42. For complete
    classification of this Act to the Code, see section 1305 of Title
    42 and Tables.

-End-



-CITE-
    25 USC Sec. 1616n                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616n. Tribal health program administration

-STATUTE-
      The Secretary shall, by contract or otherwise, provide training
    for individuals in the administration and planning of tribal health
    programs.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 121, as added Pub. L. 102-573, title
    I, Sec. 113, Oct. 29, 1992, 106 Stat. 4542.)

-End-



-CITE-
    25 USC Sec. 1616o                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616o. University of South Dakota pilot program

-STATUTE-
    (a) Establishment
      The Secretary may make a grant to the School of Medicine of the
    University of South Dakota (hereafter in this section referred to
    as "USDSM") to establish a pilot program on an Indian reservation
    at one or more service units in South Dakota to address the chronic
    manpower shortage in the Aberdeen Area of the Service.
    (b) Purposes
      The purposes of the program established pursuant to a grant
    provided under subsection (a) of this section are - 
        (1) to provide direct clinical and practical experience at a
      service unit to medical students and residents from USDSM and
      other medical schools;
        (2) to improve the quality of health care for Indians by
      assuring access to qualified health care professionals; and
        (3) to provide academic and scholarly opportunities for
      physicians, physician assistants, nurse practitioners, nurses,
      and other allied health professionals serving Indian people by
      identifying and utilizing all academic and scholarly resources of
      the region.
    (c) Composition; designation
      The pilot program established pursuant to a grant provided under
    subsection (a) of this section shall - 
        (1) incorporate a program advisory board composed of
      representatives from the tribes and communities in the area which
      will be served by the program; and
        (2) shall be designated as an extension of the USDSM campus and
      program participants shall be under the direct supervision and
      instruction of qualified medical staff serving at the service
      unit who shall be members of the USDSM faculty.
    (d) Coordination with other schools
      The USDSM shall coordinate the program established pursuant to a
    grant provided under subsection (a) of this section with other
    medical schools in the region, nursing schools, tribal community
    colleges, and other health professional schools.
    (e) Development of additional professional opportunities
      The USDSM, in cooperation with the Service, shall develop
    additional professional opportunities for program participants on
    Indian reservations in order to improve the recruitment and
    retention of qualified health professionals in the Aberdeen Area of
    the Service.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 122, as added Pub. L. 102-573, title
    I, Sec. 116, Oct. 29, 1992, 106 Stat. 4543.)

-End-



-CITE-
    25 USC Sec. 1616p                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL

-HEAD-
    Sec. 1616p. Authorization of appropriations

-STATUTE-
      There are authorized to be appropriated such sums as may be
    necessary for each fiscal year through fiscal year 2000 to carry
    out this subchapter.

-SOURCE-
    (Pub. L. 94-437, title I, Sec. 123, as added Pub. L. 102-573, title
    I, Sec. 117(a), Oct. 29, 1992, 106 Stat. 4544.)

-End-


-CITE-
    25 USC SUBCHAPTER II - HEALTH SERVICES                      01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
                      SUBCHAPTER II - HEALTH SERVICES                  

-End-



-CITE-
    25 USC Sec. 1621                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621. Indian Health Care Improvement Fund

-STATUTE-
    (a) Approved expenditures
      The Secretary is authorized to expend funds which are
    appropriated under the authority of this section, through the
    Service, for the purposes of - 
        (1) eliminating the deficiencies in health status and resources
      of all Indian tribes,
        (2) eliminating backlogs in the provision of health care
      services to Indians,
        (3) meeting the health needs of Indians in an efficient and
      equitable manner, and
        (4) augmenting the ability of the Service to meet the following
      health service responsibilities, either through direct or
      contract care or through contracts entered into pursuant to the
      Indian Self-Determination Act [25 U.S.C. 450f et seq.], with
      respect to those Indian tribes with the highest levels of health
      status and resource deficiencies:
          (A) clinical care (direct and indirect) including clinical
        eye and vision care;
          (B) preventive health, including screening mammography in
        accordance with section 1621k of this title;
          (C) dental care (direct and indirect);
          (D) mental health, including community mental health
        services, inpatient mental health services, dormitory mental
        health services, therapeutic and residential treatment centers,
        and training of traditional Indian practitioners;
          (E) emergency medical services;
          (F) treatment and control of, and rehabilitative care related
        to, alcoholism and drug abuse (including fetal alcohol
        syndrome) among Indians;
          (G) accident prevention programs;
          (H) home health care;
          (I) community health representatives; and
          (J) maintenance and repair.
    (b) Effect on other appropriations; allocation to service units
      (1) Any funds appropriated under the authority of this section
    shall not be used to offset or limit any appropriations made to the
    Service under section 13 of this title, or any other provision of
    law.
      (2)(A) Funds appropriated under the authority of this section may
    be allocated on a service unit basis. The funds allocated to each
    service unit under this subparagraph shall be used by the service
    unit to reduce the health status and resource deficiency of each
    tribe served by such service unit.
      (B) The apportionment of funds allocated to a service unit under
    subparagraph (A) among the health service responsibilities
    described in subsection (a)(4) of this section shall be determined
    by the Service in consultation with, and with the active
    participation of, the affected Indian tribes.
    (c) Health resources deficiency levels
      For purposes of this section - 
        (1) The term "health status and resource deficiency" means the
      extent to which - 
          (A) the health status objectives set forth in section 1602(b)
        of this title are not being achieved; and
          (B) the Indian tribe does not have available to it the health
        resources it needs, taking into account the actual cost of
        providing health care services given local geographic,
        climatic, rural, or other circumstances.

        (2) The health resources available to an Indian tribe include
      health resources provided by the Service as well as health
      resources used by the Indian tribe, including services and
      financing systems provided by any Federal programs, private
      insurance, and programs of State or local governments.
        (3) The Secretary shall establish procedures which allow any
      Indian tribe to petition the Secretary for a review of any
      determination of the extent of the health status and resource
      deficiency of such tribe.
    (d) Programs administered by Indian tribe
      (1) Programs administered by any Indian tribe or tribal
    organization under the authority of the Indian Self-Determination
    Act [25 U.S.C. 450f et seq.] shall be eligible for funds
    appropriated under the authority of this section on an equal basis
    with programs that are administered directly by the Service.
      (2) If any funds allocated to a tribe or service unit under the
    authority of this section are used for a contract entered into
    under the Indian Self-Determination Act, a reasonable portion of
    such funds may be used for health planning, training, technical
    assistance, and other administrative support functions.
    (e) Report to Congress
      By no later than the date that is 3 years after October 29, 1992,
    the Secretary shall submit to the Congress the current health
    status and resource deficiency report of the Service for each
    Indian tribe or service unit, including newly recognized or
    acknowledged tribes. Such report shall set out - 
        (1) the methodology then in use by the Service for determining
      tribal health status and resource deficiencies, as well as the
      most recent application of that methodology;
        (2) the extent of the health status and resource deficiency of
      each Indian tribe served by the Service;
        (3) the amount of funds necessary to eliminate the health
      status and resource deficiencies of all Indian tribes served by
      the Service; and
        (4) an estimate of - 
          (A) the amount of health service funds appropriated under the
        authority of this chapter, or any other Act, including the
        amount of any funds transferred to the Service, for the
        preceding fiscal year which is allocated to each service unit,
        Indian tribe, or comparable entity;
          (B) the number of Indians eligible for health services in
        each service unit or Indian tribe; and
          (C) the number of Indians using the Service resources made
        available to each service unit or Indian tribe.
    (f) Appropriated funds included in base budget of Service
      Funds appropriated under authority of this section for any fiscal
    year shall be included in the base budget of the Service for the
    purpose of determining appropriations under this section in
    subsequent fiscal years.
    (g) Continuation of Service responsibilities for backlogs and
      parity
      Nothing in this section is intended to diminish the primary
    responsibility of the Service to eliminate existing backlogs in
    unmet health care needs, nor are the provisions of this section
    intended to discourage the Service from undertaking additional
    efforts to achieve parity among Indian tribes.
    (h) Authorization of appropriations
      Any funds appropriated under the authority of this section shall
    be designated as the "Indian Health Care Improvement Fund".

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 201, Sept. 30, 1976, 90 Stat. 1404;
    Pub. L. 96-537, Sec. 4, Dec. 17, 1980, 94 Stat. 3174; Pub. L. 100-
    713, title II, Sec. 201(a), Nov. 23, 1988, 102 Stat. 4800; Pub. L.
    102-573, title II, Sec. 201(a), (c), 207(b), 217(b)(1), Oct. 29,
    1992, 106 Stat. 4544, 4546, 4551, 4559.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsecs. (a)(4)
    and (d), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206,
    as amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 201(c), amended section catchline
    generally.
      Subsec. (a). Pub. L. 102-573, Sec. 201(a)(1)(A), substituted
    "this section" for "subsection (h) of this section" in introductory
    provisions.
      Subsec. (a)(1). Pub. L. 102-573, Sec. 201(a)(1)(B), amended par.
    (1) generally. Prior to amendment, par. (1) read as follows:
    "raising the health status of Indians to zero deficiency,".
      Subsec. (a)(4). Pub. L. 102-573, Sec. 201(a)(1)(C), in
    introductory provisions inserted ", either through direct or
    contract care or through contracts entered into pursuant to the
    Indian Self-Determination Act," after "responsibilities" and
    substituted "status and resource deficiencies" for "resources
    deficiency".
      Subsec. (a)(4)(B). Pub. L. 102-573, Sec. 207(b), substituted
    "preventive health, including screening mammography in accordance
    with section 1621k of this title" for "preventive health".
      Subsec. (b)(1). Pub. L. 102-573, Sec. 201(a)(2)(A), substituted
    "this section" for "subsection (h) of this section".
      Subsec. (b)(2). Pub. L. 102-573, Sec. 201(a)(2)(B), redesignated
    par. (3) as (2) and struck out former par. (2) which read as
    follows: "Funds which are appropriated under the authority of
    subsection (h) of this section may be allocated to, or used for the
    benefit of, any Indian tribe which has a health resources
    deficiency level at level I or II only if a sufficient amount of
    funds have been appropriated under the authority of subsection (h)
    of this section to raise all Indian tribes to health resources
    deficiency level II."
      Subsec. (b)(2)(A). Pub. L. 102-573, Sec. 201(a)(2)(C), in first
    sentence, substituted "this section" for "subsection (h) of this
    section" and struck out "but such allocation shall be made in a
    manner which ensures that the requirement of paragraph (2) is met"
    after "service unit basis" and, in second sentence, struck out "(in
    accordance with paragraph (2))" after "the service unit" and
    substituted "reduce the health status and resource deficiency" for
    "raise the deficiency level".
      Subsec. (b)(2)(B). Pub. L. 102-573, Sec. 201(a)(2)(D), inserted
    ", and with the active participation of," after "in consultation
    with".
      Subsec. (b)(3). Pub. L. 102-573, Sec. 201(a)(2)(B), redesignated
    par. (3) as (2).
      Subsec. (c)(1). Pub. L. 102-573, Sec. 201(a)(3)(B), amended par.
    (1) generally, substituting provisions defining "health status and
    resource deficiency" for former provisions defining "health
    resources deficiency".
      Pub. L. 102-573, Sec. 201(a)(3)(A), redesignated par. (2) as (1)
    and struck out former par. (1) which specified the health resource
    deficiency levels of an Indian tribe.
      Subsec. (c)(2). Pub. L. 102-573, Sec. 201(a)(3)(A), redesignated
    par. (3) as (2). Former par. (2) redesignated (1).
      Subsec. (c)(3). Pub. L. 102-573, Sec. 201(a)(3)(A), (C),
    redesignated par. (4) as (3) and substituted "The" for "Under
    regulations, the" and "extent of the health status and resource
    deficiency" for "health resources deficiency level". Former par.
    (3) redesignated (2).
      Subsec. (c)(4). Pub. L. 102-573, Sec. 201(a)(3)(A), redesignated
    par. (4) as (3).
      Subsec. (d)(1). Pub. L. 102-573, Sec. 201(a)(4), substituted
    "this section" for "subsection (h) of this section".
      Subsec. (e). Pub. L. 102-573, Sec. 201(a)(5)(A), in introductory
    provisions, substituted "3 years after October 29, 1992, the
    Secretary shall submit to the Congress the current health status
    and resource deficiency report" for "60 days after November 23,
    1988, the Secretary shall submit to the Congress the current health
    services priority system report".
      Subsec. (e)(1). Pub. L. 102-573, Sec. 201(a)(5)(B), substituted
    "health status and resource deficiencies" for "health resources
    deficiencies".
      Subsec. (e)(2). Pub. L. 102-573, Sec. 201(a)(5)(C), substituted
    "the extent of the health status and resource deficiency of" for
    "the level of health resources deficiency for".
      Subsec. (e)(3). Pub. L. 102-573, Sec. 201(a)(5)(D), substituted
    "eliminate the health status and resource deficiencies of all
    Indian tribes served by the Service; and" for "raise all Indian
    tribes served by the Service below health resources deficiency
    level II to health resources deficiency level II;".
      Subsec. (e)(4) to (6). Pub. L. 102-573, Sec. 201(a)(5)(E),
    redesignated par. (6) as (4) and struck out former pars. (4) and
    (5) which read as follows:
      "(4) the amount of funds necessary to raise all tribes served by
    the Service below health resources deficiency level I to health
    resources deficiency level I;
      "(5) the amount of funds necessary to raise all tribes served by
    the Service to zero health resources deficiency; and".
      Subsec. (f). Pub. L. 102-573, Sec. 201(a)(6), redesignated par.
    (2) as entire subsec. and struck out former par. (1) which read as
    follows: "The President shall include with the budget submitted to
    the Congress under section 1105 of title 31 for each fiscal year a
    separate statement which specifies the amount of funds requested to
    carry out the provisions of this section for such fiscal year."
      Subsec. (h). Pub. L. 102-573, Sec. 217(b)(1), substituted "this
    section" for "this subsection" and struck out former first sentence
    which authorized appropriations for fiscal years 1990 to 1992.
      1988 - Pub. L. 100-713 amended section generally, substituting
    subsecs. (a) to (h) relating to improvement of Indian health status
    for former subsecs. (a) to (e) relating to direct patient care
    program.
      1980 - Subsec. (c)(1). Pub. L. 96-537, Sec. 4(a)(1), inserted
    provisions authorizing appropriation of specific amounts for fiscal
    years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and
    Sept. 30, 1984, and further authorizing additional positions as may
    be necessary for each such fiscal year.
      Subsec. (c)(2). Pub. L. 96-537, Sec. 4(a)(2), inserted provisions
    authorizing appropriation of specific amounts for fiscal years
    ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept.
    30, 1984, and further authorizing additional positions as may be
    necessary for each such fiscal year.
      Subsec. (c)(3). Pub. L. 96-537, Sec. 4(a)(3), inserted provisions
    authorizing appropriation of specific amounts for fiscal years
    ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept.
    30, 1984, and further authorizing additional positions as may be
    necessary for each such fiscal year.
      Subsec. (c)(4)(A). Pub. L. 96-537, Sec. 4(b)(1), inserted
    provisions authorizing appropriation of specific amounts for fiscal
    years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and
    Sept. 30, 1984, and further authorizing additional positions as may
    be necessary for each such fiscal year.
      Subsec. (c)(4)(B). Pub. L. 96-537, Sec. 4(b)(2), inserted
    provisions authorizing appropriation of specific amounts for fiscal
    years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and
    Sept. 30, 1984, and further authorizing additional positions as may
    be necessary for each such fiscal year.
      Subsec. (c)(4)(C). Pub. L. 96-537, Sec. 4(b)(3), inserted
    provisions authorizing appropriation of specific amounts for fiscal
    years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and
    Sept. 30, 1984, and further authorizing additional positions as may
    be necessary for each such fiscal year.
      Subsec. (c)(4)(D). Pub. L. 96-537, Sec. 4(b)(4), inserted
    provisions authorizing appropriation of specific amounts for fiscal
    years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and
    Sept. 30, 1984, and further authorizing additional positions as may
    be necessary for each such fiscal year.
      Subsec. (c)(4)(E). Pub. L. 96-537, Sec. 4(b)(5), inserted
    provisions authorizing appropriation of specific amounts for fiscal
    years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and
    Sept. 30, 1984.
      Subsec. (c)(5). Pub. L. 96-537, Sec. 4(c)(1), inserted provisions
    authorizing appropriation of specific amounts for fiscal years
    ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept.
    30, 1984.
      Subsec. (c)(6). Pub. L. 96-537, Sec. 4(c)(2), inserted provisions
    authorizing appropriation of specific amounts for fiscal years
    ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept.
    30, 1984, and further authorizing additional positions as may be
    necessary for each such fiscal year.
      Subsec. (c)(7). Pub. L. 96-537, Sec. 4(c)(3), struck out par. (7)
    which authorized appropriation for the items referred to in
    subsecs. (c)(1) to (c)(6) of such sums as may be specifically
    authorized by an act enacted after Sept. 30, 1976, for fiscal years
    1981, 1982, 1983, and 1984, and which further authorized positions
    for items referred to in subsecs. (c)(1) to (c)(6) other than
    subsecs. (c)(4)(E) and (c)(5), as may be specified in an act
    enacted after Sept. 30, 1976.

                     EFFECTIVE DATE OF 1992 AMENDMENTS                 
      Section 201(b) of Pub. L. 102-573 provided that: "Except with
    respect to the amendments made by subsection (a)(5) [amending this
    section], the amendments made by subsection (a) [amending this
    section] shall take effect three years after the date of the
    enactment of this Act [Oct. 29, 1992]. The amendments made by
    subsection (a)(5) shall take effect upon the date of the enactment
    of this Act."

                        CONTRACT MEDICAL CARE FUNDS                    
      Pub. L. 108-7, div. F, title II, Feb. 20, 2003, 117 Stat. 261,
    provided in part: "That contract medical care funds appropriated
    heretofore and hereafter for tribes recognized after January 1,
    1995, may be used to provide medical services directly or through
    contract medical care".

-End-



-CITE-
    25 USC Sec. 1621a                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621a. Catastrophic Health Emergency Fund

-STATUTE-
    (a) Establishment; administration; purpose
      (1) There is hereby established an Indian Catastrophic Health
    Emergency Fund (hereafter in this section referred to as the
    "Fund") consisting of - 
        (A) the amounts deposited under subsection (d) of this section,
      and
        (B) the amounts appropriated to the Fund under this section.

      (2) The Fund shall be administered by the Secretary, acting
    through the central office of the Service, solely for the purpose
    of meeting the extraordinary medical costs associated with the
    treatment of victims of disasters or catastrophic illnesses who are
    within the responsibility of the Service.
      (3) The Fund shall not be allocated, apportioned, or delegated on
    a service unit, area office, or any other basis.
      (4) No part of the Fund or its administration shall be subject to
    contract or grant under any law, including the Indian Self-
    Determination Act [25 U.S.C. 450f et seq.].
    (b) Regulations; procedures for payment
      The Secretary shall, through the promulgation of regulations
    consistent with the provisions of this section - 
        (1) establish a definition of disasters and catastrophic
      illnesses for which the cost of treatment provided under contract
      would qualify for payment from the Fund;
        (2) provide that a service unit shall not be eligible for
      reimbursement for the cost of treatment from the Fund until its
      cost of treating any victim of such catastrophic illness or
      disaster has reached a certain threshold cost which the Secretary
      shall establish at - 
          (A) for 1993, not less than $15,000 or not more than $25,000;
        and
          (B) for any subsequent year, not less than the threshold cost
        of the previous year increased by the percentage increase in
        the medical care expenditure category of the consumer price
        index for all urban consumers (United States city average) for
        the 12-month period ending with December of the previous year;

        (3) establish a procedure for the reimbursement of the portion
      of the costs incurred by - 
          (A) service units or facilities of the Service, or
          (B) whenever otherwise authorized by the Service, non-Service
        facilities or providers,

      in rendering treatment that exceeds such threshold cost;
        (4) establish a procedure for payment from the Fund in cases in
      which the exigencies of the medical circumstances warrant
      treatment prior to the authorization of such treatment by the
      Service; and
        (5) establish a procedure that will ensure that no payment
      shall be made from the Fund to any provider of treatment to the
      extent that such provider is eligible to receive payment for the
      treatment from any other Federal, State, local, or private source
      of reimbursement for which the patient is eligible.
    (c) Effect on other appropriations
      Amounts appropriated to the Fund under this section shall not be
    used to offset or limit appropriations made to the Service under
    authority of section 13 of this title or any other law.
    (d) Reimbursements to Fund
      There shall be deposited into the Fund all reimbursements to
    which the Service is entitled from any Federal, State, local, or
    private source (including third party insurance) by reason of
    treatment rendered to any victim of a disaster or catastrophic
    illness the cost of which was paid from the Fund.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 202, as added Pub. L. 100-713,
    title II, Sec. 202, Nov. 23, 1988, 102 Stat. 4803; amended Pub. L.
    102-573, title II, Secs. 202(a), 217(b)(2), Oct. 29, 1992, 106
    Stat. 4546, 4559.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a)(4),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a)(1)(B). Pub. L. 102-573, Sec. 202(a)(1),
    substituted "to the Fund under this section" for "under subsection
    (e) of this section".
      Subsec. (b)(2). Pub. L. 102-573, Sec. 202(a)(2), substituted
    "shall establish at - " and subpars. (A) and (B) for "shall
    establish at not less than $10,000 or not more than $20,000;".
      Subsec. (c). Pub. L. 102-573, Sec. 202(a)(3), substituted
    "Amounts appropriated to the Fund under this section" for "Funds
    appropriated under subsection (e) of this section".
      Subsec. (e). Pub. L. 102-573, Sec. 217(b)(2), struck out subsec.
    (e) which authorized appropriations for fiscal years 1989 to 1992.

                     EFFECTIVE DATE OF 1992 AMENDMENT                 
      Section 202(b) of Pub. L. 102-573 provided that: "The amendment
    made by subsection (a)(2) [amending this section] shall take effect
    January 1, 1993."

-End-



-CITE-
    25 USC Sec. 1621b                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621b. Health promotion and disease prevention services

-STATUTE-
    (a) Authorization
      The Secretary, acting through the Service, shall provide health
    promotion and disease prevention services to Indians so as to
    achieve the health status objectives set forth in section 1602(b)
    of this title.
    (b) Evaluation statement for Presidential budget
      The Secretary shall submit to the President for inclusion in each
    statement which is required to be submitted to the Congress under
    section 1671 of this title an evaluation of - 
        (1) the health promotion and disease prevention needs of
      Indians,
        (2) the health promotion and disease prevention activities
      which would best meet such needs,
        (3) the internal capacity of the Service to meet such needs,
      and
        (4) the resources which would be required to enable the Service
      to undertake the health promotion and disease prevention
      activities necessary to meet such needs.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 203, as added Pub. L. 100-713,
    title II, Sec. 203(c), Nov. 23, 1988, 102 Stat. 4805; amended Pub.
    L. 102-573, title II, Sec. 203, Oct. 29, 1992, 106 Stat. 4546.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 203(1), inserted before
    period at end "so as to achieve the health status objectives set
    forth in section 1602(b) of this title".
      Subsec. (b). Pub. L. 102-573, Sec. 203(2), in introductory
    provisions, substituted "section 1671" for "section 1621(f)".
      Subsec. (c). Pub. L. 102-573, Sec. 203(3), struck out subsec. (c)
    which directed establishment of between 1 and 4 health-related
    demonstration projects to terminate 30 months after Nov. 23, 1988.

     CONGRESSIONAL FINDINGS ON HEALTH PROMOTION AND DISEASE PREVENTION 
      Section 203(a) of Pub. L. 100-713 provided that: "The Congress
    finds that health promotion and disease prevention activities will -
     
        "(1) improve the health and well being of Indians, and
        "(2) reduce the expenses for medical care of Indians."

-End-



-CITE-
    25 USC Sec. 1621c                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621c. Diabetes prevention, treatment, and control

-STATUTE-
    (a) Incidence and complications
      The Secretary, in consultation with the tribes, shall determine -
    
        (1) by tribe and by Service unit of the Service, the incidence
      of, and the types of complications resulting from, diabetes among
      Indians; and
        (2) based on paragraph (1), the measures (including patient
      education) each Service unit should take to reduce the incidence
      of, and prevent, treat, and control the complications resulting
      from, diabetes among tribes within that Service unit.
    (b) Screening
      The Secretary shall screen each Indian who receives services from
    the Service for diabetes and for conditions which indicate a high
    risk that the individual will become diabetic. Such screening may
    be done by a tribe or tribal organization operating health care
    programs or facilities with funds from the Service under the Indian
    Self-Determination Act [25 U.S.C. 450f et seq.].
    (c) Model diabetes projects
      (1) The Secretary shall continue to maintain through fiscal year
    2000 each model diabetes project in existence on October 29, 1992,
    and located - 
        (A) at the Claremore Indian Hospital in Oklahoma;
        (B) at the Fort Totten Health Center in North Dakota;
        (C) at the Sacaton Indian Hospital in Arizona;
        (D) at the Winnebago Indian Hospital in Nebraska;
        (E) at the Albuquerque Indian Hospital in New Mexico;
        (F) at the Perry, Princeton, and Old Town Health Centers in
      Maine;
        (G) at the Bellingham Health Center in Washington;
        (H) at the Fort Berthold Reservation;
        (I) at the Navajo Reservation;
        (J) at the Papago Reservation;
        (K) at the Zuni Reservation; or
        (L) in the States of Alaska, California, Minnesota, Montana,
      Oregon, or Utah.

      (2) The Secretary may establish new model diabetes projects under
    this section taking into consideration applications received under
    this section from all service areas, except that the Secretary may
    not establish a greater number of such projects in one service area
    than in any other service area until there is an equal number of
    such projects established with respect to all service areas from
    which the Secretary receives qualified applications during the
    application period (as determined by the Secretary).
    (d) Control officer; registry of patients
      The Secretary shall - 
        (1) employ in each area office of the Service at least one
      diabetes control officer who shall coordinate and manage on a
      full-time basis activities within that area office for the
      prevention, treatment, and control of diabetes;
        (2) establish in each area office of the Service a registry of
      patients with diabetes to track the incidence of diabetes and the
      complications from diabetes in that area;
        (3) ensure that data collected in each area office regarding
      diabetes and related complications among Indians is disseminated
      to all other area offices; and
        (4) evaluate the effectiveness of services provided through
      model diabetes projects established under this section.
    (e) Authorization of appropriations
      Funds appropriated under this section in any fiscal year shall be
    in addition to base resources appropriated to the Service for that
    year.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 204, as added Pub. L. 100-713,
    title II, Sec. 203(c), Nov. 23, 1988, 102 Stat. 4806; amended Pub.
    L. 102-573, title II, Secs. 204, 217(b)(3), title IX, Sec. 901(2),
    Oct. 29, 1992, 106 Stat. 4546, 4559, 4590.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (b), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 901(2), redesignated
    par. (1) as entire subsec., redesignated subpars. (A) and (B) as
    pars. (1) and (2), respectively, substituted "paragraph (1)" for
    "subparagraph (A)" in par. (2), and struck out former par. (2)
    which read as follows: "Within 18 months after November 23, 1988,
    the Secretary shall prepare and transmit to the President and the
    Congress a report describing the determinations made and measures
    taken under paragraph (1) and making recommendations for additional
    funding to prevent, treat, and control diabetes among Indians."
      Subsec. (c). Pub. L. 102-573, Sec. 204(1), amended subsec. (c)
    generally. Prior to amendment, subsec. (c) read as follows:
      "(1) The Secretary shall continue to maintain during fiscal years
    1988 through 1991 each of the following model diabetes projects
    which are in existence on November 23, 1988:
        "(A) Claremore Indian Hospital in Oklahoma;
        "(B) Fort Totten Health Center in North Dakota;
        "(C) Sacaton Indian Hospital in Arizona;
        "(D) Winnebago Indian Hospital in Nebraska;
        "(E) Albuquerque Indian Hospital in New Mexico;
        "(F) Perry, Princeton, and Old Town Health Centers in Maine;
      and
        "(G) Bellingham Health Center in Washington.
      "(2) The Secretary shall establish in fiscal year 1989, and
    maintain during fiscal years 1989 through 1991, a model diabetes
    project in each of the following locations:
        "(A) Fort Berthold Reservation;
        "(B) the Navajo Reservation;
        "(C) the Papago Reservation;
        "(D) the Zuni Reservation; and
        "(E) the States of Alaska, California, Minnesota, Montana,
      Oregon, and Utah."
      Subsec. (d)(4). Pub. L. 102-573, Sec. 204(2), added par. (4).
      Subsec. (e). Pub. L. 102-573, Sec. 217(b)(3), substituted "this
    section" for "subsection (c) of this section" and struck out at
    beginning "There are authorized to be appropriated such sums as may
    be necessary to carry out the provisions of this section."

-End-



-CITE-
    25 USC Sec. 1621d                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621d. Hospice care feasibility study

-STATUTE-
    (a) Duty of Secretary
      The Secretary, acting through the Service and in consultation
    with representatives of Indian tribes, tribal organizations, Indian
    Health Service personnel, and hospice providers, shall conduct a
    study - 
        (1) to assess the feasibility and desirability of furnishing
      hospice care to terminally ill Indians; and
        (2) to determine the most efficient and effective means of
      furnishing such care.
    (b) Functions of study
      Such study shall - 
        (1) assess the impact of Indian culture and beliefs concerning
      death and dying on the provision of hospice care to Indians;
        (2) estimate the number of Indians for whom hospice care may be
      appropriate and determine the geographic distribution of such
      individuals;
        (3) determine the most appropriate means to facilitate the
      participation of Indian tribes and tribal organizations in
      providing hospice care;
        (4) identify and evaluate various means for providing hospice
      care, including - 
          (A) the provision of such care by the personnel of a Service
        hospital pursuant to a hospice program established by the
        Secretary at such hospital; and
          (B) the provision of such care by a community-based hospice
        program under contract to the Service; and

        (5) identify and assess any difficulties in furnishing such
      care and the actions needed to resolve such difficulties.
    (c) Report to Congress
      Not later than the date which is 12 months after October 29,
    1992, the Secretary shall transmit to the Congress a report
    containing - 
        (1) a detailed description of the study conducted pursuant to
      this section; and
        (2) a discussion of the findings and conclusions of such study.
    (d) Definitions
      For the purposes of this section - 
        (1) the term "terminally ill" means any Indian who has a
      medical prognosis (as certified by a physician) of a life
      expectancy of six months or less; and
        (2) the term "hospice program" means any program which
      satisfies the requirements of section 1395x(dd)((2) of title 42;
      and
        (3) the term "hospice care" means the items and services
      specified in subparagraphs (A) through (H) of section
      1395x(dd)(1) of title 42.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 205, as added Pub. L. 102-573,
    title II, Sec. 206(a), Oct. 29, 1992, 106 Stat. 4548.)


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1621d, Pub. L. 94-437, title II, Sec. 205, as
    added Pub. L. 100-713, title II, Sec. 203(c), Nov. 23, 1988, 102
    Stat. 4807, related to Native Hawaiian health promotion and disease
    prevention, prior to repeal by Pub. L. 100-579, Sec. 14, formerly
    Sec. 10, Oct. 31, 1988, 102 Stat. 2923; Pub. L. 100-690, title II,
    Sec. 2310, Nov. 18, 1988, 102 Stat. 4229; renumbered Sec. 14, Pub.
    L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948. See
    section 11701 et seq. of Title 42, The Public Health and Welfare.

-End-



-CITE-
    25 USC Sec. 1621e                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621e. Reimbursement from certain third parties of costs of
      health services

-STATUTE-
    (a) Right of recovery
      Except as provided in subsection (f) of this section, the United
    States, an Indian tribe, or a tribal organization shall have the
    right to recover the reasonable expenses incurred by the Secretary,
    an Indian tribe, or a tribal organization in providing health
    services, through the Service, an Indian tribe, or a tribal
    organization, to any individual to the same extent that such
    individual, or any nongovernmental provider of such services, would
    be eligible to receive reimbursement or indemnification for such
    expenses if - 
        (1) such services had been provided by a nongovernmental
      provider, and
        (2) such individual had been required to pay such expenses and
      did pay such expenses.
    (b) Recovery against State with workers' compensation laws or no-
      fault automobile accident insurance program
      Subsection (a) of this section shall provide a right of recovery
    against any State only if the injury, illness, or disability for
    which health services were provided is covered under - 
        (1) workers' compensation laws, or
        (2) a no-fault automobile accident insurance plan or program.
    (c) Prohibition of State law or contract provision impeding right
      of recovery
      No law of any State, or of any political subdivision of a State,
    and no provision of any contract entered into or renewed after
    November 23, 1988, shall prevent or hinder the right of recovery of
    the United States, an Indian tribe, or a tribal organization under
    subsection (a) of this section.
    (d) Right to damages
      No action taken by the United States, an Indian tribe, or a
    tribal organization to enforce the right of recovery provided under
    subsection (a) of this section shall affect the right of any person
    to any damages (other than damages for the cost of health services
    provided by the Secretary through the Service).
    (e) Intervention or separate civil action
      The United States, an Indian tribe, or a tribal organization may
    enforce the right of recovery provided under subsection (a) of this
    section by - 
        (1) intervening or joining in any civil action or proceeding
      brought - 
          (A) by the individual for whom health services were provided
        by the Secretary, an Indian tribe, or a tribal organization, or
          (B) by any representative or heirs of such individual, or

        (2) instituting a separate civil action, after providing to
      such individual, or to the representative or heirs of such
      individual, notice of the intention of the United States, an
      Indian tribe, or a tribal organization to institute a separate
      civil action.
    (f) Right of recovery for services when self-insurance plan
      provides coverage
      The United States shall not have a right of recovery under this
    section if the injury, illness, or disability for which health
    services were provided is covered under a self-insurance plan
    funded by an Indian tribe or tribal organization.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 206, as added Pub. L. 100-713,
    title II, Sec. 204, Nov. 23, 1988, 102 Stat. 4811; amended Pub. L.
    102-573, title II, Sec. 209, Oct. 29, 1992, 106 Stat. 4551.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 209(b)(1), substituted
    "Except as provided in subsection (f) of this section, the" for
    "The".
      Pub. L. 102-573, Sec. 209(a)(1)-(3), inserted ", an Indian tribe,
    or a tribal organization" after "United States", after "Service",
    and after "Secretary".
      Subsec. (b). Pub. L. 102-573, Sec. 209(a)(4), struck out ", or
    any political subdivision of a State," after "against any State".
      Subsecs. (c), (d). Pub. L. 102-573, Sec. 209(a)(1), inserted ",
    an Indian tribe, or a tribal organization" after "United States".
      Subsec. (e). Pub. L. 102-573, Sec. 209(a)(1), (3), inserted ", an
    Indian tribe, or a tribal organization" after "United States" in
    two places and after "Secretary".
      Subsec. (f). Pub. L. 102-573, Sec. 209(b)(2), added subsec. (f).

-End-



-CITE-
    25 USC Sec. 1621f                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621f. Crediting of reimbursements

-STATUTE-
      (a) Except as provided in section 1621a(d) of this title,
    subchapter III-A of this chapter, and section 1680c of this title,
    all reimbursements received or recovered, under authority of this
    chapter, Public Law 87-693 (42 U.S.C. 2651, et seq.), or any other
    provision of law, by reason of the provision of health services by
    the Service or by a tribe or tribal organization under a contract
    pursuant to the Indian Self-Determination Act [25 U.S.C. 450f et
    seq.] shall be retained by the Service or that tribe or tribal
    organization and shall be available for the facilities, and to
    carry out the programs, of the Service or that tribe or tribal
    organization to provide health care services to Indians.
      (b) The Service may not offset or limit the amount of funds
    obligated to any service unit or any entity under contract with the
    Service because of the receipt of reimbursements under subsection
    (a) of this section.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 207, as added Pub. L. 100-713,
    title II, Sec. 204, Nov. 23, 1988, 102 Stat. 4812; amended Pub. L.
    102-573, title VII, Sec. 701(c)(1), Oct. 29, 1992, 106 Stat. 4572.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      Public Law 87-693, referred to in subsec. (a), is Pub. L. 87-693,
    Sept. 25, 1962, 76 Stat. 593, which is classified generally to
    chapter 32 (Sec. 2651 et seq.) of Title 42, The Public Health and
    Welfare. For complete classification of this Act to the Code, see
    Tables.
      The Indian Self-Determination Act, referred to in subsec. (a), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573 made technical amendment to
    reference to section 1680c of this title to reflect renumbering of
    corresponding section of original act.

-End-



-CITE-
    25 USC Sec. 1621g                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621g. Health services research

-STATUTE-
      Of the amounts appropriated for the Service in any fiscal year,
    other than amounts made available for the Indian Health Care
    Improvement Fund, not less than $200,000 shall be available only
    for research to further the performance of the health service
    responsibilities of the Service. Indian tribes and tribal
    organizations contracting with the Service under the authority of
    the Indian Self-Determination Act [25 U.S.C. 450f et seq.] shall be
    given an equal opportunity to compete for, and receive, research
    funds under this section.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 208, as added Pub. L. 100-713,
    title II, Sec. 204, Nov. 23, 1988, 102 Stat. 4812.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in text, is title
    I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which
    is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-End-



-CITE-
    25 USC Sec. 1621h                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621h. Mental health prevention and treatment services

-STATUTE-
    (a) National plan for Indian Mental Health Services
      (1) Not later than 120 days after November 28, 1990, the
    Secretary, acting through the Service, shall develop and publish in
    the Federal Register a final national plan for Indian Mental Health
    Services. The plan shall include - 
        (A) an assessment of the scope of the problem of mental illness
      and dysfunctional and self-destructive behavior, including child
      abuse and family violence, among Indians, including - 
          (i) the number of Indians served by the Service who are
        directly or indirectly affected by such illness or behavior,
        and
          (ii) an estimate of the financial and human cost attributable
        to such illness or behavior;

        (B) an assessment of the existing and additional resources
      necessary for the prevention and treatment of such illness and
      behavior; and
        (C) an estimate of the additional funding needed by the Service
      to meet its responsibilities under the plan.

      (2) The Secretary shall submit a copy of the national plan to the
    Congress.
    (b) Memorandum of agreement
      Not later than 180 days after November 28, 1990, the Secretary
    and the Secretary of the Interior shall develop and enter into a
    memorandum of agreement under which the Secretaries shall, among
    other things - 
        (1) determine and define the scope and nature of mental illness
      and dysfunctional and self-destructive behavior, including child
      abuse and family violence, among Indians;
        (2) make an assessment of the existing Federal, tribal, State,
      local, and private services, resources, and programs available to
      provide mental health services for Indians;
        (3) make an initial determination of the unmet need for
      additional services, resources, and programs necessary to meet
      the needs identified pursuant to paragraph (1);
        (4)(A) ensure that Indians, as citizens of the United States
      and of the States in which they reside, have access to mental
      health services to which all citizens have access;
        (B) determine the right of Indians to participate in, and
      receive the benefit of, such services; and
        (C) take actions necessary to protect the exercise of such
      right;
        (5) delineate the responsibilities of the Bureau of Indian
      Affairs and the Service, including mental health identification,
      prevention, education, referral, and treatment services
      (including services through multidisciplinary resource teams), at
      the central, area, and agency and service unit levels to address
      the problems identified in paragraph (1);
        (6) provide a strategy for the comprehensive coordination of
      the mental health services provided by the Bureau of Indian
      Affairs and the Service to meet the needs identified pursuant to
      paragraph (1), including - 
          (A) the coordination of alcohol and substance abuse programs
        of the Service, the Bureau of Indian Affairs, and the various
        tribes (developed under the Indian Alcohol and Substance Abuse
        Prevention and Treatment Act of 1986 [25 U.S.C. 2401 et seq.])
        with the mental health initiatives pursuant to this chapter,
        particularly with respect to the referral and treatment of
        dually-diagnosed individuals requiring mental health and
        substance abuse treatment; and
          (B) ensuring that Bureau of Indian Affairs and Service
        programs and services (including multidisciplinary resource
        teams) addressing child abuse and family violence are
        coordinated with such non-Federal programs and services;

        (7) direct appropriate officials of the Bureau of Indian
      Affairs and the Service, particularly at the agency and service
      unit levels, to cooperate fully with tribal requests made
      pursuant to subsection (d) of this section; and
        (8) provide for an annual review of such agreement by the two
      Secretaries.
    (c) Community mental health plan
      (1) The governing body of any Indian tribe may, at its
    discretion, adopt a resolution for the establishment of a community
    mental health plan providing for the identification and
    coordination of available resources and programs to identify,
    prevent, or treat mental illness or dysfunctional and self-
    destructive behavior, including child abuse and family violence,
    among its members.
      (2) In furtherance of a plan established pursuant to paragraph
    (1) and at the request of a tribe, the appropriate agency, service
    unit, or other officials of the Bureau of Indian Affairs and the
    Service shall cooperate with, and provide technical assistance to,
    the tribe in the development of such plan. Upon the establishment
    of such a plan and at the request of the tribe, such officials, as
    directed by the memorandum of agreement developed pursuant to
    subsection (c) of this section, shall cooperate with the tribe in
    the implementation of such plan.
      (3) Two or more Indian tribes may form a coalition for the
    adoption of resolutions and the establishment and development of a
    joint community mental health plan under this subsection.
      (4) The Secretary, acting through the Service, may make grants to
    Indian tribes adopting a resolution pursuant to paragraph (1) to
    obtain technical assistance for the development of a community
    mental health plan and to provide administrative support in the
    implementation of such plan.
    (d) Mental health training and community education programs
      (1) The Secretary and the Secretary of the Interior, in
    consultation with representatives of Indian tribes, shall conduct a
    study and compile a list, of the types of staff positions specified
    in paragraph (2) whose qualifications include, or should include,
    training in the identification, prevention, education, referral, or
    treatment of mental illness or dysfunctional and self-destructive
    behavior.
      (2) The positions referred to in paragraph (1) are - 
        (A) staff positions within the Bureau of Indian Affairs,
      including existing positions, in the fields of - 
          (i) elementary and secondary education;
          (ii) social services and family and child welfare;
          (iii) law enforcement and judicial services; and
          (iv) alcohol and substance abuse;

        (B) staff positions with the Service; and
        (C) staff positions similar to those identified in
      subparagraphs (A) and (B) established and maintained by Indian
      tribes, including positions established in contracts entered into
      under the Indian Self-Determination Act [25 U.S.C. 450f et seq.].

      (3)(A) The appropriate Secretary shall provide training criteria
    appropriate to each type of position identified in paragraph (2)(A)
    and ensure that appropriate training has been, or will be, provided
    to any individual in any such position. With respect to any such
    individual in a position identified pursuant to paragraph (2)(C),
    the respective Secretaries shall provide appropriate training to,
    or provide funds to an Indian tribe for the training of, such
    individual. In the case of positions funded under a contract
    entered into under the Indian Self-Determination Act, the
    appropriate Secretary shall ensure that such training costs are
    included in the contract, if necessary.
      (B) Funds authorized to be appropriated pursuant to this section
    may be used to provide training authorized by this paragraph for
    community education programs described in paragraph (5) if a plan
    adopted pursuant to subsection (d) of this section identifies
    individuals or employment categories, other than those identified
    pursuant to paragraph (1), for which such training or community
    education is deemed necessary or desirable.
      (4) Position-specific training criteria described in paragraph
    (3) shall be culturally relevant to Indians and Indian tribes and
    shall ensure that appropriate information regarding traditional
    Indian healing and treatment practices is provided.
      (5) The Service shall develop and implement or, upon the request
    of an Indian tribe, assist such tribe to develop and implement, a
    program of community education on mental illness and dysfunctional
    and self-destructive behavior for individuals, as determined in a
    plan adopted pursuant to subsection (d) of this section. In
    carrying out this paragraph, the Service shall provide, upon the
    request of an Indian tribe, technical assistance to the Indian
    tribe to obtain or develop community education and training
    materials on the identification, prevention, referral, and
    treatment of mental illness and dysfunctional and self-destructive
    behavior.
    (e) Staffing
      (1) Within 90 days after November 28, 1990, the Secretary shall
    develop a plan under which the Service will increase the health
    care staff providing mental health services by at least 500
    positions within five years after November 28, 1990, with at least
    200 of such positions devoted to child, adolescent, and family
    services. Such additional staff shall be primarily assigned to the
    service unit level for services which shall include outpatient,
    emergency, aftercare and follow-up, and prevention and education
    services.
      (2) The plan developed under paragraph (1) shall be implemented
    under section 13 of this title.
    (f) Staff recruitment and retention
      (1) The Secretary shall provide for the recruitment of the
    additional personnel required by subsection (f) of this section and
    the retention of all Service personnel providing mental health
    services. In carrying out this subsection, the Secretary shall give
    priority to practitioners providing mental health services to
    children and adolescents with mental health problems.
      (2) In carrying out paragraph (1), the Secretary shall develop a
    program providing for - 
        (A) the payment of bonuses (which shall not be more favorable
      than those provided for under sections 1616i and 1616j of this
      title) for service in hardship posts;
        (B) the repayment of loans (for which the provisions of
      repayment contracts shall not be more favorable than the
      repayment contracts under section 1616a of this title) for health
      professions education as a recruitment incentive; and
        (C) a system of postgraduate rotations as a retention
      incentive.

      (3) This subsection shall be carried out in coordination with the
    recruitment and retention programs under subchapter I of this
    chapter.
    (g) Mental Health Technician program
      (1) Under the authority of section 13 of this title, the
    Secretary shall establish and maintain a Mental Health Technician
    program within the Service which - 
        (A) provides for the training of Indians as mental health
      technicians; and
        (B) employs such technicians in the provision of community-
      based mental health care that includes identification,
      prevention, education, referral, and treatment services.

      (2) In carrying out paragraph (1)(A), the Secretary shall provide
    high standard paraprofessional training in mental health care
    necessary to provide quality care to the Indian communities to be
    served. Such training shall be based upon a curriculum developed or
    approved by the Secretary which combines education in the theory of
    mental health care with supervised practical experience in the
    provision of such care.
      (3) The Secretary shall supervise and evaluate the mental health
    technicians in the training program.
      (4) The Secretary shall ensure that the program established
    pursuant to this subsection involves the utilization and promotion
    of the traditional Indian health care and treatment practices of
    the Indian tribes to be served.
    (h) Mental health research
      The Secretary, acting through the Service and in consultation
    with the National Institute of Mental Health, shall enter into
    contracts with, or make grants to, appropriate institutions for the
    conduct of research on the incidence and prevalence of mental
    disorders among Indians on Indian reservations and in urban areas.
    Research priorities under this subsection shall include - 
        (1) the inter-relationship and inter-dependence of mental
      disorders with alcoholism, suicide, homicides, accidents, and the
      incidence of family violence, and
        (2) the development of models of prevention techniques.

    The effect of the inter-relationships and interdependencies
    referred to in paragraph (1) on children, and the development of
    prevention techniques under paragraph (2) applicable to children,
    shall be emphasized.
    (i) Facilities assessment
      Within one year after November 28, 1990, the Secretary, acting
    through the Service, shall make an assessment of the need for
    inpatient mental health care among Indians and the availability and
    cost of inpatient mental health facilities which can meet such
    need. In making such assessment, the Secretary shall consider the
    possible conversion of existing, under-utilized service hospital
    beds into psychiatric units to meet such need.
    (j) Annual report
      The Service shall develop methods for analyzing and evaluating
    the overall status of mental health programs and services for
    Indians and shall submit to the President, for inclusion in each
    report required to be transmitted to the Congress under section
    1671 of this title, a report on the mental health status of Indians
    which shall describe the progress being made to address mental
    health problems of Indian communities.
    (k) Mental health demonstration grant program
      (1) The Secretary, acting through the Service, is authorized to
    make grants to Indian tribes and inter-tribal consortia to pay 75
    percent of the cost of planning, developing, and implementing
    programs to deliver innovative community-based mental health
    services to Indians. The 25 percent tribal share of such cost may
    be provided in cash or through the provision of property or
    services.
      (2) The Secretary may award a grant for a project under paragraph
    (1) to an Indian tribe or inter-tribal consortium which meets the
    following criteria:
        (A) The project will address significant unmet mental health
      needs among Indians.
        (B) The project will serve a significant number of Indians.
        (C) The project has the potential to deliver services in an
      efficient and effective manner.
        (D) The tribe or consortium has the administrative and
      financial capability to administer the project.
        (E) The project will deliver services in a manner consistent
      with traditional Indian healing and treatment practices.
        (F) The project is coordinated with, and avoids duplication of,
      existing services.

      (3) For purposes of this subsection, the Secretary shall, in
    evaluating applications for grants for projects to be operated
    under any contract entered into with the Service under the Indian
    Self-Determination Act [25 U.S.C. 450f et seq.], use the same
    criteria that the Secretary uses in evaluating any other
    application for such a grant.
      (4) The Secretary may only award one grant under this subsection
    with respect to a service area until the Secretary has awarded
    grants for all service areas with respect to which the Secretary
    receives applications during the application period, as determined
    by the Secretary, which meet the criteria specified in paragraph
    (2).
      (5) Not later than 180 days after the close of the term of the
    last grant awarded pursuant to this subsection, the Secretary shall
    submit to the Congress a report evaluating the effectiveness of the
    innovative community-based projects demonstrated pursuant to this
    subsection. Such report shall include findings and recommendations,
    if any, relating to the reorganization of the programs of the
    Service for delivery of mental health services to Indians.
      (6) Grants made pursuant to this section may be expended over a
    period of three years and no grant may exceed $1,000,000 for the
    fiscal years involved.
    (l) Licensing requirement for mental health care workers
      Any person employed as a psychologist, social worker, or marriage
    and family therapist for the purpose of providing mental health
    care services to Indians in a clinical setting under the authority
    of this chapter or through a contract pursuant to the Indian Self-
    Determination Act [25 U.S.C. 450f et seq.] shall - 
        (1) in the case of a person employed as a psychologist, be
      licensed as a clinical psychologist or working under the direct
      supervision of a licensed clinical psychologist;
        (2) in the case of a person employed as a social worker, be
      licensed as a social worker or working under the direct
      supervision of a licensed social worker; or
        (3) in the case of a person employed as a marriage and family
      therapist, be licensed as a marriage and family therapist or
      working under the direct supervision of a licensed marriage and
      family therapist.
    (m) Intermediate adolescent mental health services
      (1) The Secretary, acting through the Service, may make grants to
    Indian tribes and tribal organizations to provide intermediate
    mental health services to Indian children and adolescents,
    including - 
        (A) inpatient and outpatient services;
        (B) emergency care;
        (C) suicide prevention and crisis intervention; and
        (D) prevention and treatment of mental illness, and
      dysfunctional and self-destructive behavior, including child
      abuse and family violence.

      (2) Funds provided under this subsection may be used - 
        (A) to construct or renovate an existing health facility to
      provide intermediate mental health services;
        (B) to hire mental health professionals;
        (C) to staff, operate, and maintain an intermediate mental
      health facility, group home, or youth shelter where intermediate
      mental health services are being provided; and
        (D) to make renovations and hire appropriate staff to convert
      existing hospital beds into adolescent psychiatric units.

      (3) Funds provided under this subsection may not be used for the
    purposes described in section 1621o(b)(1) of this title.
      (4) An Indian tribe or tribal organization receiving a grant
    under this subsection shall ensure that intermediate adolescent
    mental health services are coordinated with other tribal, Service,
    and Bureau of Indian Affairs mental health, alcohol and substance
    abuse, and social services programs on the reservation of such
    tribe or tribal organization.
      (5) The Secretary shall establish criteria for the review and
    approval of applications for grants made pursuant to this
    subsection.
      (6) There are authorized to be appropriated to carry out this
    section $10,000,000 for fiscal year 1993 and such sums as may be
    necessary for each of the fiscal years 1994, 1995, 1996, 1997,
    1998, 1999, and 2000.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 209, as added Pub. L. 101-630,
    title V, Sec. 503(b), Nov. 28, 1990, 104 Stat. 4557; amended Pub.
    L. 102-573, title II, Secs. 205, 217(b)(4), title IX, Sec. 902(3),
    Oct. 29, 1992, 106 Stat. 4547, 4559, 4591.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Alcohol and Substance Abuse Prevention and Treatment
    Act of 1986, referred to in subsec. (b)(6)(A), is subtitle C of
    title IV of Pub. L. 99-570, Oct. 27, 1986, 100 Stat. 3207-137, as
    amended, which is classified generally to chapter 26 (Sec. 2401 et
    seq.) of this title. For complete classification of subtitle C to
    the Code, see Short Title note set out under section 2401 of this
    title and Tables.
      The Indian Self-Determination Act, referred to in subsecs.
    (d)(2)(C), (3)(A), (k)(3), and (l), is title I of Pub. L. 93-638,
    Jan. 4, 1975, 88 Stat. 2206, as amended, which is classified
    principally to part A (Sec. 450f et seq.) of subchapter II of
    chapter 14 of this title. For complete classification of this Act
    to the Code, see Short Title note set out under section 450 of this
    title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 902(3)(A), made technical amendment
    to section catchline.
      Subsec. (b). Pub. L. 102-573, Sec. 902(3)(B), redesignated
    subsec. (c) as (b). Prior to amendment, no subsec. (b) had been
    enacted.
      Subsec. (c). Pub. L. 102-573, Secs. 217(b)(4)(A), 902(3)(B),
    redesignated subsec. (d) as (c) and struck out par. (5) which
    authorized appropriations of $500,000 for fiscal year 1991 and
    $1,000,000 for fiscal year 1992 to carry out this subsec. Former
    subsec. (c) redesignated (b).
      Subsec. (d). Pub. L. 102-573, Secs. 217(b)(4)(A), (D), 902(3)(B),
    redesignated subsec. (e) as (d), substituted "this section" for
    "this subsection" in par. (3)(B), and struck out par. (6) which
    authorized appropriations of $500,000 for fiscal year 1991 and
    $5,000,000 for fiscal year 1992 to carry out this subsec., with
    certain amounts to be allocated for community education. Former
    subsec. (d) redesignated (c).
      Subsec. (e). Pub. L. 102-573, Sec. 902(3)(B), redesignated
    subsec. (f) as (e). Former subsec. (e) redesignated (d).
      Subsec. (f). Pub. L. 102-573, Secs. 217(b)(4)(A), 902(3)(B),
    redesignated subsec. (g) as (f) and struck out par. (4) which
    appropriated $1,200,000 for fiscal year 1992 to carry out this
    subsec. Former subsec. (f) redesignated (e).
      Subsec. (g). Pub. L. 102-573, Secs. 217(b)(4)(A), 902(3)(B),
    redesignated subsec. (h) as (g) and struck out par. (5) which
    authorized appropriation of $1,000,000 for fiscal year 1992 for
    purposes of providing training required under this subsec. Former
    subsec. (g) redesignated (f).
      Subsec. (h). Pub. L. 102-573, Secs. 217(b)(4)(B), 902(3)(B),
    redesignated subsec. (i) as (h), struck out par. (1) designation
    before "The Secretary, acting", redesignated subpars. (A) and (B)
    as pars. (1) and (2), respectively, substituted "paragraph (1)" and
    "paragraph (2)" for "subparagraph (A)" and "subparagraph (B)",
    respectively, in closing provisions, and struck out former par. (2)
    which authorized appropriation of $2,000,000 for fiscal year 1992
    to carry out this subsec., to remain available until expended.
    Former subsec. (h) redesignated (g).
      Subsec. (i). Pub. L. 102-573, Secs. 217(b)(4)(C), 902(3)(B),
    redesignated subsec. (j) as (i), struck out par. (1) designation
    before "Within one year", and struck out par. (2) which authorized
    appropriation of $500,000 for fiscal year 1992 to make the
    assessment required by this subsec. Former subsec. (i) redesignated
    (h).
      Subsec. (j). Pub. L. 102-573, Secs. 205(1), 902(3)(B),
    redesignated subsec. (k) as (j) and substituted "submit to the
    President, for inclusion in each report required to be transmitted
    to the Congress under section 1671 of this title, a report" for
    "submit to the Congress an annual report". Former subsec. (j)
    redesignated (i).
      Subsec. (k). Pub. L. 102-573, Secs. 217(b)(4)(E), 902(3)(B),
    redesignated subsec. (l) as (k), and in par. (6) substituted
    "section" for "subsection" in second sentence and struck out first
    sentence which authorized appropriations of $2,000,000 for fiscal
    year 1991 and $3,000,000 for fiscal year 1992 to carry out purposes
    of this subsec. Former subsec. (k) redesignated (j).
      Subsecs. (l), (m). Pub. L. 102-573, Sec. 205(2), added subsecs.
    (l) and (m). Former subsec. (l) redesignated (k).

                           STATEMENT OF PURPOSES                       
      Section 503(a) of Pub. L. 101-630 provided that: "The purposes of
    this section [enacting this section] are to - 
        "(1) authorize and direct the Indian Health Service to develop
      a comprehensive mental health prevention and treatment program;
        "(2) provide direction and guidance relating to mental illness
      and dysfunctional and self-destructive behavior, including child
      abuse and family violence, to those Federal, tribal, State, and
      local agencies responsible for programs in Indian communities in
      areas of health care, education, social services, child and
      family welfare, alcohol and substance abuse, law enforcement, and
      judicial services;
        "(3) assist Indian tribes to identify services and resources
      available to address mental illness and dysfunctional and self-
      destructive behavior;
        "(4) provide authority and opportunities for Indian tribes to
      develop and implement, and coordinate with, community-based
      mental health programs which include identification, prevention,
      education, referral, and treatment services, including through
      multidisciplinary resource teams;
        "(5) ensure that Indians, as citizens of the United States and
      of the States in which they reside, have the same access to
      mental health services to which all such citizens have access;
      and
        "(6) modify or supplement existing programs and authorities in
      the areas identified in paragraph (2)."

-End-



-CITE-
    25 USC Sec. 1621i                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621i. Managed care feasibility study

-STATUTE-
      (a) The Secretary, acting through the Service, shall conduct a
    study to assess the feasibility of allowing an Indian tribe to
    purchase, directly or through the Service, managed care coverage
    for all members of the tribe from - 
        (1) a tribally owned and operated managed care plan; or
        (2) a State licensed managed care plan.

      (b) Not later than the date which is 12 months after October 29,
    1992, the Secretary shall transmit to the Congress a report
    containing - 
        (1) a detailed description of the study conducted pursuant to
      this section; and
        (2) a discussion of the findings and conclusions of such study.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 210, as added Pub. L. 102-573,
    title II, Sec. 206(b), Oct. 29, 1992, 106 Stat. 4549.)

-End-



-CITE-
    25 USC Sec. 1621j                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621j. California contract health services demonstration
      program

-STATUTE-
    (a) Establishment
      The Secretary shall establish a demonstration program to evaluate
    the use of a contract care intermediary to improve the
    accessibility of health services to California Indians.
    (b) Agreement with California Rural Indian Health Board
      (1) In establishing such program, the Secretary shall enter into
    an agreement with the California Rural Indian Health Board to
    reimburse the Board for costs (including reasonable administrative
    costs) incurred, during the period of the demonstration program, in
    providing medical treatment under contract to California Indians
    described in section 1679(b) of this title throughout the
    California contract health services delivery area described in
    section 1680 of this title with respect to high-cost contract care
    cases.
      (2) Not more than 5 percent of the amounts provided to the Board
    under this section for any fiscal year may be for reimbursement for
    administrative expenses incurred by the Board during such fiscal
    year.
      (3) No payment may be made for treatment provided under the
    demonstration program to the extent payment may be made for such
    treatment under the Catastrophic Health Emergency Fund described in
    section 1621a of this title or from amounts appropriated or
    otherwise made available to the California contract health service
    delivery area for a fiscal year.
    (c) Advisory board
      There is hereby established an advisory board which shall advise
    the California Rural Indian Health Board in carrying out the
    demonstration pursuant to this section. The advisory board shall be
    composed of representatives, selected by the California Rural
    Indian Health Board, from not less than 8 tribal health programs
    serving California Indians covered under such demonstration, at
    least one half of whom are not affiliated with the California Rural
    Indian Health Board.
    (d) Commencement and termination dates
      The demonstration program described in this section shall begin
    on January 1, 1993, and shall terminate on September 30, 1997.
    (e) Report
      Not later than July 1, 1998, the California Rural Indian Health
    Board shall submit to the Secretary a report on the demonstration
    program carried out under this section, including a statement of
    its findings regarding the impact of using a contract care
    intermediary on - 
        (1) access to needed health services;
        (2) waiting periods for receiving such services; and
        (3) the efficient management of high-cost contract care cases.
    (f) "High-cost contract care cases" defined
      For the purposes of this section, the term "high-cost contract
    care cases" means those cases in which the cost of the medical
    treatment provided to an individual - 
        (1) would otherwise be eligible for reimbursement from the
      Catastrophic Health Emergency Fund established under section
      1621a of this title, except that the cost of such treatment does
      not meet the threshold cost requirement established pursuant to
      section 1621a(b)(2) of this title; and
        (2) exceeds $1,000.
    (g) Authorization of appropriations
      There are authorized to be appropriated for each of the fiscal
    years 1996 through 2000 such sums as may be necessary to carry out
    the purposes of this section.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 211, as added Pub. L. 102-573,
    title II, Sec. 206(c), Oct. 29, 1992, 106 Stat. 4549; amended Pub.
    L. 104-313, Sec. 2(c), Oct. 19, 1996, 110 Stat. 3822.)


-MISC1-
                                AMENDMENTS                            
      1996 - Subsec. (g). Pub. L. 104-313 substituted "1996 through
    2000" for "1993, 1994, 1995, 1996, and 1997".

                      TERMINATION OF ADVISORY BOARDS                  
      Advisory boards established after Jan. 5, 1973, to terminate not
    later than the expiration of the 2-year period beginning on the
    date of their establishment, unless, in the case of a board
    established by the President or an officer of the Federal
    Government, such board is renewed by appropriate action prior to
    the expiration of such 2-year period, or in the case of a board
    established by Congress, its duration is otherwise provided by law.
    See sections 3(2) and 14 of Pub. L. 92-463, Oct. 6, 1972, 86 Stat.
    770, 776, set out in the Appendix to Title 5, Government
    Organization and Employees.

-End-



-CITE-
    25 USC Sec. 1621k                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621k. Coverage of screening mammography

-STATUTE-
      The Secretary, through the Service, shall provide for screening
    mammography (as defined in section 1861(jj) of the Social Security
    Act [42 U.S.C. 1395x(jj)]) for Indian and urban Indian women 35
    years of age or older at a frequency, determined by the Secretary
    (in consultation with the Director of the National Cancer
    Institute), appropriate to such women, and under such terms and
    conditions as are consistent with standards established by the
    Secretary to assure the safety and accuracy of screening
    mammography under part B of title XVIII of the Social Security Act
    [42 U.S.C. 1395j et seq.].

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 212, as added Pub. L. 102-573,
    title II, Sec. 207(a), Oct. 29, 1992, 106 Stat. 4550.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Social Security Act, referred to in text, is act Aug. 14,
    1935, ch. 531, 49 Stat. 620, as amended. Part B of title XVIII of
    the Act is classified generally to part B (Sec. 1395j et seq.) of
    subchapter XVIII of chapter 7 of Title 42, The Public Health and
    Welfare. For complete classification of this Act to the Code, see
    section 1305 of Title 42 and Tables.

-End-



-CITE-
    25 USC Sec. 1621l                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621l. Patient travel costs

-STATUTE-
      (a) The Secretary, acting through the Service, shall provide
    funds for the following patient travel costs associated with
    receiving health care services provided (either through direct or
    contract care or through contracts entered into pursuant to the
    Indian Self-Determination Act [25 U.S.C. 450f et seq.]) under this
    chapter - 
        (1) emergency air transportation; and
        (2) nonemergency air transportation where ground transportation
      is infeasible.

      (b) There are authorized to be appropriated to carry out this
    section $15,000,000 for fiscal year 1993 and such sums as may be
    necessary for each of the fiscal years 1994, 1995, 1996, 1997,
    1998, 1999, and 2000.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 213, as added Pub. L. 102-573,
    title II, Sec. 208, Oct. 29, 1992, 106 Stat. 4551.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-End-



-CITE-
    25 USC Sec. 1621m                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621m. Epidemiology centers

-STATUTE-
      (a)(1) The Secretary shall establish an epidemiology center in
    each Service area to carry out the functions described in paragraph
    (3).
      (2) To assist such centers in carrying out such functions, the
    Secretary shall perform the following:
        (A) In consultation with the Centers for Disease Control and
      Indian tribes, develop sets of data (which to the extent
      practicable, shall be consistent with the uniform data sets used
      by the States with respect to the year 2000 health objectives)
      for uniformly defining health status for purposes of the
      objectives specified in section 1602(b) of this title. Such sets
      shall consist of one or more categories of information. The
      Secretary shall develop formats for the uniform collecting and
      reporting of information on such categories.
        (B) Establish and maintain a system for monitoring the progress
      made toward meeting each of the health status objectives
      described in section 1602(b) of this title.

      (3) In consultation with Indian tribes and urban Indian
    communities, each area epidemiology center established under this
    subsection shall, with respect to such area - 
        (A) collect data relating to, and monitor progress made toward
      meeting, each of the health status objectives described in
      section 1602(b) of this title using the data sets and monitoring
      system developed by the Secretary pursuant to paragraph (2);
        (B) evaluate existing delivery systems, data systems, and other
      systems that impact the improvement of Indian health;
        (C) assist tribes and urban Indian communities in identifying
      their highest priority health status objectives and the services
      needed to achieve such objectives, based on epidemiological data;
        (D) make recommendations for the targeting of services needed
      by tribal, urban, and other Indian communities;
        (E) make recommendations to improve health care delivery
      systems for Indians and urban Indians;
        (F) work cooperatively with tribal providers of health and
      social services in order to avoid duplication of existing
      services; and
        (G) provide technical assistance to Indian tribes and urban
      Indian organizations in the development of local health service
      priorities and incidence and prevalence rates of disease and
      other illness in the community.

      (4) Epidemiology centers established under this subsection shall
    be subject to the provisions of the Indian Self-Determination Act
    (25 U.S.C. 450f et seq.).
      (5) The director of the Centers for Disease Control shall provide
    technical assistance to the centers in carrying out the
    requirements of this subsection.
      (6) The Service shall assign one epidemiologist from each of its
    area offices to each area epidemiology center to provide such
    center with technical assistance necessary to carry out this
    subsection.
      (b)(1) The Secretary may make grants to Indian tribes, tribal
    organizations, and eligible intertribal consortia or Indian
    organizations to conduct epidemiological studies of Indian
    communities.
      (2) An intertribal consortia or Indian organization is eligible
    to receive a grant under this subsection if - 
        (A) it is incorporated for the primary purpose of improving
      Indian health; and
        (B) it is representative of the tribes or urban Indian
      communities in which it is located.

      (3) An application for a grant under this subsection shall be
    submitted in such manner and at such time as the Secretary shall
    prescribe.
      (4) Applicants for grants under this subsection shall - 
        (A) demonstrate the technical, administrative, and financial
      expertise necessary to carry out the functions described in
      paragraph (5);
        (B) consult and cooperate with providers of related health and
      social services in order to avoid duplication of existing
      services; and
        (C) demonstrate cooperation from Indian tribes or urban Indian
      organizations in the area to be served.

      (5) A grant awarded under paragraph (1) may be used to - 
        (A) carry out the functions described in subsection (a)(3) of
      this section;
        (B) provide information to and consult with tribal leaders,
      urban Indian community leaders, and related health staff, on
      health care and health services management issues; and
        (C) provide, in collaboration with tribes and urban Indian
      communities, the Service with information regarding ways to
      improve the health status of Indian people.

      (6) There are authorized to be appropriated to carry out the
    purposes of this subsection not more than $12,000,000 for fiscal
    year 1993 and such sums as may be necessary for each of the fiscal
    years 1994, 1995, 1996, 1997, 1998, 1999, and 2000.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 214, as added Pub. L. 102-573,
    title II, Sec. 210, Oct. 29, 1992, 106 Stat. 4551.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a)(4),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-End-



-CITE-
    25 USC Sec. 1621n                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621n. Comprehensive school health education programs

-STATUTE-
    (a) Award of grants
      The Secretary, acting through the Service and in consultation
    with the Secretary of the Interior, may award grants to Indian
    tribes to develop comprehensive school health education programs
    for children from preschool through grade 12 in schools located on
    Indian reservations.
    (b) Use of grants
      Grants awarded under this section may be used to - 
        (1) develop health education curricula;
        (2) train teachers in comprehensive school health education
      curricula;
        (3) integrate school-based, community-based, and other public
      and private health promotion efforts;
        (4) encourage healthy, tobacco-free school environments;
        (5) coordinate school-based health programs with existing
      services and programs available in the community;
        (6) develop school programs on nutrition education, personal
      health, and fitness;
        (7) develop mental health wellness programs;
        (8) develop chronic disease prevention programs;
        (9) develop substance abuse prevention programs;
        (10) develop accident prevention and safety education programs;
        (11) develop activities for the prevention and control of
      communicable diseases; and
        (12) develop community and environmental health education
      programs.
    (c) Assistance
      The Secretary shall provide technical assistance to Indian tribes
    in the development of health education plans, and the dissemination
    of health education materials and information on existing health
    programs and resources.
    (d) Criteria for review and approval of applications
      The Secretary shall establish criteria for the review and
    approval of applications for grants made pursuant to this section.
    (e) Report of recipient
      Recipients of grants under this section shall submit to the
    Secretary an annual report on activities undertaken with funds
    provided under this section. Such reports shall include a statement
    of - 
        (1) the number of preschools, elementary schools, and secondary
      schools served;
        (2) the number of students served;
        (3) any new curricula established with funds provided under
      this section;
        (4) the number of teachers trained in the health curricula; and
        (5) the involvement of parents, members of the community, and
      community health workers in programs established with funds
      provided under this section.
    (f) Program development
      (1) The Secretary of the Interior, acting through the Bureau of
    Indian Affairs and in cooperation with the Secretary, shall develop
    a comprehensive school health education program for children from
    preschool through grade 12 in schools operated by the Bureau of
    Indian Affairs.
      (2) Such program shall include - 
        (A) school programs on nutrition education, personal health,
      and fitness;
        (B) mental health wellness programs;
        (C) chronic disease prevention programs;
        (D) substance abuse prevention programs;
        (E) accident prevention and safety education programs; and
        (F) activities for the prevention and control of communicable
      diseases.

      (3) The Secretary of the Interior shall - 
        (A) provide training to teachers in comprehensive school health
      education curricula;
        (B) ensure the integration and coordination of school-based
      programs with existing services and health programs available in
      the community; and
        (C) encourage healthy, tobacco-free school environments.
    (g) Authorization of appropriations
      There are authorized to be appropriated to carry out this section
    $15,000,000 for fiscal year 1993 and such sums as may be necessary
    for each of the fiscal years 1994, 1995, 1996, 1997, 1998, 1999,
    and 2000.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 215, as added Pub. L. 102-573,
    title II, Sec. 211, Oct. 29, 1992, 106 Stat. 4553.)

-End-



-CITE-
    25 USC Sec. 1621o                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621o. Indian youth grant program

-STATUTE-
    (a) Grants
      The Secretary, acting through the Service, is authorized to make
    grants to Indian tribes, tribal organizations, and urban Indian
    organizations for innovative mental and physical disease prevention
    and health promotion and treatment programs for Indian
    preadolescent and adolescent youths.
    (b) Use of funds
      (1) Funds made available under this section may be used to - 
        (A) develop prevention and treatment programs for Indian youth
      which promote mental and physical health and incorporate cultural
      values, community and family involvement, and traditional
      healers; and
        (B) develop and provide community training and education.

      (2) Funds made available under this section may not be used to
    provide services described in section 1621h(m) of this title.
    (c) Models for delivery of comprehensive health care services
      The Secretary shall - 
        (1) disseminate to Indian tribes information regarding models
      for the delivery of comprehensive health care services to Indian
      and urban Indian adolescents;
        (2) encourage the implementation of such models; and
        (3) at the request of an Indian tribe, provide technical
      assistance in the implementation of such models.
    (d) Criteria for review and approval of applications
      The Secretary shall establish criteria for the review and
    approval of applications under this section.
    (e) Authorization of appropriations
      There are authorized to be appropriated to carry out this section
    $5,000,000 for fiscal year 1993 and such sums as may be necessary
    for each of the fiscal years 1994, 1995, 1996, 1997, 1998, 1999,
    and 2000.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 216, as added Pub. L. 102-573,
    title II, Sec. 212, Oct. 29, 1992, 106 Stat. 4554.)

-End-



-CITE-
    25 USC Sec. 1621p                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621p. American Indians Into Psychology Program

-STATUTE-
    (a) Grants
      The Secretary may provide grants to at least 3 colleges and
    universities for the purpose of developing and maintaining American
    Indian psychology career recruitment programs as a means of
    encouraging Indians to enter the mental health field.
    (b) Quentin N. Burdick American Indians Into Psychology Program
      The Secretary shall provide one of the grants authorized under
    subsection (a) of this section to develop and maintain a program at
    the University of North Dakota to be known as the "Quentin N.
    Burdick American Indians Into Psychology Program". Such program
    shall, to the maximum extent feasible, coordinate with the Quentin
    N. Burdick Indian Health Programs authorized under section 1616g(b)
    of this title, the Quentin N. Burdick American Indians Into Nursing
    Program authorized under section 1616e(e) of this title, and
    existing university research and communications networks.
    (c) Issuance of regulations
      (1) The Secretary shall issue regulations for the competitive
    awarding of the grants provided under this section.
      (2) Applicants for grants under this section shall agree to
    provide a program which, at a minimum - 
        (A) provides outreach and recruitment for health professions to
      Indian communities including elementary, secondary and community
      colleges located on Indian reservations that will be served by
      the program;
        (B) incorporates a program advisory board comprised of
      representatives from the tribes and communities that will be
      served by the program;
        (C) provides summer enrichment programs to expose Indian
      students to the varied fields of psychology through research,
      clinical, and experiential activities;
        (D) provides stipends to undergraduate and graduate students to
      pursue a career in psychology;
        (E) develops affiliation agreements with tribal community
      colleges, the Service, university affiliated programs, and other
      appropriate entities to enhance the education of Indian students;
        (F) to the maximum extent feasible, utilizes existing
      university tutoring, counseling and student support services; and
        (G) to the maximum extent feasible, employs qualified Indians
      in the program.
    (d) Active duty service obligation
      The active duty service obligation prescribed under section 254m
    of title 42 shall be met by each graduate student who receives a
    stipend described in subsection (c)(2)(D) of this section that is
    funded by a grant provided under this section. Such obligation
    shall be met by service - 
        (1) in the Indian Health Service;
        (2) in a program conducted under a contract entered into under
      the Indian Self-Determination Act [25 U.S.C. 450f et seq.];
        (3) in a program assisted under subchapter IV of this chapter;
      or
        (4) in the private practice of psychology if, as determined by
      the Secretary, in accordance with guidelines promulgated by the
      Secretary, such practice is situated in a physician or other
      health professional shortage area and addresses the health care
      needs of a substantial number of Indians.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 217, as added Pub. L. 102-573,
    title II, Sec. 213, Oct. 29, 1992, 106 Stat. 4555.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (d)(2),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-End-



-CITE-
    25 USC Sec. 1621q                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621q. Prevention, control, and elimination of tuberculosis

-STATUTE-
    (a) Grants
      The Secretary, acting through the Service after consultation with
    the Centers for Disease Control, may make grants to Indian tribes
    and tribal organizations for - 
        (1) projects for the prevention, control, and elimination of
      tuberculosis;
        (2) public information and education programs for the
      prevention, control, and elimination of tuberculosis; and
        (3) education, training, and clinical skills improvement
      activities in the prevention, control, and elimination of
      tuberculosis for health professionals, including allied health
      professionals.
    (b) Application for grant
      The Secretary may make a grant under subsection (a) of this
    section only if an application for the grant is submitted to the
    Secretary and the application is in such form, is made in such
    manner, and contains the assurances required by subsection (c) of
    this section and such other agreements, assurances, and information
    as the Secretary may require.
    (c) Eligibility for grant
      To be eligible for a grant under subsection (a) of this section,
    an applicant must provide assurances satisfactory to the Secretary
    that - 
        (1) the applicant will coordinate its activities for the
      prevention, control, and elimination of tuberculosis with
      activities of the Centers for Disease Control, and State and
      local health agencies; and
        (2) the applicant will submit to the Secretary an annual report
      on its activities for the prevention, control, and elimination of
      tuberculosis.
    (d) Duties of Secretary
      In carrying out this section, the Secretary - 
        (1) shall establish criteria for the review and approval of
      applications for grants under subsection (a) of this section,
      including requirement of public health qualifications of
      applicants;
        (2) shall, subject to available appropriations, make at least
      one grant under subsection (a) of this section within each area
      office;
        (3) may, at the request of an Indian tribe or tribal
      organization, provide technical assistance; and
        (4) shall prepare and submit a report to the Committee on
      Energy and Commerce and the Committee on Natural Resources of the
      House and the Committee on Indian Affairs of the Senate not later
      than February 1, 1994, and biennially thereafter, on the use of
      funds under this section and on the progress made toward the
      prevention, control, and elimination of tuberculosis among Indian
      tribes and tribal organizations.
    (e) Reduction of amount of grant
      The Secretary may, at the request of a recipient of a grant under
    subsection (a) of this section, reduce the amount of such grant by -
     
        (1) the fair market value of any supplies or equipment
      furnished the grant recipient; and
        (2) the amount of the pay, allowances, and travel expenses of
      any officer or employee of the Government when detailed to the
      grant recipient and the amount of any other costs incurred in
      connection with the detail of such officer or employee,

    when the furnishing of such supplies or equipment or the detail of
    such an officer or employee is for the convenience of and at the
    request of such grant recipient and for the purpose of carrying out
    a program with respect to which the grant under subsection (a) of
    this section is made. The amount by which any such grant is so
    reduced shall be available for payment by the Secretary of the
    costs incurred in furnishing the supplies or equipment, or in
    detailing the personnel, on which the reduction of such grant is
    based, and such amount shall be deemed as part of the grant and
    shall be deemed to have been paid to the grant recipient.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 218, as added Pub. L. 102-573,
    title II, Sec. 214, Oct. 29, 1992, 106 Stat. 4556; amended Pub. L.
    103-437, Sec. 10(e)(1), (2)(B), Nov. 2, 1994, 108 Stat. 4589.)


-MISC1-
                                AMENDMENTS                            
      1994 - Subsec. (d)(4). Pub. L. 103-437 substituted "Committee on
    Indian" for "Select Committee on Indian" and "Natural Resources"
    for "Interior and Insular Affairs".

-CHANGE-
                              CHANGE OF NAME                          
      Centers for Disease Control changed to Centers for Disease
    Control and Prevention by Pub. L. 102-531, title III, Sec. 312,
    Oct. 27, 1992, 106 Stat. 3504.
      Committee on Energy and Commerce of House of Representatives
    treated as referring to Committee on Commerce of House of
    Representatives and Committee on Natural Resources of House of
    Representatives treated as referring to Committee on Resources of
    House of Representatives by section 1(a) of Pub. L. 104-14, set out
    as a note preceding section 21 of Title 2, The Congress. Committee
    on Commerce of House of Representatives changed to Committee on
    Energy and Commerce of House of Representatives, and jurisdiction
    over matters relating to securities and exchanges and insurance
    generally transferred to Committee on Financial Services of House
    of Representatives by House Resolution No. 5, One Hundred Seventh
    Congress, Jan. 3, 2001.

-End-



-CITE-
    25 USC Sec. 1621r                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621r. Contract health services payment study

-STATUTE-
    (a) Duty of Secretary
      The Secretary, acting through the Service and in consultation
    with representatives of Indian tribes and tribal organizations
    operating contract health care programs under the Indian Self-
    Determination Act (25 U.S.C. 450f et seq.) or under self-
    governance compacts, Service personnel, private contract health
    services providers, the Indian Health Service Fiscal Intermediary,
    and other appropriate experts, shall conduct a study - 
        (1) to assess and identify administrative barriers that hinder
      the timely payment for services delivered by private contract
      health services providers to individual Indians by the Service
      and the Indian Health Service Fiscal Intermediary;
        (2) to assess and identify the impact of such delayed payments
      upon the personal credit histories of individual Indians who have
      been treated by such providers; and
        (3) to determine the most efficient and effective means of
      improving the Service's contract health services payment system
      and ensuring the development of appropriate consumer protection
      policies to protect individual Indians who receive authorized
      services from private contract health services providers from
      billing and collection practices, including the development of
      materials and programs explaining patients' rights and
      responsibilities.
    (b) Functions of study
      The study required by subsection (a) of this section shall - 
        (1) assess the impact of the existing contract health services
      regulations and policies upon the ability of the Service and the
      Indian Health Service Fiscal Intermediary to process, on a timely
      and efficient basis, the payment of bills submitted by private
      contract health services providers;
        (2) assess the financial and any other burdens imposed upon
      individual Indians and private contract health services providers
      by delayed payments;
        (3) survey the policies and practices of collection agencies
      used by contract health services providers to collect payments
      for services rendered to individual Indians;
        (4) identify appropriate changes in Federal policies,
      administrative procedures, and regulations, to eliminate the
      problems experienced by private contract health services
      providers and individual Indians as a result of delayed payments;
      and
        (5) compare the Service's payment processing requirements with
      private insurance claims processing requirements to evaluate the
      systemic differences or similarities employed by the Service and
      private insurers.
    (c) Report to Congress
      Not later than 12 months after October 29, 1992, the Secretary
    shall transmit to the Congress a report that includes - 
        (1) a detailed description of the study conducted pursuant to
      this section; and
        (2) a discussion of the findings and conclusions of such study.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 219, as added Pub. L. 102-573,
    title II, Sec. 215, Oct. 29, 1992, 106 Stat. 4557.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-End-



-CITE-
    25 USC Sec. 1621s                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621s. Prompt action on payment of claims

-STATUTE-
    (a) Time of response
      The Service shall respond to a notification of a claim by a
    provider of a contract care service with either an individual
    purchase order or a denial of the claim within 5 working days after
    the receipt of such notification.
    (b) Failure to timely respond
      If the Service fails to respond to a notification of a claim in
    accordance with subsection (a) of this section, the Service shall
    accept as valid the claim submitted by the provider of a contract
    care service.
    (c) Time of payment
      The Service shall pay a completed contract care service claim
    within 30 days after completion of the claim.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 220, as added Pub. L. 102-573,
    title II, Sec. 215, Oct. 29, 1992, 106 Stat. 4558.)

-End-



-CITE-
    25 USC Sec. 1621t                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621t. Demonstration of electronic claims processing

-STATUTE-
      (a) Not later than June 15, 1993, the Secretary shall develop and
    implement, directly or by contract, 2 projects to demonstrate in a
    pilot setting the use of claims processing technology to improve
    the accuracy and timeliness of the billing for, and payment of,
    contract health services.
      (b) The Secretary shall conduct one of the projects authorized in
    subsection (a) of this section in the Service area served by the
    area office located in Phoenix, Arizona.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 221, as added Pub. L. 102-573,
    title II, Sec. 215, Oct. 29, 1992, 106 Stat. 4559.)

-End-



-CITE-
    25 USC Sec. 1621u                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621u. Liability for payment

-STATUTE-
      (a) A patient who receives contract health care services that are
    authorized by the Service shall not be liable for the payment of
    any charges or costs associated with the provision of such
    services.
      (b) The Secretary shall notify a contract care provider and any
    patient who receives contract health care services authorized by
    the Service that such patient is not liable for the payment of any
    charges or costs associated with the provision of such services.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 222, as added Pub. L. 102-573,
    title II, Sec. 215, Oct. 29, 1992, 106 Stat. 4559.)

-End-



-CITE-
    25 USC Sec. 1621v                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621v. Office of Indian Women's Health Care

-STATUTE-
      There is established within the Service an Office of Indian
    Women's Health Care to oversee efforts of the Service to monitor
    and improve the quality of health care for Indian women of all ages
    through the planning and delivery of programs administered by the
    Service, in order to improve and enhance the treatment models of
    care for Indian women.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 223, as added Pub. L. 102-573,
    title II, Sec. 216, Oct. 29, 1992, 106 Stat. 4559.)

-End-



-CITE-
    25 USC Sec. 1621w                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621w. Authorization of appropriations

-STATUTE-
      Except as provided in sections 1621h(m), 1621j, 1621l,
    1621m(b)(5), 1621n, and 1621o of this title, there are authorized
    to be appropriated such sums as may be necessary for each fiscal
    year through fiscal year 2000 to carry out this subchapter.

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 224, as added Pub. L. 102-573,
    title II, Sec. 217(a), Oct. 29, 1992, 106 Stat. 4559.)

-End-



-CITE-
    25 USC Sec. 1621x                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1621x. Limitation on use of funds

-STATUTE-
      Amounts appropriated to carry out this subchapter may not be used
    in a manner inconsistent with the Assisted Suicide Funding
    Restriction Act of 1997 [42 U.S.C. 14401 et seq.].

-SOURCE-
    (Pub. L. 94-437, title II, Sec. 225, as added Pub. L. 105-12, Sec.
    9(f), Apr. 30, 1997, 111 Stat. 27.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Assisted Suicide Funding Restriction Act of 1997, referred to
    in text, is Pub. L. 105-12, Apr. 30, 1997, 111 Stat. 23, which is
    classified principally to chapter 138 (Sec. 14401 et seq.) of Title
    42, The Public Health and Welfare. For complete classification of
    this Act to the Code, see Short Title note set out under section
    14401 of Title 42 and Tables.


-MISC1-
                              EFFECTIVE DATE                          
      Section effective Apr. 30, 1997, and applicable to Federal
    payments made pursuant to obligations incurred after Apr. 30, 1997,
    for items and services provided on or after such date, subject to
    also being applicable with respect to contracts entered into,
    renewed, or extended after Apr. 30, 1997, as well as contracts
    entered into before Apr. 30, 1997, to the extent permitted under
    such contracts, see section 11 of Pub. L. 105-12, set out as a note
    under section 14401 of Title 42, The Public Health and Welfare.

-End-



-CITE-
    25 USC Sec. 1622                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER II - HEALTH SERVICES

-HEAD-
    Sec. 1622. Transferred

-COD-
                               CODIFICATION                           
      Section, Pub. L. 94-437, title IV, Sec. 404, as added Pub. L. 96-
    537, Sec. 6, Dec. 17, 1980, 94 Stat. 3176, which related to grants
    to and contracts with tribal organizations, was transferred to
    section 1644 of this title.

-End-


-CITE-
    25 USC SUBCHAPTER III - HEALTH FACILITIES                   01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
                    SUBCHAPTER III - HEALTH FACILITIES                

-End-



-CITE-
    25 USC Sec. 1631                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1631. Consultation; closure of facilities; reports

-STATUTE-
    (a) Consultation; standards for accreditation
      Prior to the expenditure of, or the making of any firm commitment
    to expend, any funds appropriated for the planning, design,
    construction, or renovation of facilities pursuant to section 13 of
    this title, the Secretary, acting through the Service, shall - 
        (1) consult with any Indian tribe that would be significantly
      affected by such expenditure for the purpose of determining and,
      whenever practicable, honoring tribal preferences concerning
      size, location, type, and other characteristics of any facility
      on which such expenditure is to be made, and
        (2) ensure, whenever practicable, that such facility meets the
      standards of the Joint Commission on Accreditation of Health Care
      Organizations by not later than 1 year after the date on which
      the construction or renovation of such facility is completed.
    (b) Closure; report on proposed closure
      (1) Notwithstanding any provision of law other than this
    subsection, no Service hospital or outpatient health care facility
    of the Service, or any portion of such a hospital or facility, may
    be closed if the Secretary has not submitted to the Congress at
    least 1 year prior to the date such hospital or facility (or
    portion thereof) is proposed to be closed an evaluation of the
    impact of such proposed closure which specifies, in addition to
    other considerations - 
        (A) the accessibility of alternative health care resources for
      the population served by such hospital or facility;
        (B) the cost effectiveness of such closure;
        (C) the quality of health care to be provided to the population
      served by such hospital or facility after such closure;
        (D) the availability of contract health care funds to maintain
      existing levels of service;
        (E) the views of the Indian tribes served by such hospital or
      facility concerning such closure;
        (F) the level of utilization of such hospital or facility by
      all eligible Indians; and
        (G) the distance between such hospital or facility and the
      nearest operating Service hospital.

      (2) Paragraph (1) shall not apply to any temporary closure of a
    facility or of any portion of a facility if such closure is
    necessary for medical, environmental, or safety reasons.
    (c) Annual report on health facility priority system
      (1) The Secretary shall submit to the President, for inclusion in
    each report required to be transmitted to the Congress under
    section 1671 of this title, a report which sets forth - 
        (A) the current health facility priority system of the Service,
        (B) the planning, design, construction, and renovation needs
      for the 10 top-priority inpatient care facilities and the 10 top-
      priority ambulatory care facilities (together with required
      staff quarters),
        (C) the justification for such order of priority,
        (D) the projected cost of such projects, and
        (E) the methodology adopted by the Service in establishing
      priorities under its health facility priority system.

      (2) In preparing each report required under paragraph (1) (other
    than the initial report), the Secretary shall - 
        (A) consult with Indian tribes and tribal organizations
      including those tribes or tribal organizations operating health
      programs or facilities under any contract entered into with the
      Service under the Indian Self-Determination Act [25 U.S.C. 450f
      et seq.], and
        (B) review the needs of such tribes and tribal organizations
      for inpatient and outpatient facilities, including their needs
      for renovation and expansion of existing facilities.

      (3) For purposes of this subsection, the Secretary shall, in
    evaluating the needs of facilities operated under any contract
    entered into with the Service under the Indian Self-Determination
    Act, use the same criteria that the Secretary uses in evaluating
    the needs of facilities operated directly by the Service.
      (4) The Secretary shall ensure that the planning, design,
    construction, and renovation needs of Service and non-Service
    facilities which are the subject of a contract for health services
    entered into with the Service under the Indian Self-Determination
    Act are fully and equitably integrated into the development of the
    health facility priority system.
    (d) Funds appropriated subject to section 450f of this title
      All funds appropriated under section 13 of this title for the
    planning, design, construction, or renovation of health facilities
    for the benefit of an Indian tribe or tribes shall be subject to
    the provisions of section 102 of the Indian Self-Determination Act
    [25 U.S.C. 450f].

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 301, Sept. 30, 1976, 90 Stat.
    1406; Pub. L. 100-713, title III, Sec. 301, Nov. 23, 1988, 102
    Stat. 4812; Pub. L. 102-573, title III, Sec. 301, title IX, Sec.
    902(4)(B), Oct. 29, 1992, 106 Stat. 4560, 4591.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (c)(2)
    to (4), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206,
    as amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a)(2). Pub. L. 102-573, Sec. 301(1), substituted
    "Health Care Organizations" for "Hospitals".
      Subsec. (b)(1). Pub. L. 102-573, Sec. 301(2), struck out "other"
    before "outpatient health care facility" in introductory provisions
    and added subpars. (F) and (G).
      Subsec. (c). Pub. L. 102-573, Sec. 301(3), redesignated subsec.
    (d) as (c) and struck out former subsec. (c) which read as follows:
    "The President shall include with the budget submitted under
    section 1105 of title 31, for each of the fiscal years 1990, 1991,
    and 1992, program information documents for the construction of 10
    Indian health facilities which - 
        "(1) comply with applicable construction standards, and
        "(2) have been approved by the Secretary."
      Subsec. (c)(1). Pub. L. 102-573, Sec. 301(4), amended
    introductory provisions generally. Prior to amendment, introductory
    provisions read as follows: "The Secretary shall submit to the
    Congress an annual report which sets forth - ".
      Subsec. (c)(2) to (5). Pub. L. 102-573, Sec. 301(5), redesignated
    pars. (3) to (5) as (2) to (4), respectively, and struck out former
    par. (2) which read as follows: "The first report required under
    paragraph (1) shall be submitted by no later than the date that is
    180 days after November 23, 1988, and, beginning in 1990, each
    subsequent annual report shall be submitted by the date that is 60
    days after the date on which the President submits the budget to
    the Congress under section 1105 of title 31."
      Subsecs. (d), (e). Pub. L. 102-573, Secs. 301(3), 902(4)(B),
    redesignated subsec. (e) as (d) and substituted "section 102 of the
    Indian Self-Determination Act" for "sections 102 and 103(b) of the
    Indian Self-Determination Act". Former subsec. (d) redesignated
    (c).
      1988 - Pub. L. 100-713 amended section generally, substituting
    subsecs. (a) to (e) relating to consultation, closure of
    facilities, and reports for former subsecs. (a) to (c) relating to
    construction and renovation of Service facilities.

-End-



-CITE-
    25 USC Sec. 1632                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1632. Safe water and sanitary waste disposal facilities

-STATUTE-
    (a) Congressional findings
      The Congress hereby finds and declares that - 
        (1) the provision of safe water supply systems and sanitary
      sewage and solid waste disposal systems is primarily a health
      consideration and function;
        (2) Indian people suffer an inordinately high incidence of
      disease, injury, and illness directly attributable to the absence
      or inadequacy of such systems;
        (3) the long-term cost to the United States of treating and
      curing such disease, injury, and illness is substantially greater
      than the short-term cost of providing such systems and other
      preventive health measures;
        (4) many Indian homes and communities still lack safe water
      supply systems and sanitary sewage and solid waste disposal
      systems; and
        (5) it is in the interest of the United States, and it is the
      policy of the United States, that all Indian communities and
      Indian homes, new and existing, be provided with safe and
      adequate water supply systems and sanitary sewage waste disposal
      systems as soon as possible.
    (b) Authority; assistance; transfer of funds
      (1) In furtherance of the findings and declarations made in
    subsection (a) of this section, Congress reaffirms the primary
    responsibility and authority of the Service to provide the
    necessary sanitation facilities and services as provided in section
    2004a of title 42.
      (2) The Secretary, acting through the Service, is authorized to
    provide under section 2004a of title 42 - 
        (A) financial and technical assistance to Indian tribes and
      communities in the establishment, training, and equipping of
      utility organizations to operate and maintain Indian sanitation
      facilities;
        (B) ongoing technical assistance and training in the management
      of utility organizations which operate and maintain sanitation
      facilities; and
        (C) operation and maintenance assistance for, and emergency
      repairs to, tribal sanitation facilities when necessary to avoid
      a health hazard or to protect the Federal investment in
      sanitation facilities.

      (3) Notwithstanding any other provision of law - 
        (A) the Secretary of Housing and Urban Affairs is authorized to
      transfer funds appropriated under the Housing and Community
      Development Act of 1974 (42 U.S.C. 5301, et seq.) to the
      Secretary of Health and Human Services, and
        (B) the Secretary of Health and Human Services is authorized to
      accept and use such funds for the purpose of providing sanitation
      facilities and services for Indians under section 2004a of title
      42.
    (c) 10-year plan
      Beginning in fiscal year 1990, the Secretary, acting through the
    Service, shall develop and begin implementation of a 10-year plan
    to provide safe water supply and sanitation sewage and solid waste
    disposal facilities to existing Indian homes and communities and to
    new and renovated Indian homes.
    (d) Tribal capability
      The financial and technical capability of an Indian tribe or
    community to safely operate and maintain a sanitation facility
    shall not be a prerequisite to the provision or construction of
    sanitation facilities by the Secretary.
    (e) Amount of assistance
      (1) The Secretary is authorized to provide financial assistance
    to Indian tribes and communities in an amount equal to the Federal
    share of the costs of operating, managing, and maintaining the
    facilities provided under the plan described in subsection (c) of
    this section.
      (2) For the purposes of paragraph (1), the term "Federal share"
    means 80 percent of the costs described in paragraph (1).
      (3) With respect to Indian tribes with fewer than 1,000 enrolled
    members, the non-Federal portion of the costs of operating,
    managing, and maintaining such facilities may be provided, in part,
    through cash donations or in kind property, fairly evaluated.
    (f) Eligibility of programs administered by Indian tribes
      Programs administered by Indian tribes or tribal organizations
    under the authority of the Indian Self-Determination Act [25 U.S.C.
    450f et seq.] shall be eligible for - 
        (1) any funds appropriated pursuant to this section, and
        (2) any funds appropriated for the purpose of providing water
      supply or sewage disposal services,

    on an equal basis with programs that are administered directly by
    the Service.
    (g) Annual report; sanitation deficiency levels
      (1) The Secretary shall submit to the President, for inclusion in
    each report required to be transmitted to the Congress under
    section 1671 of this title, a report which sets forth - 
        (A) the current Indian sanitation facility priority system of
      the Service;
        (B) the methodology for determining sanitation deficiencies;
        (C) the level of sanitation deficiency for each sanitation
      facilities project of each Indian tribe or community;
        (D) the amount of funds necessary to raise all Indian tribes
      and communities to a level I sanitation deficiency; and
        (E) the amount of funds necessary to raise all Indian tribes
      and communities to zero sanitation deficiency.

      (2) In preparing each report required under paragraph (1) (other
    than the initial report), the Secretary shall consult with Indian
    tribes and tribal organizations (including those tribes or tribal
    organizations operating health care programs or facilities under
    any contract entered into with the Service under the Indian Self-
    Determination Act [25 U.S.C. 450f et seq.]) to determine the
    sanitation needs of each tribe.
      (3) The methodology used by the Secretary in determining
    sanitation deficiencies for purposes of paragraph (1) shall be
    applied uniformly to all Indian tribes and communities.
      (4) For purposes of this subsection, the sanitation deficiency
    levels for an Indian tribe or community are as follows:
        (A) level I is an Indian tribe or community with a sanitation
      system - 
          (i) which complies with all applicable water supply and
        pollution control laws, and
          (ii) in which the deficiencies relate to routine replacement,
        repair, or maintenance needs;

        (B) level II is an Indian tribe or community with a sanitation
      system - 
          (i) which complies with all applicable water supply and
        pollution control laws, and
          (ii) in which the deficiencies relate to capital improvements
        that are necessary to improve the facilities in order to meet
        the needs of such tribe or community for domestic sanitation
        facilities;

        (C) level III is an Indian tribe or community with a sanitation
      system which - 
          (i) has an inadequate or partial water supply and a sewage
        disposal facility that does not comply with applicable water
        supply and pollution control laws, or
          (ii) has no solid waste disposal facility;

        (D) level IV is an Indian tribe or community with a sanitation
      system which lacks either a safe water supply system or a sewage
      disposal system; and
        (E) level V is an Indian tribe or community that lacks a safe
      water supply and a sewage disposal system.

      (5) For purposes of this subsection, any Indian tribe or
    community that lacks the operation and maintenance capability to
    enable its sanitation system to meet pollution control laws may not
    be treated as having a level I or II sanitation deficiency.

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 302, Sept. 30, 1976, 90 Stat.
    1407; Pub. L. 100-713, title III, Sec. 302, Nov. 23, 1988, 102
    Stat. 4814; Pub. L. 102-573, title III, Secs. 302, 307(b)(1), Oct.
    29, 1992, 106 Stat. 4560, 4564.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Housing and Community Development Act of 1974, referred to in
    subsec. (b)(3)(A), is Pub. L. 93-383, Aug. 22, 1974, 88 Stat. 633,
    as amended. For complete classification of this Act to the Code,
    see Short Title note set out under section 5301 of Title 42, The
    Public Health and Welfare, and Tables.
      The Indian Self-Determination Act, referred to in subsecs. (f)
    and (g)(2), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat.
    2206, as amended, which is classified principally to part A (Sec.
    450f et seq.) of subchapter II of chapter 14 of this title. For
    complete classification of this Act to the Code, see Short Title
    note set out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (e). Pub. L. 102-573, Sec. 302(1), amended subsec.
    (e) generally. Prior to amendment, subsec. (e) read as follows:
    "The provisions of this section shall not diminish the primary
    responsibility of the Indian family, community, or tribe to
    establish, collect, and utilize reasonable user fees, or otherwise
    set aside funding, for the purpose of operating and maintaining
    sanitation facilities."
      Subsec. (f)(1). Pub. L. 102-573, Sec. 302(2), substituted "this
    section" for "subsection (h) of this section".
      Subsec. (g)(1). Pub. L. 102-573, Sec. 302(3)(A), substituted "The
    Secretary shall submit to the President, for inclusion in each
    report required to be transmitted to the Congress under section
    1671 of this title, a report" for "The Secretary shall submit to
    the Congress an annual report".
      Subsec. (g)(2) to (6). Pub. L. 102-573, Sec. 302(3)(B),
    redesignated pars. (3) to (6) as (2) to (5), respectively, and
    struck out former par. (2) which read as follows: "The first report
    required under paragraph (1) shall be submitted by no later than
    the date that is 180 days after November 23, 1988, and, beginning
    in 1990, each subsequent annual report shall be submitted by the
    date that is 60 days after the date on which the President submits
    the budget to the Congress under section 1105 of title 31."
      Subsec. (h). Pub. L. 102-573, Sec. 307(b)(1), struck out subsec.
    (h) which authorized appropriations to carry out subsec. (b)(2) for
    fiscal years 1990 to 1992.
      1988 - Pub. L. 100-713 amended section generally, substituting
    subsecs. (a) to (h) relating to safe water and sanitary waste
    disposal facilities for former subsecs. (a) to (c) relating to
    construction of safe water and sanitary waste disposal facilities.

-End-



-CITE-
    25 USC Sec. 1633                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1633. Preferences to Indians and Indian firms

-STATUTE-
    (a) Discretionary authority; covered activities
      The Secretary, acting through the Service, may utilize the
    negotiating authority of section 47 of this title, to give
    preference to any Indian or any enterprise, partnership,
    corporation, or other type of business organization owned and
    controlled by an Indian or Indians including former or currently
    federally recognized Indian tribes in the State of New York
    (hereinafter referred to as an "Indian firm") in the construction
    and renovation of Service facilities pursuant to section 1631 of
    this title and in the construction of safe water and sanitary waste
    disposal facilities pursuant to section 1632 of this title. Such
    preference may be accorded by the Secretary unless he finds,
    pursuant to rules and regulations promulgated by him, that the
    project or function to be contracted for will not be satisfactory
    or such project or function cannot be properly completed or
    maintained under the proposed contract. The Secretary, in arriving
    at his finding, shall consider whether the Indian or Indian firm
    will be deficient with respect to (1) ownership and control by
    Indians, (2) equipment, (3) bookkeeping and accounting procedures,
    (4) substantive knowledge of the project or function to be
    contracted for, (5) adequately trained personnel, or (6) other
    necessary components of contract performance.
    (b) Pay rates
      For the purpose of implementing the provisions of this
    subchapter, the Secretary shall assure that the rates of pay for
    personnel engaged in the construction or renovation of facilities
    constructed or renovated in whole or in part by funds made
    available pursuant to this subchapter are not less than the
    prevailing local wage rates for similar work as determined in
    accordance with sections 3141-3144, 3146, and 3147 of title 40.

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 303, Sept. 30, 1976, 90 Stat.
    1407.)

-COD-
                               CODIFICATION                           
      "Sections 3141-3144, 3146, and 3147 of title 40" substituted in
    subsec. (b) for "the Act of March 3, 1931 (40 U.S.C. 276a - 276a-5,
    known as the Davis-Bacon Act)" on authority of Pub. L. 107-217,
    Sec. 5(c), Aug. 21, 2002, 116 Stat. 1303, the first section of
    which enacted Title 40, Public Buildings, Property, and Works.

-End-



-CITE-
    25 USC Sec. 1634                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1634. Expenditure of non-Service funds for renovation

-STATUTE-
    (a) Authority of Secretary
      (1) Notwithstanding any other provision of law, the Secretary is
    authorized to accept any major renovation or modernization by any
    Indian tribe of any Service facility, or of any other Indian health
    facility operated pursuant to a contract entered into under the
    Indian Self-Determination Act [25 U.S.C. 450f et seq.], including -
    
        (A) any plans or designs for such renovation or modernization;
      and
        (B) any renovation or modernization for which funds
      appropriated under any Federal law were lawfully expended,

    but only if the requirements of subsection (b) of this section are
    met.
      (2) The Secretary shall maintain a separate priority list to
    address the needs of such facilities for personnel or equipment.
      (3) The Secretary shall submit to the President, for inclusion in
    each report required to be transmitted to the Congress under
    section 1671 of this title, the priority list maintained pursuant
    to paragraph (2).
    (b) Requirements
      The requirements of this subsection are met with respect to any
    renovation or modernization if - 
        (1) the tribe or tribal organization - 
          (A) provides notice to the Secretary of its intent to
        renovate or modernize; and
          (B) applies to the Secretary to be placed on a separate
        priority list to address the needs of such new facilities for
        personnel or equipment; and

        (2) the renovation or modernization - 
          (A) is approved by the appropriate area director of the
        Service; and
          (B) is administered by the tribe in accordance with the rules
        and regulations prescribed by the Secretary with respect to
        construction or renovation of Service facilities.
    (c) Recovery for non-use as Service facility
      If any Service facility which has been renovated or modernized by
    an Indian tribe under this section ceases to be used as a Service
    facility during the 20-year period beginning on the date such
    renovation or modernization is completed, such Indian tribe shall
    be entitled to recover from the United States an amount which bears
    the same ratio to the value of such facility at the time of such
    cessation as the value of such renovation or modernization (less
    the total amount of any funds provided specifically for such
    facility under any Federal program that were expended for such
    renovation or modernization) bore to the value of such facility at
    the time of the completion of such renovation or modernization.

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 305, as added Pub. L. 96-537, Sec.
    5, Dec. 17, 1980, 94 Stat. 3175; amended Pub. L. 100-713, title
    III, Sec. 303(a), Nov. 23, 1988, 102 Stat. 4816; Pub. L. 102-573,
    title III, Sec. 305, Oct. 29, 1992, 106 Stat. 4563.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a)(1),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573 amended section generally, substituting
    present provisions for former provisions which related to: in
    subsec. (a), authority of Secretary; in subsec. (b), requirements;
    in subsec. (c), higher priority project; and in subsec. (d),
    recovery for non-use as Service facility.
      1988 - Pub. L. 100-713 amended section generally, substituting
    "Expenditure of non-Service funds for renovation" for
    "Authorization of appropriations" in section catchline and subsecs.
    (a) to (d) for former single unlettered par.

-End-



-CITE-
    25 USC Sec. 1635                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1635. Repealed.

-MISC1-
    Sec. 1635. Repealed. Pub. L. 100-713, title III, Sec. 303(b), Nov.
      23, 1988, 102 Stat. 4817.
      Section, Pub. L. 98-473, title I, Sec. 101(c) [title II, Sec.
    201], Oct. 12, 1984, 98 Stat. 1837, 1865, related to renovation and
    modernization of facilities.

-End-



-CITE-
    25 USC Sec. 1636                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1636. Grant program for construction, expansion, and
      modernization of small ambulatory care facilities

-STATUTE-
    (a) Authorization
      (1) The Secretary, acting through the Service, shall make grants
    to tribes and tribal organizations for the construction, expansion,
    or modernization of facilities for the provision of ambulatory care
    services to eligible Indians (and noneligible persons as provided
    in subsection (c)(1)(C) of this section). A grant made under this
    section may cover up to 100 percent of the costs of such
    construction, expansion, or modernization. For the purposes of this
    section, the term "construction" includes the replacement of an
    existing facility.
      (2) A grant under paragraph (1) may only be made to a tribe or
    tribal organization operating an Indian health facility (other than
    a facility owned or constructed by the Service, including a
    facility originally owned or constructed by the Service and
    transferred to a tribe or tribal organization) pursuant to a
    contract entered into under the Indian Self-Determination Act [25
    U.S.C. 450f et seq.].
    (b) Use of grant
      (1) A grant provided under this section may be used only for the
    construction, expansion, or modernization (including the planning
    and design of such construction, expansion, or modernization) of an
    ambulatory care facility - 
        (A) located apart from a hospital;
        (B) not funded under section 1631 of this title or section 1637
      of this title; and
        (C) which, upon completion of such construction, expansion, or
      modernization will - 
          (i) have a total capacity appropriate to its projected
        service population;
          (ii) serve no less than 500 eligible Indians annually; and
          (iii) provide ambulatory care in a service area (specified in
        the contract entered into under the Indian Self-Determination
        Act [25 U.S.C. 450f et seq.]) with a population of not less
        than 2,000 eligible Indians.

      (2) The requirements of clauses (ii) and (iii) of paragraph
    (1)(C) shall not apply to a tribe or tribal organization applying
    for a grant under this section whose tribal government offices are
    located on an island.
    (c) Application for grant
      (1) No grant may be made under this section unless an application
    for such a grant has been submitted to and approved by the
    Secretary. An application for a grant under this section shall be
    submitted in such form and manner as the Secretary shall by
    regulation prescribe and shall set forth reasonable assurance by
    the applicant that, at all times after the construction, expansion,
    or modernization of a facility carried out pursuant to a grant
    received under this section - 
        (A) adequate financial support will be available for the
      provision of services at such facility;
        (B) such facility will be available to eligible Indians without
      regard to ability to pay or source of payment; and
        (C) such facility will, as feasible without diminishing the
      quality or quantity of services provided to eligible Indians,
      serve noneligible persons on a cost basis.

      (2) In awarding grants under this section, the Secretary shall
    give priority to tribes and tribal organizations that demonstrate -
    
        (A) a need for increased ambulatory care services; and
        (B) insufficient capacity to deliver such services.
    (d) Transfer of interest to United States upon cessation of
      facility
      If any facility (or portion thereof) with respect to which funds
    have been paid under this section, ceases, at any time after
    completion of the construction, expansion, or modernization carried
    out with such funds, to be utilized for the purposes of providing
    ambulatory care services to eligible Indians, all of the right,
    title, and interest in and to such facility (or portion thereof)
    shall transfer to the United States.

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 306, as added Pub. L. 100-713,
    title III, Sec. 304, Nov. 23, 1988, 102 Stat. 4817; amended Pub. L.
    102-573, title III, Sec. 303, Oct. 29, 1992, 106 Stat. 4561.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsecs. (a)(2)
    and (b)(1)(C)(iii), is title I of Pub. L. 93-638, Jan. 4, 1975, 88
    Stat. 2206, as amended, which is classified principally to part A
    (Sec. 450f et seq.) of subchapter II of chapter 14 of this title.
    For complete classification of this Act to the Code, see Short
    Title note set out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573 amended section generally, substituting
    provisions relating to grant program for construction, expansion,
    and modernization of small ambulatory care facilities for
    provisions relating to conveyance of certain real property under
    Alaska Native Claims Settlement Act.

-End-



-CITE-
    25 USC Sec. 1637                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1637. Indian health care delivery demonstration project

-STATUTE-
    (a) Health care delivery demonstration projects
      The Secretary, acting through the Service, is authorized to enter
    into contracts with, or make grants to, Indian tribes or tribal
    organizations for the purpose of carrying out a health care
    delivery demonstration project to test alternative means of
    delivering health care and services through health facilities to
    Indians.
    (b) Use of funds
      The Secretary, in approving projects pursuant to this section,
    may authorize funding for the construction and renovation of
    hospitals, health centers, health stations, and other facilities to
    deliver health care services and is authorized to - 
        (1) waive any leasing prohibition;
        (2) permit carryover of funds appropriated for the provision of
      health care services;
        (3) permit the use of non-Service Federal funds and non-Federal
      funds;
        (4) permit the use of funds or property donated from any source
      for project purposes; and
        (5) provide for the reversion of donated real or personal
      property to the donor.
    (c) Criteria
      (1) Within 180 days after November 28, 1990, the Secretary, after
    consultation with Indian tribes and tribal organizations, shall
    develop and publish in the Federal Register criteria for the review
    and approval of applications submitted under this section. The
    Secretary may enter into a contract or award a grant under this
    section for projects which meet the following criteria:
        (A) There is a need for a new facility or program or the
      reorientation of an existing facility or program.
        (B) A significant number of Indians, including those with low
      health status, will be served by the project.
        (C) The project has the potential to address the health needs
      of Indians in an innovative manner.
        (D) The project has the potential to deliver services in an
      efficient and effective manner.
        (E) The project is economically viable.
        (F) The Indian tribe or tribal organization has the
      administrative and financial capability to administer the
      project.
        (G) The project is integrated with providers of related health
      and social services and is coordinated with, and avoids
      duplication of, existing services.

      (2) The Secretary may provide for the establishment of peer
    review panels, as necessary, to review and evaluate applications
    and to advise the Secretary regarding such applications using the
    criteria developed pursuant to paragraph (1).
      (3)(A) On or before September 30, 1995, the Secretary shall enter
    into contracts or award grants under this section for a
    demonstration project in each of the following service units which
    meets the criteria specified in paragraph (1) and for which a
    completed application has been received by the Secretary:
        (i) Cass Lake, Minnesota.
        (ii) Clinton, Oklahoma.
        (iii) Harlem, Montana.
        (iv) Mescalero, New Mexico.
        (v) Owyhee, Nevada.
        (vi) Parker, Arizona.
        (vii) Schurz, Nevada.
        (viii) Winnebago, Nebraska.
        (ix) Ft. Yuma, California.

      (B) The Secretary may also enter into contracts or award grants
    under this section taking into consideration applications received
    under this section from all service areas. The Secretary may not
    award a greater number of such contracts or grants in one service
    area than in any other service area until there is an equal number
    of such contracts or grants awarded with respect to all service
    areas from which the Secretary receives applications during the
    application period (as determined by the Secretary) which meet the
    criteria specified in paragraph (1).
    (d) Technical assistance
      The Secretary shall provide such technical and other assistance
    as may be necessary to enable applicants to comply with the
    provisions of this section.
    (e) Service to ineligible persons
      The authority to provide services to persons otherwise ineligible
    for the health care benefits of the Service and the authority to
    extend hospital privileges in service facilities to non-Service
    health care practitioners as provided in section 1680c of this
    title may be included, subject to the terms of such section, in any
    demonstration project approved pursuant to this section.
    (f) Equitable treatment
      For purposes of subsection (c)(1)(A) of this section, the
    Secretary shall, in evaluating facilities operated under any
    contract entered into with the Service under the Indian Self-
    Determination Act [25 U.S.C. 450f et seq.], use the same criteria
    that the Secretary uses in evaluating facilities operated directly
    by the Service.
    (g) Equitable integration of facilities
      The Secretary shall ensure that the planning, design,
    construction, and renovation needs of Service and non-Service
    facilities which are the subject of a contract for health services
    entered into with the Service under the Indian Self-Determination
    Act [25 U.S.C. 450f et seq.], are fully and equitably integrated
    into the implementation of the health care delivery demonstration
    projects under this section.
    (h) Report to Congress
      (1) The Secretary shall submit to the President, for inclusion in
    the report which is required to be submitted to the Congress under
    section 1671 of this title for fiscal year 1997, an interim report
    on the findings and conclusions derived from the demonstration
    projects established under this section.
      (2) The Secretary shall submit to the President, for inclusion in
    the report which is required to be submitted to the Congress under
    section 1671 of this title for fiscal year 1999, a final report on
    the findings and conclusions derived from the demonstration
    projects established under this section, together with legislative
    recommendations.

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 307, as added Pub. L. 101-630,
    title V, Sec. 504, Nov. 28, 1990, 104 Stat. 4562; amended Pub. L.
    102-573, title III, Secs. 304, 307(b)(2), title VII, Sec.
    701(c)(2), title IX, Sec. 902(4)(A), Oct. 29, 1992, 106 Stat. 4562,
    4564, 4572, 4591.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsecs. (f)
    and (g), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206,
    as amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 902(4)(A), made technical amendment
    to section catchline.
      Subsec. (c)(1)(A). Pub. L. 102-573, Sec. 304(a)(1), inserted "or
    program" after "facility" in two places.
      Subsec. (c)(3)(A). Pub. L. 102-573, Sec. 304(a)(2), substituted
    "On or before September 30, 1995, the" for "The" and inserted "and
    for which a completed application has been received by the
    Secretary" after "paragraph (1)".
      Subsec. (c)(3)(B). Pub. L. 102-573, Sec. 304(a)(3), which
    directed amendment of subsec. (c) by striking subpar. (B) and
    inserting a new subpar. (B), was executed by making the amendment
    in par. (3) of subsec. (c) to reflect the probable intent of
    Congress. Prior to amendment, subpar. (B) read as follows: "After
    entering into contracts or awarding grants in accordance with
    subparagraph (A), and taking into account contracts entered into
    and grants awarded under such subparagraph, the Secretary may only
    enter into one contract or award one grant under this subsection
    with respect to a service area until the Secretary has entered into
    contracts or awarded grants for all service areas with respect to
    which the Secretary receives applications during the application
    period, as determined by the Secretary, which meet the criteria
    developed under paragraph (1)."
      Subsec. (e). Pub. L. 102-573, Sec. 701(c)(2), made technical
    amendment to the reference to section 1680c of this title to
    reflect renumbering of corresponding section of original act.
      Subsec. (h). Pub. L. 102-573, Sec. 304(b), amended subsec. (h)
    generally. Prior to amendment, subsec. (h) read as follows: "Within
    90 days after the end of the period set out in subsection (a) of
    this section, the Secretary shall prepare and submit to Congress a
    report, together with legislative recommendations, on the findings
    and conclusions derived from the demonstration projects."
      Subsec. (i). Pub. L. 102-573, Sec. 307(b)(2), struck out subsec.
    (i) which authorized appropriation of such sums as necessary for
    fiscal years 1991 and 1992 for purpose of carrying out this
    section.

-End-



-CITE-
    25 USC Sec. 1638                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1638. Land transfer

-STATUTE-
      The Bureau of Indian Affairs is authorized to transfer, at no
    cost, up to 5 acres of land at the Chemawa Indian School, Salem,
    Oregon, to the Service for the provision of health care services.
    The land authorized to be transferred by this section is that land
    adjacent to land under the jurisdiction of the Service and occupied
    by the Chemawa Indian Health Center.

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 308, as added Pub. L. 102-573,
    title III, Sec. 306, Oct. 29, 1992, 106 Stat. 4564.)

-End-



-CITE-
    25 USC Sec. 1638a                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1638a. Authorization of appropriations

-STATUTE-
      There are authorized to be appropriated such sums as may be
    necessary for each fiscal year through fiscal year 2000 to carry
    out this subchapter.

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 309, as added Pub. L. 102-573,
    title III, Sec. 307(a), Oct. 29, 1992, 106 Stat. 4564.)

-End-



-CITE-
    25 USC Sec. 1638b                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1638b. Applicability of Buy American requirement

-STATUTE-
    (a) Duty of Secretary
      The Secretary shall ensure that the requirements of the Buy
    American Act [41 U.S.C. 10a et seq.] apply to all procurements made
    with funds provided pursuant to the authorization contained in
    section 1638a of this title.
    (b) Report to Congress
      The Secretary shall submit to the Congress a report on the amount
    of procurements from foreign entities made in fiscal years 1993 and
    1994 with funds provided pursuant to the authorization contained in
    section 1638a of this title. Such report shall separately indicate
    the dollar value of items procured with such funds for which the
    Buy American Act [41 U.S.C. 10a et seq.] was waived pursuant to the
    Trade Agreement Act of 1979 or any international agreement to which
    the United States is a party.
    (c) Fraudulent use of Made-in-America label
      If it has been finally determined by a court or Federal agency
    that any person intentionally affixed a label bearing a "Made in
    America" inscription, or any inscription with the same meaning, to
    any product sold in or shipped to the United States that is not
    made in the United States, such person shall be ineligible to
    receive any contract or subcontract made with funds provided
    pursuant to the authorization contained in section 1638a of this
    title, pursuant to the debarment, suspension, and ineligibility
    procedures described in sections 9.400 through 9.409 of title 48,
    Code of Federal Regulations.
    (d) "Buy American Act" defined
      For purposes of this section, the term "Buy American Act" means
    title III of the Act entitled "An Act making appropriations for the
    Treasury and Post Office Departments for the fiscal year ending
    June 30, 1934, and for other purposes", approved March 3, 1933 (41
    U.S.C. 10a et seq.).

-SOURCE-
    (Pub. L. 94-437, title III, Sec. 310, as added Pub. L. 102-573,
    title III, Sec. 308, Oct. 29, 1992, 106 Stat. 4564.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Buy American Act, referred to in subsecs. (a), (b), and (d),
    is title III of act Mar. 3, 1933, ch. 212, 47 Stat. 1520, as
    amended, which is classified generally to sections 10a, 10b, and
    10c of Title 41, Public Contracts. For complete classification of
    this Act to the Code, see Short Title note set out under section
    10a of Title 41 and Tables.
      The Trade Agreement Act of 1979, referred to in subsec. (b),
    probably means the Trade Agreements Act of 1979, Pub. L. 96-39,
    July 26, 1979, 93 Stat. 144, as amended. For complete
    classification of this Act to the Code, see References in Text note
    set out under section 2501 of Title 19, Customs Duties, and Tables.

-End-



-CITE-
    25 USC Sec. 1638c                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1638c. Contracts for personal services in Indian Health
      Service facilities

-STATUTE-
      In fiscal year 1995 and thereafter (a) the Secretary may enter
    into personal services contracts with entities, either individuals
    or organizations, for the provision of services in facilities
    owned, operated or constructed under the jurisdiction of the Indian
    Health Service; (b) the Secretary may exempt such a contract from
    competitive contracting requirements upon adequate notice of
    contracting opportunities to individuals and organizations residing
    in the geographic vicinity of the health facility; (c)
    consideration of individuals and organizations shall be based
    solely on the qualifications established for the contract and the
    proposed contract price; and (d) individuals providing health care
    services pursuant to these contracts are covered by the Federal
    Tort Claims Act.

-SOURCE-
    (Pub. L. 103-332, title II, Sept. 30, 1994, 108 Stat. 2530.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Federal Tort Claims Act, referred to in text, is title IV of
    act Aug. 2, 1946, ch. 753, 60 Stat. 842, which was classified
    principally to chapter 20 (Secs. 921, 922, 931-934, 941-946) of
    former Title 28, Judicial Code and Judiciary. Title IV of act Aug.
    2, 1946, was substantially repealed and reenacted as sections
    1346(b) and 2671 et seq. of Title 28, Judiciary and Judicial
    Procedure, by act June 25, 1948, ch. 646, 62 Stat. 992, the first
    section of which enacted Title 28. The Federal Tort Claims Act is
    also commonly used to refer to chapter 171 of Title 28, Judiciary
    and Judicial Procedure. For complete classification of title IV to
    the Code, see Tables. For distribution of former sections of Title
    28 into the revised Title 28, see Table at the beginning of Title
    28.

-COD-
                               CODIFICATION                           
      Section was enacted as part of the Department of the Interior and
    Related Agencies Appropriations Act, 1995, and not as part of the
    Indian Health Care Improvement Act which comprises this chapter.

-End-



-CITE-
    25 USC Sec. 1638d                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III - HEALTH FACILITIES

-HEAD-
    Sec. 1638d. Credit to appropriations of money collected for meals
      at Indian Health Service facilities

-STATUTE-
      Money before, on, and after September 30, 1994, collected for
    meals served at Indian Health Service facilities will be credited
    to the appropriations from which the services were furnished and
    shall be credited to the appropriation when received.

-SOURCE-
    (Pub. L. 103-332, title II, Sept. 30, 1994, 108 Stat. 2530.)

-COD-
                               CODIFICATION                           
      Section was enacted as part of the Department of the Interior and
    Related Agencies Appropriations Act, 1995, and not as part of the
    Indian Health Care Improvement Act which comprises this chapter.

-End-


-CITE-
    25 USC SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES         01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES

-HEAD-
               SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES           

-COD-
                               CODIFICATION                           
      This subchapter was in the original title IV of Pub. L. 94-437,
    as amended. Prior to amendment by Pub. L. 102-573, title IV enacted
    section 1622 of this title and sections 1395qq and 1396j of Title
    42, The Public Health and Welfare, amended sections 1395f, 1395n,
    and 1396d of Title 42, and enacted provisions set out as notes
    under section 1671 of this title and sections 1395qq and 1396j of
    Title 42.

-End-



-CITE-
    25 USC Sec. 1641                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES

-HEAD-
    Sec. 1641. Treatment of payments under medicare program

-STATUTE-
    (a) Determination of appropriations
      Any payments received by a hospital or skilled nursing facility
    of the Service (whether operated by the Service or by an Indian
    tribe or tribal organization pursuant to a contract under the
    Indian Self-Determination Act [25 U.S.C. 450f et seq.]) for
    services provided to Indians eligible for benefits under title
    XVIII of the Social Security Act [42 U.S.C. 1395 et seq.] shall not
    be considered in determining appropriations for health care and
    services to Indians.
    (b) Preferences
      Nothing in this chapter authorizes the Secretary to provide
    services to an Indian beneficiary with coverage under title XVIII
    of the Social Security Act [42 U.S.C. 1395 et seq.], as amended, in
    preference to an Indian beneficiary without such coverage.

-SOURCE-
    (Pub. L. 94-437, title IV, Sec. 401, Sept. 30, 1976, 90 Stat. 1408;
    Pub. L. 102-573, title IV, Sec. 401(a), Oct. 29, 1992, 106 Stat.
    4565.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.
      The Social Security Act, referred to in subsecs. (a) and (b), is
    act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XVIII
    of the Act is classified generally to subchapter XVIII (Sec. 1395
    et seq.) of chapter 7 of Title 42, The Public Health and Welfare.
    For complete classification of this Act to the Code, see section
    1305 of Title 42 and Tables.

-COD-
                               CODIFICATION                           
      Prior to general amendment by Pub. L. 102-573, section 401 of
    Pub. L. 94-437, in subsec. (a) amended sections 1395f and 1395n of
    Title 42, The Public Health and Welfare, in subsec. (b) enacted
    section 1395qq of Title 42, and in subsecs. (c) and (d) enacted
    provisions set out as notes under section 1395qq of Title 42 which
    were restated in this section.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573 amended section generally, substituting
    subsecs. (a) and (b) for former subsecs. (a) to (d). See
    Codification note above.

-End-



-CITE-
    25 USC Sec. 1642                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES

-HEAD-
    Sec. 1642. Treatment of payments under medicaid program

-STATUTE-
    (a) Payments to special fund
      Notwithstanding any other provision of law, payments to which any
    facility of the Service (including a hospital, nursing facility,
    intermediate care facility for the mentally retarded, or any other
    type of facility which provides services for which payment is
    available under title XIX of the Social Security Act [42 U.S.C.
    1396 et seq.]) is entitled under a State plan by reason of section
    1911 of such Act [42 U.S.C. 1396j] shall be placed in a special
    fund to be held by the Secretary and used by him (to such extent or
    in such amounts as are provided in appropriation Acts) exclusively
    for the purpose of making any improvements in the facilities of
    such Service which may be necessary to achieve compliance with the
    applicable conditions and requirements of such title. In making
    payments from such fund, the Secretary shall ensure that each
    service unit of the Service receives at least 80 percent of the
    amounts to which the facilities of the Service, for which such
    service unit makes collections, are entitled by reason of section
    1911 of the Social Security Act.
    (b) Determination of appropriations
      Any payments received by such facility for services provided to
    Indians eligible for benefits under title XIX of the Social
    Security Act [42 U.S.C. 1396 et seq.] shall not be considered in
    determining appropriations for the provision of health care and
    services to Indians.

-SOURCE-
    (Pub. L. 94-437, title IV, Sec. 402, Sept. 30, 1976, 90 Stat. 1409;
    Pub. L. 100-713, title IV, Sec. 401(a), (b), Nov. 23, 1988, 102
    Stat. 4818; Pub. L. 102-573, title IV, Sec. 401(b)(1), Oct. 29,
    1992, 106 Stat. 4565.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Social Security Act, referred to in text, is act Aug. 14,
    1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the Act is
    classified generally to subchapter XIX (Sec. 1396 et seq.) of
    chapter 7 of Title 42, The Public Health and Welfare. For complete
    classification of this Act to the Code, see section 1305 of Title
    42 and Tables.

-COD-
                               CODIFICATION                           
      Prior to general amendment by Pub. L. 102-573, section 402 of
    Pub. L. 94-437, in subsec. (a) enacted section 1396j of Title 42,
    The Public Health and Welfare, in subsecs. (b) to (d) enacted
    provisions set out as notes under section 1396j of Title 42 (of
    which subsecs. (c) and (d) were restated in this section), and in
    subsec. (e) amended section 1396d of Title 42.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573 amended section generally, substituting
    subsecs. (a) and (b) for former subsecs. (a) to (e). See
    Codification note above.
      1988 - Subsec. (b). Pub. L. 100-713, Sec. 401(b), struck out
    subsec. (b) which authorized Secretary of Health and Human Services
    to enter into agreements to reimburse State agencies for health
    care and services provided in Indian Health Service facilities to
    Indians eligible for medical assistance under title XIX of the
    Social Security Act.
      Subsec. (c). Pub. L. 100-713, Sec. 401(a), substituted "skilled
    nursing facility, or any other type of facility which provides
    services of a type otherwise covered under a State plan for medical
    assistance approved under title XIX of the Social Security Act" for
    "or skilled nursing facility", "such a State plan" for "a State
    plan approved under title XIX of the Social Security Act", and "In
    making payments from such fund, the Secretary shall ensure that
    each service unit of the Indian Health Service receives at least 50
    percent of the amounts to which the facilities of the Indian Health
    Service, for which such service unit makes collections, are
    entitled by reason of section 1911 of the Social Security Act, if
    such amount is necessary for the purpose of making improvements in
    such facilities in order to achieve compliance with the conditions
    and requirements of title XIX of the Social Security Act. This
    subsection shall" for "The preceding sentence shall".

                     EFFECTIVE DATE OF 1992 AMENDMENT                 
      Section 401(b)(2) of Pub. L. 102-573 provided that: "The increase
    (from 50 percent) in the percentage of the payments from the fund
    to be made to each service unit of the Service specified in the
    amendment made by paragraph (1) [amending this section] shall take
    effect beginning with payments made on January 1, 1993."

                     EFFECTIVE DATE OF 1988 AMENDMENT                 
      Section 401(c) of Pub. L. 100-713 provided that: "The amendments
    made by this section [amending this section] shall apply to
    services performed on or after the date of the enactment of this
    Act [Nov. 23, 1988]."

-End-



-CITE-
    25 USC Sec. 1643                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES

-HEAD-
    Sec. 1643. Amount and use of funds reimbursed through medicare and
      medicaid available to Indian Health Service

-STATUTE-
      The Secretary shall submit to the President, for inclusion in the
    report required to be transmitted to the Congress under section
    1671 of this title, an accounting on the amount and use of funds
    made available to the Service pursuant to this subchapter as a
    result of reimbursements through titles XVIII and XIX of the Social
    Security Act, as amended [42 U.S.C. 1395 et seq., 1396 et seq.].

-SOURCE-
    (Pub. L. 94-437, title IV, Sec. 403, Sept. 30, 1976, 90 Stat. 1410;
    Pub. L. 102-573, title IV, Sec. 402, Oct. 29, 1992, 106 Stat.
    4566.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Social Security Act, referred to in text, is act Aug. 14,
    1935, ch. 531, 49 Stat. 620, as amended. Titles XVIII and XIX of
    the Act are classified generally to subchapters XVIII (Sec. 1395 et
    seq.) and XIX (Sec. 1396 et seq.) of chapter 7 of Title 42, The
    Public Health and Welfare. For complete classification of this Act
    to the Code, see section 1305 of Title 42 and Tables.

-COD-
                               CODIFICATION                           
      Section was formerly set out as a note under section 1671 of this
    title.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573 substituted "The Secretary shall submit to
    the President, for inclusion in the report required to be
    transmitted to the Congress under section 1671 of this title," for
    "The Secretary shall include in his annual report required by
    section 1671 of this title".

-End-



-CITE-
    25 USC Sec. 1644                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES

-HEAD-
    Sec. 1644. Grants to and contracts with tribal organizations

-STATUTE-
    (a) Access to health services
      The Secretary, acting through the Service, shall make grants to
    or enter into contracts with tribal organizations to assist such
    organizations in establishing and administering programs on or near
    Federal Indian reservations and trust areas and in or near Alaska
    Native villages to assist individual Indians to - 
        (1) enroll under section 1818 of part A and sections 1836 and
      1837 of part B of title XVIII of the Social Security Act [42
      U.S.C. 1395i-2, 1395o, 1395p];
        (2) pay monthly premiums for coverage due to financial need of
      such individual; and
        (3) apply for medical assistance provided pursuant to title XIX
      of the Social Security Act [42 U.S.C. 1396 et seq.].
    (b) Terms and conditions
      The Secretary, acting through the Service, shall place conditions
    as deemed necessary to effect the purpose of this section in any
    contract or grant which the Secretary makes with any tribal
    organization pursuant to this section. Such conditions shall
    include, but are not limited to, requirements that the organization
    successfully undertake to - 
        (1) determine the population of Indians to be served that are
      or could be recipients of benefits under titles XVIII and XIX of
      the Social Security Act [42 U.S.C. 1395 et seq., 1396 et seq.];
        (2) assist individual Indians in becoming familiar with and
      utilizing such benefits;
        (3) provide transportation to such individual Indians to the
      appropriate offices for enrollment or application for medical
      assistance;
        (4) develop and implement - 
          (A) a schedule of income levels to determine the extent of
        payments of premiums by such organizations for coverage of
        needy individuals; and
          (B) methods of improving the participation of Indians in
        receiving the benefits provided under titles XVIII and XIX of
        the Social Security Act [42 U.S.C. 1395 et seq., 1396 et seq.].
    (c) Application for medical assistance
      The Secretary, acting through the Service, may enter into an
    agreement with an Indian tribe, tribal organization, or urban
    Indian organization which provides for the receipt and processing
    of applications for medical assistance under title XIX of the
    Social Security Act [42 U.S.C. 1396 et seq.] and benefits under
    title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.] at
    a Service facility or a health care facility administered by such
    tribe or organization pursuant to a contract under the Indian Self-
    Determination Act [25 U.S.C. 450f et seq.].

-SOURCE-
    (Pub. L. 94-437, title IV, Sec. 404, as added Pub. L. 96-537, Sec.
    6, Dec. 17, 1980, 94 Stat. 3176; amended Pub. L. 102-573, title IV,
    Sec. 403, Oct. 29, 1992, 106 Stat. 4566.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Social Security Act, referred to in subsecs. (a)(1), (3),
    (b)(1), (4)(B), and (c), is act Aug. 14, 1935, ch. 531, 49 Stat.
    620, as amended. Titles XVIII and XIX of the Act are classified
    generally to subchapters XVIII (Sec. 1395 et seq.) and XIX (Sec.
    1396 et seq.) of chapter 7 of Title 42, The Public Health and
    Welfare. For complete classification of this Act to the Code, see
    section 1305 of Title 42 and Tables.
      The Indian Self-Determination Act, referred to in subsec. (c), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-COD-
                               CODIFICATION                           
      Section was formerly classified to section 1622 of this title.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (b)(4). Pub. L. 102-573, Sec. 403(1), amended par.
    (4) generally. Prior to amendment, par. (4) read as follows:
    "develop and implement a schedule of income levels to determine the
    extent of payment of premiums by such organization for coverage of
    needy individuals; and methods of improving the participation of
    Indians in receiving the benefits provided pursuant to titles XVIII
    and XIX of the Social Security Act."
      Subsec. (c). Pub. L. 102-573, Sec. 403(2), amended subsec. (c)
    generally. Prior to amendment, subsec. (c) read as follows: "There
    are authorized to be appropriated $5,000,000 for the fiscal year
    ending September 30, 1981, $5,750,000 for the fiscal year ending
    September 30, 1982, $6,615,000 for the fiscal year ending September
    30, 1983, and $7,610,000 for the fiscal year ending September 30,
    1984."

-End-



-CITE-
    25 USC Sec. 1645                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES

-HEAD-
    Sec. 1645. Direct billing of medicare, medicaid, and other third
      party payors

-STATUTE-
    (a) Establishment of direct billing program
      (1) In general
        The Secretary shall establish a program under which Indian
      tribes, tribal organizations, and Alaska Native health
      organizations that contract or compact for the operation of a
      hospital or clinic of the Service under the Indian Self-
      Determination and Education Assistance Act [25 U.S.C. 450 et
      seq.] may elect to directly bill for, and receive payment for,
      health care services provided by such hospital or clinic for
      which payment is made under title XVIII of the Social Security
      Act (42 U.S.C. 1395 et seq.) (in this section referred to as the
      "medicare program"), under a State plan for medical assistance
      approved under title XIX of the Social Security Act (42 U.S.C.
      1396 et seq.) (in this section referred to as the "medicaid
      program"), or from any other third party payor.
      (2) Application of 100 percent FMAP
        The third sentence of section 1905(b) of the Social Security
      Act (42 U.S.C. 1396d(b)) shall apply for purposes of
      reimbursement under the medicaid program for health care services
      directly billed under the program established under this section.
    (b) Direct reimbursement
      (1) Use of funds
        Each hospital or clinic participating in the program described
      in subsection (a) of this section shall be reimbursed directly
      under the medicare and medicaid programs for services furnished,
      without regard to the provisions of section 1880(c) of the Social
      Security Act (42 U.S.C. 1395qq(c)) and sections 1642(a) and
      1680c(b)(2)(A) of this title, but all funds so reimbursed shall
      first be used by the hospital or clinic for the purpose of making
      any improvements in the hospital or clinic that may be necessary
      to achieve or maintain compliance with the conditions and
      requirements applicable generally to facilities of such type
      under the medicare or medicaid programs. Any funds so reimbursed
      which are in excess of the amount necessary to achieve or
      maintain such conditions shall be used - 
          (A) solely for improving the health resources deficiency
        level of the Indian tribe; and
          (B) in accordance with the regulations of the Service
        applicable to funds provided by the Service under any contract
        entered into under the Indian Self-Determination Act (25 U.S.C.
        450f et seq.).
      (2) Audits
        The amounts paid to the hospitals and clinics participating in
      the program established under this section shall be subject to
      all auditing requirements applicable to programs administered
      directly by the Service and to facilities participating in the
      medicare and medicaid programs.
      (3) Secretarial oversight
        The Secretary shall monitor the performance of hospitals and
      clinics participating in the program established under this
      section, and shall require such hospitals and clinics to submit
      reports on the program to the Secretary on an annual basis.
      (4) No payments from special funds
        Notwithstanding section 1880(c) of the Social Security Act (42
      U.S.C. 1395qq(c)) or section 1642(a) of this title, no payment
      may be made out of the special funds described in such sections
      for the benefit of any hospital or clinic during the period that
      the hospital or clinic participates in the program established
      under this section.
    (c) Requirements for participation
      (1) Application
        Except as provided in paragraph (2)(B), in order to be eligible
      for participation in the program established under this section,
      an Indian tribe, tribal organization, or Alaska Native health
      organization shall submit an application to the Secretary that
      establishes to the satisfaction of the Secretary that - 
          (A) the Indian tribe, tribal organization, or Alaska Native
        health organization contracts or compacts for the operation of
        a facility of the Service;
          (B) the facility is eligible to participate in the medicare
        or medicaid programs under section 1880 or 1911 of the Social
        Security Act (42 U.S.C. 1395qq; 1396j);
          (C) the facility meets the requirements that apply to
        programs operated directly by the Service; and
          (D) the facility - 
            (i) is accredited by an accrediting body as eligible for
          reimbursement under the medicare or medicaid programs; or
            (ii) has submitted a plan, which has been approved by the
          Secretary, for achieving such accreditation.
      (2) Approval
        (A) In general
          The Secretary shall review and approve a qualified
        application not later than 90 days after the date the
        application is submitted to the Secretary unless the Secretary
        determines that any of the criteria set forth in paragraph (1)
        are not met.
        (B) Grandfather of demonstration program participants
          Any participant in the demonstration program authorized under
        this section as in effect on the day before November 1, 2000,
        shall be deemed approved for participation in the program
        established under this section and shall not be required to
        submit an application in order to participate in the program.
        (C) Duration
          An approval by the Secretary of a qualified application under
        subparagraph (A), or a deemed approval of a demonstration
        program under subparagraph (B), shall continue in effect as
        long as the approved applicant or the deemed approved
        demonstration program meets the requirements of this section.
    (d) Examination and implementation of changes
      (1) In general
        The Secretary, acting through the Service, and with the
      assistance of the Administrator of the Centers for Medicare &
      Medicaid Services, shall examine on an ongoing basis and
      implement - 
          (A) any administrative changes that may be necessary to
        facilitate direct billing and reimbursement under the program
        established under this section, including any agreements with
        States that may be necessary to provide for direct billing
        under the medicaid program; and
          (B) any changes that may be necessary to enable participants
        in the program established under this section to provide to the
        Service medical records information on patients served under
        the program that is consistent with the medical records
        information system of the Service.
      (2) Accounting information
        The accounting information that a participant in the program
      established under this section shall be required to report shall
      be the same as the information required to be reported by
      participants in the demonstration program authorized under this
      section as in effect on the day before November 1, 2000. The
      Secretary may from time to time, after consultation with the
      program participants, change the accounting information
      submission requirements.
    (e) Withdrawal from program
      A participant in the program established under this section may
    withdraw from participation in the same manner and under the same
    conditions that a tribe or tribal organization may retrocede a
    contracted program to the Secretary under authority of the Indian
    Self-Determination Act [25 U.S.C. 450f et seq.]. All cost
    accounting and billing authority under the program established
    under this section shall be returned to the Secretary upon the
    Secretary's acceptance of the withdrawal of participation in this
    program.

-SOURCE-
    (Pub. L. 94-437, title IV, Sec. 405, as added Pub. L. 100-713,
    title IV, Sec. 402, Nov. 23, 1988, 102 Stat. 4818; amended Pub. L.
    102-573, title IV, Sec. 404, title VII, Sec. 701(c)(3), Oct. 29,
    1992, 106 Stat. 4566, 4572; Pub. L. 104-313, Sec. 2(d), Oct. 19,
    1996, 110 Stat. 3822; Pub. L. 105-277, div. A, Sec. 101(e) [title
    III, Sec. 336], Oct. 21, 1998, 112 Stat. 2681-231, 2681-295; Pub.
    L. 105-362, title VI, Sec. 601(a)(2)(B), Nov. 10, 1998, 112 Stat.
    3285; Pub. L. 106-417, Secs. 3(a), 4, Nov. 1, 2000, 114 Stat. 1813,
    1816; Pub. L. 108-173, title IX, Sec. 900(e)(6)(B), Dec. 8, 2003,
    117 Stat. 2373.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination and Education Assistance Act,
    referred to in subsec. (a)(1), is Pub. L. 93-638, Jan. 4, 1975, 88
    Stat. 2203, as amended, which is classified principally to
    subchapter II (Sec. 450 et seq.) of chapter 14 of this title. For
    complete classification of this Act to the Code, see Short Title
    note set out under section 450 of this title and Tables.
      The Social Security Act, referred to in subsec. (a)(1), is act
    Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles XVIII and
    XIX of the Act are classified generally to subchapters XVIII (Sec.
    1395 et seq.) and XIX (Sec. 1396 et seq.) of chapter 7 of Title 42,
    The Public Health and Welfare. For complete classification of this
    Act to the Code, see section 1305 of Title 42 and Tables.
      The Indian Self-Determination Act, referred to in subsecs.
    (b)(1)(B) and (e), is title I of Pub. L. 93-638, Jan. 4, 1975, 88
    Stat. 2206, as amended, which is classified principally to part A
    (Sec. 450f et seq.) of subchapter II of chapter 14 of this title.
    For complete classification of this Act to the Code, see Short
    Title note set out under section 450 of this title and Tables.

-COD-
                               CODIFICATION                           
      November 1, 2000, referred to in subsecs. (c)(2)(B) and (d)(2),
    was in the original "the date of enactment of the Alaska Native and
    American Indian Direct Reimbursement Act of 1999", which was
    translated as meaning the date of enactment of Pub. L. 106-417, the
    Alaska Native and American Indian Direct Reimbursement Act of 2000,
    to reflect the probable intent of Congress.
      Section was formerly set out as a note under section 1395qq of
    Title 42, The Public Health and Welfare.


-MISC1-
                                AMENDMENTS                            
      2003 - Subsec. (d)(1). Pub. L. 108-173 substituted "Centers for
    Medicare & Medicaid Services" for "Health Care Financing
    Administration" in introductory provisions.
      2000 - Pub. L. 106-417, Sec. 4(a), reenacted section as in effect
    on Nov. 9, 1998. For text of section as reenacted, see 1998
    Amendment note below.
      Pub. L. 106-417, Sec. 3(a), amended section generally. For text
    of section prior to amendment, see subsecs. (a) to (d) of section
    as set out in 1998 Amendment note below.
      Subsec. (e). Pub. L. 106-417, Sec. 4(b), struck out subsec. (e).
    For text of subsec. (e) prior to amendment, see subsec. (e) of
    section as set out in 1998 Amendment note below.
      1998 - Pub. L. 105-362 repealed section. Prior to repeal, section
    read as follows:

      "Sec. 1645. Demonstration program for direct billing of medicare,
        medicaid, and other third party payors
      "(a) The Secretary shall establish a demonstration program under
    which Indian tribes, tribal organizations, and Alaska Native health
    organizations, which are contracting the entire operation of an
    entire hospital or clinic of the Service under the authority of the
    Indian Self-Determination Act, shall directly bill for, and receive
    payment for, health care services provided by such hospital or
    clinic for which payment is made under title XVIII of the Social
    Security Act (medicare), under a State plan for medical assistance
    approved under title XIX of the Social Security Act (medicaid), or
    from any other third-party payor. The last sentence of section
    1905(b) of the Social Security Act shall apply for purposes of the
    demonstration program.
      "(b)(1) Each hospital or clinic participating in the
    demonstration program described in subsection (a) of this section
    shall be reimbursed directly under the medicare and medicaid
    programs for services furnished, without regard to the provisions
    of section 1880(c) of the Social Security Act and sections 1642(a)
    and 1680c(b)(2)(A) of this title, but all funds so reimbursed shall
    first be used by the hospital or clinic for the purpose of making
    any improvements in the hospital or clinic that may be necessary to
    achieve or maintain compliance with the conditions and requirements
    applicable generally to facilities of such type under the medicare
    or medicaid program. Any funds so reimbursed which are in excess of
    the amount necessary to achieve or maintain such conditions or
    requirements shall be used - 
        "(A) solely for improving the health resources deficiency level
      of the Indian tribe, and
        "(B) in accordance with the regulations of the Service
      applicable to funds provided by the Service under any contract
      entered into under the Indian Self-Determination Act.
      "(2) The amounts paid to the hospitals and clinics participating
    in the demonstration program described in subsection (a) of this
    section shall be subject to all auditing requirements applicable to
    programs administered directly by the Service and to facilities
    participating in the medicare and medicaid programs.
      "(3) The Secretary shall monitor the performance of hospitals and
    clinics participating in the demonstration program described in
    subsection (a) of this section, and shall require such hospitals
    and clinics to submit reports on the program to the Secretary on a
    quarterly basis (or more frequently if the Secretary deems it to be
    necessary).
      "(4) Notwithstanding section 1880(c) of the Social Security Act
    or section 1642(a) of this title, no payment may be made out of the
    special fund described in section 1880(c) of the Social Security
    Act, or section 1642(a) of this title, for the benefit of any
    hospital or clinic participating in the demonstration program
    described in subsection (a) of this section during the period of
    such participation.
      "(c)(1) In order to be considered for participation in the
    demonstration program described in subsection (a) of this section,
    a hospital or clinic must submit an application to the Secretary
    which establishes to the satisfaction of the Secretary that - 
        "(A) the Indian tribe, tribal organization, or Alaska Native
      health organization contracts the entire operation of the Service
      facility;
        "(B) the facility is eligible to participate in the medicare
      and medicaid programs under sections 1880 and 1911 of the Social
      Security Act;
        "(C) the facility meets any requirements which apply to
      programs operated directly by the Service; and
        "(D) the facility is accredited by the Joint Commission on
      Accreditation of Hospitals, or has submitted a plan, which has
      been approved by the Secretary, for achieving such accreditation
      prior to October 1, 1990.
      "(2) From among the qualified applicants, the Secretary shall,
    prior to October 1, 1989, select no more than 4 facilities to
    participate in the demonstration program described in subsection
    (a) of this section. The demonstration program described in
    subsection (a) of this section shall begin by no later than October
    1, 1991, and end on September 30, 2000.
      "(d)(1) On November 23, 1988, the Secretary, acting through the
    Service, shall commence an examination of - 
        "(A) any administrative changes which may be necessary to allow
      direct billing and reimbursement under the demonstration program
      described in subsection (a) of this section, including any
      agreements with States which may be necessary to provide for such
      direct billing under the medicaid program; and
        "(B) any changes which may be necessary to enable participants
      in such demonstration program to provide to the Service medical
      records information on patients served under such demonstration
      program which is consistent with the medical records information
      system of the Service.
      "(2) Prior to the commencement of the demonstration program
    described in subsection (a) of this section, the Secretary shall
    implement all changes required as a result of the examinations
    conducted under paragraph (1).
      "(3) Prior to October 1, 1990, the Secretary shall determine any
    accounting information which a participant in the demonstration
    program described in subsection (a) of this section would be
    required to report.
      "(e) The Secretary shall submit a final report at the end of
    fiscal year 1996, on the activities carried out under the
    demonstration program described in subsection (a) of this section
    which shall include an evaluation of whether such activities have
    fulfilled the objectives of such program. In such report the
    Secretary shall provide a recommendation, based upon the results of
    such demonstration program, as to whether direct billing of, and
    reimbursement by, the medicare and medicaid programs and other
    third-party payors should be authorized for all Indian tribes and
    Alaska Native health organizations which are contracting the entire
    operation of a facility of the Service.
      "(f) The Secretary shall provide for the retrocession of any
    contract entered into between a participant in the demonstration
    program described in subsection (a) of this section and the Service
    under the authority of the Indian Self-Determination Act. All cost
    accounting and billing authority shall be retroceded to the
    Secretary upon the Secretary's acceptance of a retroceded
    contract."
      Subsec. (c)(2). Pub. L. 105-277 substituted "2000" for "1998".
      1996 - Subsec. (c)(2). Pub. L. 104-313 substituted "1998" for
    "1996".
      1992 - Subsec. (b)(1). Pub. L. 102-573, Sec. 701(c)(3)(A),
    substituted "sections 1642(a)" for "sections 402(c)" and made
    technical amendment to reference to section 1680c(b)(2)(A) to
    reflect renumbering of corresponding section of original act.
      Subsec. (b)(4). Pub. L. 102-573, Sec. 701(c)(3)(B), substituted
    "section 1642(a)" for "section 402(c)" in two places.
      Subsec. (c)(2). Pub. L. 102-573, Sec. 404(1), substituted "1996"
    for "1995".
      Subsec. (e). Pub. L. 102-573, Sec. 404(2), substituted "1996" for
    "1995".

                     EFFECTIVE DATE OF 2000 AMENDMENT                 
      Pub. L. 106-417, Sec. 3(c), Nov. 1, 2000, 114 Stat. 1816,
    provided that: "The amendments made by this section [amending this
    section and sections 1395qq and 1396j of Title 42, The Public
    Health and Welfare] shall take effect on October 1, 2000."
      Pub. L. 106-417, Sec. 4(a), Nov. 1, 2000, 114 Stat. 1816,
    provided that the reenactment of this section by section 4(a) is
    effective Nov. 9, 1998.
      Pub. L. 106-417, Sec. 4(b), Nov. 1, 2000, 114 Stat. 1816,
    provided that the amendment made by section 4(b) is effective Nov.
    10, 1998.

                                 FINDINGS                             
      Pub. L. 106-417, Sec. 2, Nov. 1, 2000, 114 Stat. 1812, provided
    that: "Congress finds the following:
        "(1) In 1988, Congress enacted section 405 of the Indian Health
      Care Improvement Act (25 U.S.C. 1645) that established a
      demonstration program to authorize 4 tribally-operated Indian
      Health Service hospitals or clinics to test methods for direct
      billing and receipt of payment for health services provided to
      patients eligible for reimbursement under the medicare or
      medicaid programs under titles XVIII and XIX of the Social
      Security Act (42 U.S.C. 1395 et seq.; 1396 et seq.), and other
      third party payors.
        "(2) The 4 participants selected by the Indian Health Service
      for the demonstration program began the direct billing and
      collection program in fiscal year 1989 and unanimously expressed
      success and satisfaction with the program. Benefits of the
      program include dramatically increased collections for services
      provided under the medicare and medicaid programs, a significant
      reduction in the turn-around time between billing and receipt of
      payments for services provided to eligible patients, and
      increased efficiency of participants being able to track their
      own billings and collections.
        "(3) The success of the demonstration program confirms that the
      direct involvement of tribes and tribal organizations in the
      direct billing of, and collection of payments from, the medicare
      and medicaid programs, and other third party payor
      reimbursements, is more beneficial to Indian tribes than the
      current system of Indian Health Service-managed collections.
        "(4) Allowing tribes and tribal organizations to directly
      manage their medicare and medicaid billings and collections,
      rather than channeling all activities through the Indian Health
      Service, will enable the Indian Health Service to reduce its
      administrative costs, is consistent with the provisions of the
      Indian Self-Determination Act [25 U.S.C. 450f et seq.], and
      furthers the commitment of the Secretary to enable tribes and
      tribal organizations to manage and operate their health care
      programs.
        "(5) The demonstration program was originally to expire on
      September 30, 1996, but was extended by Congress, so that the
      current participants would not experience an interruption in the
      program while Congress awaited a recommendation from the
      Secretary of Health and Human Services on whether to make the
      program permanent.
        "(6) It would be beneficial to the Indian Health Service and to
      Indian tribes, tribal organizations, and Alaska Native
      organizations to provide permanent status to the demonstration
      program and to extend participation in the program to other
      Indian tribes, tribal organizations, and Alaska Native health
      organizations who operate a facility of the Indian Health
      Service."

-End-



-CITE-
    25 USC Sec. 1646                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES

-HEAD-
    Sec. 1646. Authorization for emergency contract health services

-STATUTE-
      With respect to an elderly or disabled Indian receiving emergency
    medical care or services from a non-Service provider or in a non-
    Service facility under the authority of this chapter, the time
    limitation (as a condition of payment) for notifying the Service of
    such treatment or admission shall be 30 days.

-SOURCE-
    (Pub. L. 94-437, title IV, Sec. 406, as added Pub. L. 102-573,
    title IV, Sec. 405, Oct. 29, 1992, 106 Stat. 4566.)

-End-



-CITE-
    25 USC Sec. 1647                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES

-HEAD-
    Sec. 1647. Authorization of appropriations

-STATUTE-
      There are authorized to be appropriated such sums as may be
    necessary for each fiscal year through fiscal year 2000 to carry
    out this subchapter.

-SOURCE-
    (Pub. L. 94-437, title IV, Sec. 407, as added Pub. L. 102-573,
    title IV, Sec. 406, Oct. 29, 1992, 106 Stat. 4566.)

-End-


-CITE-
    25 USC SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS    01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
             SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS         

-COD-
                               CODIFICATION                           
      This subchapter was in the original title V of Pub. L. 94-437.
    Title IV of Pub. L. 94-437 is classified to subchapter III-A of
    this chapter.

-End-



-CITE-
    25 USC Sec. 1651                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1651. Purpose

-STATUTE-
      The purpose of this subchapter is to establish programs in urban
    centers to make health services more accessible to urban Indians.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 501, as added Pub. L. 100-713, title
    V, Sec. 501, Nov. 23, 1988, 102 Stat. 4820.)


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1651, Pub. L. 94-437, title V, Sec. 501, Sept.
    30, 1976, 90 Stat. 1410; Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94
    Stat. 3176, related to Congressional statement of purpose, prior to
    the general revision of this subchapter by Pub. L. 100-713.

-End-



-CITE-
    25 USC Sec. 1652                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1652. Contracts with, and grants to, urban Indian
      organizations

-STATUTE-
      Under authority of section 13 of this title, the Secretary,
    through the Service, shall enter into contracts with, or make
    grants to, urban Indian organizations to assist such organizations
    in the establishment and administration, within the urban centers
    in which such organizations are situated, of programs which meet
    the requirements set forth in this subchapter. The Secretary,
    through the Service, shall include such conditions as the Secretary
    considers necessary to effect the purpose of this subchapter in any
    contract which the Secretary enters into with, or in any grant the
    Secretary makes to, any urban Indian organization pursuant to this
    subchapter.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 502, as added Pub. L. 100-713, title
    V, Sec. 501, Nov. 23, 1988, 102 Stat. 4820; amended Pub. L. 102-
    573, title V, Sec. 501(a), Oct. 29, 1992, 106 Stat. 4567.)


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1652, Pub. L. 94-437, title V, Sec. 502, Sept.
    30, 1976, 90 Stat. 1410; Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94
    Stat. 3177, related to contracts with urban and rural Indian
    organizations, prior to the general revision of this subchapter by
    Pub. L. 100-713.

                                AMENDMENTS                            
      1992 - Pub. L. 102-573 substituted "Contracts with, and grants
    to, urban Indian organizations" for "Contracts with urban Indian
    organizations" in section catchline, and in text substituted
    "contracts with, or make grants to," for "contracts with" and
    inserted ", or in any grant the Secretary makes to," after "enters
    into with".

-End-



-CITE-
    25 USC Sec. 1653                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1653. Contracts and grants for provision of health care and
      referral services

-STATUTE-
    (a) Requirements
      Under authority of section 13 of this title, the Secretary,
    through the Service, shall enter into contracts with, or make
    grants to, urban Indian organizations for the provision of health
    care and referral services for urban Indians residing in the urban
    centers in which such organizations are situated. Any such contract
    or grant shall include requirements that the urban Indian
    organization successfully undertake to - 
        (1) estimate the population of urban Indians residing in the
      urban center in which such organization is situated who are or
      could be recipients of health care or referral services;
        (2) estimate the current health status of urban Indians
      residing in such urban center;
        (3) estimate the current health care needs of urban Indians
      residing in such urban center;
        (4) identify all public and private health services resources
      within such urban center which are or may be available to urban
      Indians;
        (5) determine the use of public and private health services
      resources by the urban Indians residing in such urban center;
        (6) assist such health services resources in providing services
      to urban Indians;
        (7) assist urban Indians in becoming familiar with and
      utilizing such health services resources;
        (8) provide basic health education, including health promotion
      and disease prevention education, to urban Indians;
        (9) establish and implement training programs to accomplish the
      referral and education tasks set forth in paragraphs (6) through
      (8) of this subsection;
        (10) identify gaps between unmet health needs of urban Indians
      and the resources available to meet such needs;
        (11) make recommendations to the Secretary and Federal, State,
      local, and other resource agencies on methods of improving health
      service programs to meet the needs of urban Indians; and
        (12) where necessary, provide, or enter into contracts for the
      provision of, health care services for urban Indians.
    (b) Criteria for selection of organizations to enter into contracts
      or receive grants
      The Secretary, through the Service, shall by regulation prescribe
    the criteria for selecting urban Indian organizations to enter into
    contracts or receive grants under this section. Such criteria
    shall, among other factors, include - 
        (1) the extent of unmet health care needs of urban Indians in
      the urban center involved;
        (2) the size of the urban Indian population in the urban center
      involved;
        (3) the accessibility to, and utilization of, health care
      services (other than services provided under this subchapter) by
      urban Indians in the urban center involved;
        (4) the extent, if any, to which the activities set forth in
      subsection (a) of this section would duplicate - 
          (A) any previous or current public or private health services
        project in an urban center that was or is funded in a manner
        other than pursuant to this subchapter; or
          (B) any project funded under this subchapter;

        (5) the capability of an urban Indian organization to perform
      the activities set forth in subsection (a) of this section and to
      enter into a contract with the Secretary or to meet the
      requirements for receiving a grant under this section;
        (6) the satisfactory performance and successful completion by
      an urban Indian organization of other contracts with the
      Secretary under this subchapter;
        (7) the appropriateness and likely effectiveness of conducting
      the activities set forth in subsection (a) of this section in an
      urban center; and
        (8) the extent of existing or likely future participation in
      the activities set forth in subsection (a) of this section by
      appropriate health and health-related Federal, State, local, and
      other agencies.
    (c) Grants for health promotion and disease prevention services
      The Secretary, acting through the Service, shall facilitate
    access to, or provide, health promotion and disease prevention
    services for urban Indians through grants made to urban Indian
    organizations administering contracts entered into pursuant to this
    section or receiving grants under subsection (a) of this section.
    (d) Grants for immunization services
      (1) The Secretary, acting through the Service, shall facilitate
    access to, or provide, immunization services for urban Indians
    through grants made to urban Indian organizations administering
    contracts entered into pursuant to this section or receiving grants
    under subsection (a) of this section.
      (2) In making any grant to carry out this subsection, the
    Secretary shall take into consideration - 
        (A) the size of the urban Indian population to be served;
        (B) the immunization levels of the urban Indian population,
      particularly the immunization levels of infants, children, and
      the elderly;
        (C) the utilization by the urban Indians of alternative
      resources from State and local governments for no-cost or low-
      cost immunization services to the general population; and
        (D) the capability of the urban Indian organization to carry
      out services pursuant to this subsection.

      (3) For purposes of this subsection, the term "immunization
    services" means services to provide without charge immunizations
    against vaccine-preventable diseases.
    (e) Grants for mental health services
      (1) The Secretary, acting through the Service, shall facilitate
    access to, or provide, mental health services for urban Indians
    through grants made to urban Indian organizations administering
    contracts entered into pursuant to this section or receiving grants
    under subsection (a) of this section.
      (2) A grant may not be made under this subsection to an urban
    Indian organization until that organization has prepared, and the
    Service has approved, an assessment of the mental health needs of
    the urban Indian population concerned, the mental health services
    and other related resources available to that population, the
    barriers to obtaining those services and resources, and the needs
    that are unmet by such services and resources.
      (3) Grants may be made under this subsection - 
        (A) to prepare assessments required under paragraph (2);
        (B) to provide outreach, educational, and referral services to
      urban Indians regarding the availability of direct mental health
      services, to educate urban Indians about mental health issues and
      services, and effect coordination with existing mental health
      providers in order to improve services to urban Indians;
        (C) to provide outpatient mental health services to urban
      Indians, including the identification and assessment of illness,
      therapeutic treatments, case management, support groups, family
      treatment, and other treatment; and
        (D) to develop innovative mental health service delivery models
      which incorporate Indian cultural support systems and resources.
    (f) Grants for prevention and treatment of child abuse
      (1) The Secretary, acting through the Service, shall facilitate
    access to, or provide, services for urban Indians through grants to
    urban Indian organizations administering contracts entered into
    pursuant to this section or receiving grants under subsection (a)
    of this section to prevent and treat child abuse (including sexual
    abuse) among urban Indians.
      (2) A grant may not be made under this subsection to an urban
    Indian organization until that organization has prepared, and the
    Service has approved, an assessment that documents the prevalence
    of child abuse in the urban Indian population concerned and
    specifies the services and programs (which may not duplicate
    existing services and programs) for which the grant is requested.
      (3) Grants may be made under this subsection - 
        (A) to prepare assessments required under paragraph (2);
        (B) for the development of prevention, training, and education
      programs for urban Indian populations, including child education,
      parent education, provider training on identification and
      intervention, education on reporting requirements, prevention
      campaigns, and establishing service networks of all those
      involved in Indian child protection; and
        (C) to provide direct outpatient treatment services (including
      individual treatment, family treatment, group therapy, and
      support groups) to urban Indians who are child victims of abuse
      (including sexual abuse) or adult survivors of child sexual
      abuse, to the families of such child victims, and to urban Indian
      perpetrators of child abuse (including sexual abuse).

      (4) In making grants to carry out this subsection, the Secretary
    shall take into consideration - 
        (A) the support for the urban Indian organization demonstrated
      by the child protection authorities in the area, including
      committees or other services funded under the Indian Child
      Welfare Act of 1978 (25 U.S.C. 1901 et seq.), if any;
        (B) the capability and expertise demonstrated by the urban
      Indian organization to address the complex problem of child
      sexual abuse in the community; and
        (C) the assessment required under paragraph (2).

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 503, as added Pub. L. 100-713, title
    V, Sec. 501, Nov. 23, 1988, 102 Stat. 4821; amended Pub. L. 101-
    630, title V, Sec. 505, Nov. 28, 1990, 104 Stat. 4564; Pub. L. 102-
    573, title V, Secs. 501(b)(1), 505(b)(1), Oct. 29, 1992, 106 Stat.
    4567, 4570.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Child Welfare Act of 1978, referred to in subsec.
    (f)(4)(A), is Pub. L. 95-608, Nov. 8, 1978, 92 Stat. 3069, as
    amended, which is classified principally to chapter 21 (Sec. 1901
    et seq.) of this title. For complete classification of this Act to
    the Code, see Short Title note set out under section 1901 of this
    title and Tables.


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1653, Pub. L. 94-437, title V, Sec. 503, Sept.
    30, 1976, 90 Stat. 1410; Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94
    Stat. 3177, related to contract eligibility, prior to the general
    revision of this subchapter by Pub. L. 100-713.

                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 501(b)(1)(G), inserted "and grants"
    in section catchline.
      Subsec. (a). Pub. L. 102-573, Sec. 501(b)(1)(A), inserted ", or
    make grants to," after "contracts with" and "or grant" after "such
    contract".
      Subsec. (b). Pub. L. 102-573, Sec. 501(b)(1)(B), inserted "or
    receive grants" after "enter into contracts" in introductory
    provisions and "or to meet the requirements for receiving a grant"
    after "Secretary" in par. (5).
      Subsec. (c). Pub. L. 102-573, Sec. 505(b)(1)(A), struck out par.
    (1) designation before "The Secretary, acting" and struck out par.
    (2) which authorized appropriation of $1,000,000 for fiscal year
    1992 to carry out this subsec.
      Subsec. (c)(1). Pub. L. 102-573, Sec. 501(b)(1)(C), inserted
    before period at end "or receiving grants under subsection (a) of
    this section".
      Subsec. (d)(1). Pub. L. 102-573, Sec. 501(b)(1)(D), inserted
    before period at end "or receiving grants under subsection (a) of
    this section".
      Subsec. (d)(4). Pub. L. 102-573, Sec. 505(b)(1)(B), struck out
    par. (4) which authorized appropriation of $1,000,000 for fiscal
    year 1992 to carry out this subsec.
      Subsec. (e)(1). Pub. L. 102-573, Sec. 501(b)(1)(E), inserted
    before period at end "or receiving grants under subsection (a) of
    this section".
      Subsec. (e)(4). Pub. L. 102-573, Sec. 505(b)(1)(C), struck out
    par. (4) which authorized appropriations of $500,000 for fiscal
    year 1991 and $2,000,000 for fiscal year 1992 to carry out this
    subsec.
      Subsec. (f)(1). Pub. L. 102-573, Sec. 501(b)(1)(F), inserted "or
    receiving grants under subsection (a) of this section" after
    "pursuant to this section".
      Subsec. (f)(5). Pub. L. 102-573, Sec. 505(b)(1)(D), struck out
    par. (5) which authorized appropriations of $500,000 for fiscal
    year 1991 and $2,000,000 for fiscal year 1992 to carry out this
    subsec.
      1990 - Subsecs. (c) to (f). Pub. L. 101-630 added subsecs. (c) to
    (f).

                           FACILITIES ASSESSMENT                       
      Section 506(a), (b) of Pub. L. 101-630 provided that:
      "(a) Survey. - The Secretary shall conduct a survey of all
    facilities used by contractors under title V of the Indian Health
    Care Improvement Act [25 U.S.C. 1651 et seq.] and shall submit a
    report to the Congress on such survey not later than one year after
    the date of enactment of this Act [Nov. 28, 1990]. The report
    shall, at a minimum, contain the following information for each
    location:
        "(1) The extent to which the facility meets safety and building
      codes and, if direct care is provided, the extent of compliance
      with Joint Commission for Accreditation of Health Care
      Organizations (JCAHO) standards.
        "(2) The extent to which improvements, expansion, or relocation
      is necessary to meet program requirements, provide adequate
      services, or achieve building code compliance.
        "(3) Any lease restriction that would hamper accomplishment of
      needed improvement, expansion, or relocation.
        "(4) The term of the lease, if appropriate, the age of the
      structure, and the structure's life expectancy with and without
      improvement.
        "(5) An assessment of the deficiencies of the facility.
      "(b) Report. - The report shall contain general recommendations
    for addressing the deficiencies of facilities in which programs
    funded under title V of the Indian Health Care Improvement Act [25
    U.S.C. 1651 et seq.] are located and shall propose specific
    policies for accomplishing those recommendations."

-End-



-CITE-
    25 USC Sec. 1654                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1654. Contracts and grants for determination of unmet health
      care needs

-STATUTE-
    (a) Authority
      Under authority of section 13 of this title, the Secretary,
    through the Service, may enter into contracts with, or make grants
    to, urban Indian organizations situated in urban centers for which
    contracts have not been entered into, or grants have not been made,
    under section 1653 of this title. The purpose of a contract or
    grant made under this section shall be the determination of the
    matters described in subsection (b)(1) of this section in order to
    assist the Secretary in assessing the health status and health care
    needs of urban Indians in the urban center involved and determining
    whether the Secretary should enter into a contract or make a grant
    under section 1653 of this title with respect to the urban Indian
    organization which the Secretary has entered into a contract with,
    or made a grant to, under this section.
    (b) Requirements
      Any contract entered into, or grant made, by the Secretary under
    this section shall include requirements that - 
        (1) the urban Indian organization successfully undertake to - 
          (A) document the health care status and unmet health care
        needs of urban Indians in the urban center involved; and
          (B) with respect to urban Indians in the urban center
        involved, determine the matters described in clauses (2), (3),
        (4), and (8) of section 1653(b) of this title; and

        (2) the urban Indian organization complete performance of the
      contract, or carry out the requirements of the grant, within one
      year after the date on which the Secretary and such organization
      enter into such contract, or within one year after such
      organization receives such grant, whichever is applicable.
    (c) Renewal
      The Secretary may not renew any contract entered into, or grant
    made, under this section.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 504, as added Pub. L. 100-713, title
    V, Sec. 501, Nov. 23, 1988, 102 Stat. 4822; amended Pub. L. 102-
    573, title V, Sec. 501(b)(2), Oct. 29, 1992, 106 Stat. 4567.)


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1654, Pub. L. 94-437, title V, Sec. 504, Sept.
    30, 1976, 90 Stat. 1411; Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94
    Stat. 3178, related to other contract requirements, prior to the
    general revision of this subchapter by Pub. L. 100-713.

                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 501(b)(2)(D), inserted "and grants"
    in section catchline.
      Subsec. (a). Pub. L. 102-573, Sec. 501(b)(2)(A), added subsec.
    (a) and struck out former subsec. (a) which read as follows: "Under
    authority of section 13 of this title, the Secretary, through the
    Service, may enter into contracts with urban Indian organizations
    situated in urban centers for which contracts have not been entered
    into under section 1653 of this title. The purpose of a contract
    under this section shall be the determination of the matters
    described in subsection (b)(1) of this section in order to assist
    the Secretary in assessing the health status and health care needs
    of urban Indians in the urban center involved and determining
    whether the Secretary should enter into a contract under section
    1653 of this title with the urban Indian organization with which
    the Secretary has entered into a contract under this section."
      Subsec. (b). Pub. L. 102-573, Sec. 501(b)(2)(B), inserted ", or
    grant made," after "contract entered into" in introductory
    provisions and substituted ", or carry out the requirements of the
    grant, within one year after the date on which the Secretary and
    such organization enter into such contract, or within one year
    after such organization receives such grant, whichever is
    applicable." for "within one year after the date on which the
    Secretary and such organization enter into such contract." in par.
    (2).
      Subsec. (c). Pub. L. 102-573, Sec. 501(b)(2)(C), inserted ", or
    grant made," after "entered into".

-End-



-CITE-
    25 USC Sec. 1655                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1655. Evaluations; renewals

-STATUTE-
    (a) Contract compliance and performance
      The Secretary, through the Service, shall develop procedures to
    evaluate compliance with grant requirements under this subchapter
    and compliance with, and performance of contracts entered into by
    urban Indian organizations under this subchapter. Such procedures
    shall include provisions for carrying out the requirements of this
    section.
    (b) Annual onsite evaluation
      The Secretary, through the Service, shall conduct an annual
    onsite evaluation of each urban Indian organization which has
    entered into a contract or received a grant under section 1653 of
    this title for purposes of determining the compliance of such
    organization with, and evaluating the performance of such
    organization under, such contract or the terms of such grant.
    (c) Noncompliance or unsatisfactory performance
      If, as a result of the evaluations conducted under this section,
    the Secretary determines that an urban Indian organization has not
    complied with the requirements of a grant or complied with or
    satisfactorily performed a contract under section 1653 of this
    title, the Secretary shall, prior to renewing such contract or
    grant, attempt to resolve with such organization the areas of
    noncompliance or unsatisfactory performance and modify such
    contract or grant to prevent future occurrences of such
    noncompliance or unsatisfactory performance. If the Secretary
    determines that such noncompliance or unsatisfactory performance
    cannot be resolved and prevented in the future, the Secretary shall
    not renew such contract or grant with such organization and is
    authorized to enter into a contract or make a grant under section
    1653 of this title with another urban Indian organization which is
    situated in the same urban center as the urban Indian organization
    whose contract or grant is not renewed under this section.
    (d) Contract and grant renewals
      In determining whether to renew a contract or grant with an urban
    Indian organization under section 1653 of this title which has
    completed performance of a contract or grant under section 1654 of
    this title, the Secretary shall review the records of the urban
    Indian organization, the reports submitted under section 1657 of
    this title, and, in the case of a renewal of a contract or grant
    under section 1653 of this title, shall consider the results of the
    onsite evaluations conducted under subsection (b) of this section.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 505, as added Pub. L. 100-713, title
    V, Sec. 501, Nov. 23, 1988, 102 Stat. 4822; amended Pub. L. 102-
    573, title V, Sec. 501(b)(3), Oct. 29, 1992, 106 Stat. 4568.)


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1655, Pub. L. 94-437, title V, Sec. 505, Sept.
    30, 1976, 90 Stat. 1412; Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94
    Stat. 3179, related to reports by urban Indian organizations and
    rural Indian organizations to Secretary, contents, audit of reports
    and records, prior to the general revision of this subchapter by
    Pub. L. 100-713.

                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 501(b)(3)(E), substituted "renewals"
    for "contract renewals" in section catchline.
      Subsec. (a). Pub. L. 102-573, Sec. 501(b)(3)(A), inserted
    "compliance with grant requirements under this subchapter and"
    before "compliance with, and".
      Subsec. (b). Pub. L. 102-573, Sec. 501(b)(3)(B), inserted "or
    received a grant" after "entered into a contract" and "or the terms
    of such grant" before period at end.
      Subsec. (c). Pub. L. 102-573, Sec. 501(b)(3)(C), inserted "the
    requirements of a grant or complied with" after "has not complied
    with", "or grant" after "such contract" wherever appearing, "or
    make a grant" after "enter into a contract", and "or grant" after
    "whose contract".
      Subsec. (d). Pub. L. 102-573, Sec. 501(b)(3)(D), inserted "or
    grant" after "a contract" wherever appearing.

-End-



-CITE-
    25 USC Sec. 1656                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1656. Other contract and grant requirements

-STATUTE-
    (a) Federal regulations; exceptions
      Contracts with urban Indian organizations entered into pursuant
    to this subchapter shall be in accordance with all Federal
    contracting laws and regulations except that, in the discretion of
    the Secretary, such contracts may be negotiated without advertising
    and need not conform to the provisions of sections 3131 and 3133 of
    title 40.
    (b) Payment
      Payments under any contracts or grants pursuant to this
    subchapter may be made in advance or by way of reimbursement and in
    such installments and on such conditions as the Secretary deems
    necessary to carry out the purposes of this subchapter.
    (c) Revision or amendment
      Notwithstanding any provision of law to the contrary, the
    Secretary may, at the request or consent of an urban Indian
    organization, revise or amend any contract entered into by the
    Secretary with such organization under this subchapter as necessary
    to carry out the purposes of this subchapter.
    (d) Existing Government facilities
      In connection with any contract or grant entered into pursuant to
    this subchapter, the Secretary may permit an urban Indian
    organization to utilize, in carrying out such contract or grant,
    existing facilities owned by the Federal Government within the
    Secretary's jurisdiction under such terms and conditions as may be
    agreed upon for the use and maintenance of such facilities.
    (e) Uniform provision of services and assistance
      Contracts with, or grants to, urban Indian organizations and
    regulations adopted pursuant to this subchapter shall include
    provisions to assure the fair and uniform provision to urban
    Indians of services and assistance under such contracts or grants
    by such organizations.
    (f) Eligibility for health care or referral services
      Urban Indians, as defined in section 1603(f) of this title, shall
    be eligible for health care or referral services provided pursuant
    to this subchapter.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 506, as added Pub. L. 100-713, title
    V, Sec. 501, Nov. 23, 1988, 102 Stat. 4823; amended Pub. L. 102-
    573, title V, Sec. 501(b)(4), Oct. 29, 1992, 106 Stat. 4568.)

-COD-
                               CODIFICATION                           
      "Sections 3131 and 3133 of title 40" substituted in subsec. (a)
    for "the Act of August 24, 1935 (40 U.S.C. 270a, et seq.)" on
    authority of Pub. L. 107-217, Sec. 5(c), Aug. 21, 2002, 116 Stat.
    1303, the first section of which enacted Title 40, Public
    Buildings, Property, and Works.


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1656, Pub. L. 94-437, title V, Sec. 506, Sept.
    30, 1976, 90 Stat. 1412; Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94
    Stat. 3179, authorized appropriations, prior to the general
    revision of this subchapter by Pub. L. 100-713.

                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 501(b)(4)(D), inserted "and grant"
    in section catchline.
      Subsec. (b). Pub. L. 102-573, Sec. 501(b)(4)(A), inserted "or
    grants" after "any contracts".
      Subsec. (d). Pub. L. 102-573, Sec. 501(b)(4)(B), inserted "or
    grant" after "contract" in two places.
      Subsec. (e). Pub. L. 102-573, Sec. 501(b)(4)(C), inserted ", or
    grants to," after "Contracts with" and "or grants" after "such
    contracts".

-End-



-CITE-
    25 USC Sec. 1657                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1657. Reports and records

-STATUTE-
    (a) Quarterly reports
      For each fiscal year during which an urban Indian organization
    receives or expends funds pursuant to a contract entered into, or a
    grant received, pursuant to this subchapter, such organization
    shall submit to the Secretary a quarterly report including - 
        (1) in the case of a contract or grant under section 1653 of
      this title, information gathered pursuant to clauses (10) and
      (11) of subsection (a) of such section;
        (2) information on activities conducted by the organization
      pursuant to the contract or grant;
        (3) an accounting of the amounts and purposes for which Federal
      funds were expended; and
        (4) such other information as the Secretary may request.
    (b) Audit by Secretary and Comptroller General
      The reports and records of the urban Indian organization with
    respect to a contract or grant under this subchapter shall be
    subject to audit by the Secretary and the Comptroller General of
    the United States.
    (c) Cost of annual private audit
      The Secretary shall allow as a cost of any contract or grant
    entered into under section 1653 of this title the cost of an annual
    private audit conducted by a certified public accountant.
    (d) Health status, services, and areas of unmet needs; child
      welfare
      (1) The Secretary, acting through the Service, shall submit a
    report to the Congress not later than March 31, 1992, evaluating - 
        (A) the health status of urban Indians;
        (B) the services provided to Indians through this subchapter;
        (C) areas of unmet needs in urban areas served under this
      subchapter; and
        (D) areas of unmet needs in urban areas not served under this
      subchapter.

      (2) In preparing the report under paragraph (1), the Secretary
    shall consult with urban Indian health providers and may contract
    with a national organization representing urban Indian health
    concerns to conduct any aspect of the report.
      (3) The Secretary and the Secretary of the Interior shall - 
        (A) assess the status of the welfare of urban Indian children,
      including the volume of child protection cases, the prevalence of
      child sexual abuse, and the extent of urban Indian coordination
      with tribal authorities with respect to child sexual abuse; and
        (B) submit a report on the assessment required under
      subparagraph (A), together with recommended legislation to
      improve Indian child protection in urban Indian populations, to
      the Congress no later than March 31, 1992.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 507, as added Pub. L. 100-713, title
    V, Sec. 501, Nov. 23, 1988, 102 Stat. 4823; amended Pub. L. 101-
    630, title V, Sec. 507, Nov. 28, 1990, 104 Stat. 4566; Pub. L. 102-
    573, title V, Sec. 501(b)(5), Oct. 29, 1992, 106 Stat. 4568.)


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1657, Pub. L. 94-437, title V, Sec. 507, Sept.
    30, 1976, 90 Stat. 1412; Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94
    Stat. 3179, related to review of program by Secretary and report to
    Congress, prior to the general revision of this subchapter by Pub.
    L. 100-713.

                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 501(b)(5)(A), inserted
    ", or a grant received," after "entered into" in introductory
    provisions and "or grant" after "contract" in pars. (1) and (2).
      Subsecs. (b), (c). Pub. L. 102-573, Sec. 501(b)(5)(B), inserted
    "or grant" after "contract".
      1990 - Subsec. (d). Pub. L. 101-630 added subsec. (d).

-End-



-CITE-
    25 USC Sec. 1658                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1658. Limitation on contract authority

-STATUTE-
      The authority of the Secretary to enter into contracts under this
    subchapter shall be to the extent, and in an amount, provided for
    in appropriation Acts.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 508, as added Pub. L. 100-713, title
    V, Sec. 501, Nov. 23, 1988, 102 Stat. 4824.)


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1658, Pub. L. 94-437, title V, Sec. 508, Sept.
    30, 1976, 90 Stat. 1412, provided that not to exceed 1 per centum
    of the amounts authorized by section 1656 of this title be
    available for not to exceed two pilot projects providing outreach
    services to eligible Indians residing in rural communities near
    Indian reservations, prior to the general revision of this
    subchapter by Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94 Stat. 3176.

-End-



-CITE-
    25 USC Sec. 1659                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1659. Facilities renovation

-STATUTE-
      The Secretary may make funds available to contractors or grant
    recipients under this subchapter for minor renovations to
    facilities, including leased facilities, to assist such contractors
    or grant recipients in meeting or maintaining the Joint Commission
    for Accreditation of Health Care Organizations (JCAHO) standards.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 509, formerly Sec. 409, as added
    Pub. L. 101-630, title V, Sec. 506(c), Nov. 28, 1990, 104 Stat.
    4566; renumbered Sec. 509 and amended Pub. L. 102-573, title V,
    Secs. 501(b)(6), 505(b)(2), title IX, Sec. 902(5)(A), Oct. 29,
    1992, 106 Stat. 4569, 4571, 4591.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 902(5)(A), made technical amendment
    to section catchline.
      Pub. L. 102-573, Sec. 505(b)(2), struck out last sentence which
    authorized appropriation of $1,000,000 for fiscal year 1992 to
    carry out this section.
      Pub. L. 102-573, Sec. 501(b)(6), inserted "or grant recipients"
    after "contractors" in two places.

-End-



-CITE-
    25 USC Sec. 1660                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1660. Urban Health Programs Branch

-STATUTE-
    (a) Establishment
      There is hereby established within the Service a Branch of Urban
    Health Programs which shall be responsible for carrying out the
    provisions of this subchapter and for providing central oversight
    of the programs and services authorized under this subchapter.
    (b) Staff, services, and equipment
      The Secretary shall appoint such employees to work in the branch,
    including a program director, and shall provide such services and
    equipment, as may be necessary for it to carry out its
    responsibilities. The Secretary shall also analyze the need to
    provide at least one urban health program analyst for each area
    office of the Indian Health Service and shall submit his findings
    to the Congress as a part of the Department's fiscal year 1993
    budget request.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 510, formerly Sec. 511, as added
    Pub. L. 101-630, title V, Sec. 508, Nov. 28, 1990, 104 Stat. 4567;
    renumbered Sec. 510 and amended Pub. L. 102-573, title V, Sec.
    501(b)(7), title IX, Sec. 902(5)(B), Oct. 29, 1992, 106 Stat. 4569,
    4591.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 902(5)(B), made technical amendment
    to section catchline.
      Subsec. (a). Pub. L. 102-573, Sec. 501(b)(7), inserted "and for
    providing central oversight of the programs and services authorized
    under this subchapter" before period at end.

-End-



-CITE-
    25 USC Sec. 1660a                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1660a. Grants for alcohol and substance abuse related services

-STATUTE-
    (a) Grants
      The Secretary may make grants for the provision of health-related
    services in prevention of, treatment of, rehabilitation of, or
    school and community-based education in, alcohol and substance
    abuse in urban centers to those urban Indian organizations with
    whom the Secretary has entered into a contract under this
    subchapter or under section 1621 of this title.
    (b) Goals of grant
      Each grant made pursuant to subsection (a) of this section shall
    set forth the goals to be accomplished pursuant to the grant. The
    goals shall be specific to each grant as agreed to between the
    Secretary and the grantee.
    (c) Criteria
      The Secretary shall establish criteria for the grants made under
    subsection (a) of this section, including criteria relating to the -
     
        (1) size of the urban Indian population;
        (2) accessibility to, and utilization of, other health
      resources available to such population;
        (3) duplication of existing Service or other Federal grants or
      contracts;
        (4) capability of the organization to adequately perform the
      activities required under the grant;
        (5) satisfactory performance standards for the organization in
      meeting the goals set forth in such grant, which standards shall
      be negotiated and agreed to between the Secretary and the grantee
      on a grant-by-grant basis; and
        (6) identification of need for services.

    The Secretary shall develop a methodology for allocating grants
    made pursuant to this section based on such criteria.
    (d) Treatment of funds received by urban Indian organizations
      Any funds received by an urban Indian organization under this
    chapter for substance abuse prevention, treatment, and
    rehabilitation shall be subject to the criteria set forth in
    subsection (c) of this section.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 511, as added Pub. L. 102-573, title
    V, Sec. 502, Oct. 29, 1992, 106 Stat. 4569.)


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 511 of Pub. L. 94-437 was renumbered section 510
    and is classified to section 1660 of this title.

-End-



-CITE-
    25 USC Sec. 1660b                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1660b. Treatment of certain demonstration projects

-STATUTE-
    (a) In general
      Notwithstanding any other provision of law, the Oklahoma City
    Clinic demonstration project and the Tulsa Clinic demonstration
    project shall be treated as service units in the allocation of
    resources and coordination of care and shall not be subject to the
    provisions of the Indian Self-Determination Act [25 U.S.C. 450f et
    seq.] for the term of such projects. The Secretary shall provide
    assistance to such projects in the development of resources and
    equipment and facility needs.
    (b) Report
      The Secretary shall submit to the President, for inclusion in the
    report required to be submitted to the Congress under section 1671
    of this title for fiscal year 1999, a report on the findings and
    conclusions derived from the demonstration projects specified in
    subsection (a) of this section.
    (c) Appropriations
      In addition to the amounts made available under section 1660d of
    this title to carry out this section through fiscal year 2000,
    there are authorized to be appropriated such sums as may be
    necessary to carry out this section for each of fiscal years 2001
    and 2002.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 512, as added Pub. L. 102-573, title
    V, Sec. 503, Oct. 29, 1992, 106 Stat. 4569; amended Pub. L. 105-
    256, Sec. 4(b), Oct. 14, 1998, 112 Stat. 1897.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1998 - Subsec. (c). Pub. L. 105-256 added subsec. (c).

      PERMANENT PROGRAMS UNDER THE DIRECT CARE PROGRAM OF THE INDIAN
                              HEALTH SERVICE
      Pub. L. 108-447, div. E, title II, Dec. 8, 2004, 118 Stat. 3087,
    provided in part that: "Notwithstanding any other provision of law,
    the Tulsa and Oklahoma City Clinic demonstration projects shall be
    permanent programs under the direct care program of the Indian
    Health Service; shall be treated as service units and operating
    units in the allocation of resources and coordination of care;
    shall continue to meet the requirements applicable to an Urban
    Indian organization under this title [title II of div. E of Pub. L.
    108-447, see Tables for classification]; and shall not be subject
    to the Indian Self-Determination and Education Assistance Act (25
    U.S.C. 450 et seq.)."

                      EXTENSION OF TERMS OF PROJECTS                  
      Pub. L. 105-256, Sec. 4(a), Oct. 14, 1998, 112 Stat. 1897,
    provided that: "The Secretary of the Interior shall take such
    action as may be necessary to extend the terms of the projects
    referred to in section 512 of the Indian Health Care Improvement
    Act (25 U.S.C. 1660b) so that the term of each such project expires
    on October 1, 2002."

-End-



-CITE-
    25 USC Sec. 1660c                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1660c. Urban NIAAA transferred programs

-STATUTE-
    (a) Duty of Secretary
      The Secretary shall, within the Branch of Urban Health Programs
    of the Service, make grants or enter into contracts for the
    administration of urban Indian alcohol programs that were
    originally established under the National Institute on Alcoholism
    and Alcohol Abuse (hereafter in this section referred to as
    "NIAAA") and transferred to the Service.
    (b) Use of grants
      Grants provided or contracts entered into under this section
    shall be used to provide support for the continuation of alcohol
    prevention and treatment services for urban Indian populations and
    such other objectives as are agreed upon between the Service and a
    recipient of a grant or contract under this section.
    (c) Eligibility for grants
      Urban Indian organizations that operate Indian alcohol programs
    originally funded under NIAAA and subsequently transferred to the
    Service are eligible for grants or contracts under this section.
    (d) Combination of funds
      For the purpose of carrying out this section, the Secretary may
    combine NIAAA alcohol funds with other substance abuse funds
    currently administered through the Branch of Urban Health Programs
    of the Service.
    (e) Evaluation and report to Congress
      The Secretary shall evaluate and report to the Congress on the
    activities of programs funded under this section at least every 5
    years.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 513, as added Pub. L. 102-573, title
    V, Sec. 504, Oct. 29, 1992, 106 Stat. 4570; amended Pub. L. 105-
    362, title VI, Sec. 602(a), Nov. 10, 1998, 112 Stat. 3286.)


-MISC1-
                                AMENDMENTS                            
      1998 - Subsec. (e). Pub. L. 105-362 substituted "every 5 years"
    for "every two years".

                   TERMINATION OF REPORTING REQUIREMENTS               
      For termination, effective May 15, 2000, of provisions in subsec.
    (e) of this section relating to reporting to Congress on the
    activities of programs funded under this section, see section 3003
    of Pub. L. 104-66, as amended, set out as a note under section 1113
    of Title 31, Money and Finance, and page 97 of House Document No.
    103-7.

-End-



-CITE-
    25 USC Sec. 1660d                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS

-HEAD-
    Sec. 1660d. Authorization of appropriations

-STATUTE-
      There are authorized to be appropriated such sums as may be
    necessary for each fiscal year through fiscal year 2000 to carry
    out this subchapter.

-SOURCE-
    (Pub. L. 94-437, title V, Sec. 514, as added Pub. L. 102-573, title
    V, Sec. 505(a), Oct. 29, 1992, 106 Stat. 4570.)

-End-


-CITE-
    25 USC SUBCHAPTER V - ORGANIZATIONAL IMPROVEMENTS           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V - ORGANIZATIONAL IMPROVEMENTS

-HEAD-
                SUBCHAPTER V - ORGANIZATIONAL IMPROVEMENTS            

-COD-
                               CODIFICATION                           
      This subchapter was in the original title VI of Pub. L. 94-437.
    Titles IV and V of Pub. L. 94-437 are classified to subchapters III-
    A and IV of this chapter, respectively.

-End-



-CITE-
    25 USC Sec. 1661                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V - ORGANIZATIONAL IMPROVEMENTS

-HEAD-
    Sec. 1661. Establishment of Indian Health Service as an agency of
      Public Health Service

-STATUTE-
    (a) Establishment
      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 on and after November 23, 1988, provided by 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 President, by and with
    the 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) Agency status
      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) Duties
      The Secretary shall carry out through the Director of the Indian
    Health Service - 
        (1) all functions which were, on the day before November 23,
      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;
        (3) all health programs under which health care is provided to
      Indians based upon their status as Indians which are administered
      by the Secretary, including (but not limited to) programs under -
      
          (A) this chapter;
          (B) section 13 of this title;
          (C) the Act of August 5, 1954 (42 U.S.C. 2001, et seq.);
          (D) the Act of August 16, 1957 (42 U.S.C. 2005 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
      subchapter I of this chapter.
    (d) Authority of Secretary
      (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;
        (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 472
    of this title 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) of this section.

-SOURCE-
    (Pub. L. 94-437, title VI, Sec. 601, as added Pub. L. 100-713,
    title VI, Sec. 601(a), Nov. 23, 1988, 102 Stat. 4824; amended Pub.
    L. 102-573, title VI, Secs. 601, 602(a)(1), (c), title IX, Sec.
    902(6), (7), Oct. 29, 1992, 106 Stat. 4571, 4592.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      Act of August 5, 1954, referred to in subsec. (c)(3)(C), is act
    Aug. 5, 1954, ch. 658, 68 Stat. 674, as amended, which is
    classified generally to subchapter I (Sec. 2001 et seq.) of chapter
    22 of Title 42, The Public Health and Welfare. For complete
    classification of this Act to the Code, see Tables.
      Act of August 16, 1957, referred to in subsec. (c)(3)(D), is Pub.
    L. 85-151, Aug. 16, 1957, 71 Stat. 370, which is classified
    generally to subchapter II (Sec. 2005 et seq.) of chapter 22 of
    Title 42. For complete classification of this Act to the Code, see
    Tables.
      The Indian Self-Determination Act, referred to in subsec.
    (c)(3)(E), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat.
    2206, as amended, which is classified principally to part A (Sec.
    450f et seq.) of subchapter II of chapter 14 of this title. For
    complete classification of this Act to the Code, see Short Title
    note set out under section 450 of this title and Tables.


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1661, Pub. L. 94-437, title VI, Sec. 601, Sept.
    30, 1976, 90 Stat. 1412, related to feasibility study and report to
    Congress, prior to the general revision of this subchapter by Pub.
    L. 100-713.

                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 602(c), inserted at end
    "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."
      Pub. L. 102-573, Sec. 602(a)(1), substituted "President, by and
    with the advice and consent of the Senate" for "Secretary" in
    second sentence.
      Subsec. (c)(3)(D). Pub. L. 102-573, Sec. 902(6), substituted "(42
    U.S.C. 2005 et seq.)" for "(25 U.S.C. 2005, et seq.)".
      Subsec. (c)(4). Pub. L. 102-573, Sec. 601, added par. (4).
      Subsec. (d)(1)(C). Pub. L. 102-573, Sec. 902(7), substituted
    "appropriated" for "appropriate".

                     EFFECTIVE DATE OF 1992 AMENDMENT                 
      Section 602(a)(2) of Pub. L. 102-573 provided that: "The
    amendment made by paragraph (1) [amending this section] shall take
    effect January 1, 1993."

                              EFFECTIVE DATE                          
      Section 601(c) of Pub. L. 100-713 provided that:
      "(1) Except as provided in paragraph (2), section 601 of the
    Indian Health Care Improvement Act [this section] added by
    subsection (a) of this section shall take effect 9 months from the
    date of the enactment of this section [Nov. 23, 1988].
      "(2) Notwithstanding subsections (b) [set out below] 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."

                            INTERIM APPOINTMENT                        
      Section 602(b) of Pub. L. 102-573 provided that: "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.) [25 U.S.C.
    1661(a)] (as amended by subsection (a) of this section)."

     TRANSFER OF PERSONNEL, RECORDS, EQUIPMENT, ETC., TO INDIAN HEALTH
                                  SERVICE
      Section 601(b) of Pub. L. 100-713 provided that: "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 [see
    Effective Date note above] shall be transferred to the Indian
    Health Service established by the amendment made by subsection (a)
    of this section [enacting this section and section 1662 of this
    title]. All transfers must be accomplished within 9 months of the
    date of enactment of this section [Nov. 23, 1988]. The Secretary is
    authorized 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."

-End-



-CITE-
    25 USC Sec. 1662                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V - ORGANIZATIONAL IMPROVEMENTS

-HEAD-
    Sec. 1662. Automated management information system

-STATUTE-
    (a) Establishment
      (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.
    (b) Provision to Indian tribes and organizations; reimbursement
      (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 [25
    U.S.C. 450f et seq.] 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 of patients of the Service,
      and
        (B) meet the management information needs of the Service.

      (2) The Secretary shall reimburse each Indian tribe or tribal
    organization for the part of the cost of the operation of a system
    provided under paragraph (1) which is attributable to the treatment
    by such Indian tribe or tribal organization of patients of the
    Service.
      (3) 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, 1990.
    (c) Access to records
      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.

-SOURCE-
    (Pub. L. 94-437, title VI, Sec. 602, as added Pub. L. 100-713,
    title VI, Sec. 601(a), Nov. 23, 1988, 102 Stat. 4825; amended Pub.
    L. 102-573, title IX, Sec. 901(3), Oct. 29, 1992, 106 Stat. 4591.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (b)(1),
    is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
    amended, which is classified principally to part A (Sec. 450f et
    seq.) of subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a)(3). Pub. L. 102-573 struck out par. (3) which
    directed Secretary to submit report to Congress no later than Sept.
    30, 1989.

-End-



-CITE-
    25 USC Sec. 1663                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V - ORGANIZATIONAL IMPROVEMENTS

-HEAD-
    Sec. 1663. Authorization of appropriations

-STATUTE-
      There are authorized to be appropriated such sums as may be
    necessary for each fiscal year through fiscal year 2000 to carry
    out this subchapter.

-SOURCE-
    (Pub. L. 94-437, title VI, Sec. 603, as added Pub. L. 102-573,
    title VI, Sec. 603, Oct. 29, 1992, 106 Stat. 4571.)

-End-


-CITE-
    25 USC SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
                 SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS             

-COD-
                               CODIFICATION                           
      This subchapter was in the original title VII of Pub. L. 94-437,
    as added by Pub. L. 102-573. Former title VII was renumbered VIII
    by Pub. L. 102-573 and is classified to subchapter VI of this
    chapter. Titles IV, V, and VI of Pub. L. 102-437 are classified to
    subchapters III-A, IV, and V of this chapter, respectively.

-End-



-CITE-
    25 USC Sec. 1665                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665. Indian Health Service responsibilities

-STATUTE-
      The Memorandum of Agreement entered into pursuant to section 2411
    of this title shall include specific provisions pursuant to which
    the Service shall assume responsibility for - 
        (1) the determination of the scope of the problem of alcohol
      and substance abuse among Indian people, including the number of
      Indians within the jurisdiction of the Service who are directly
      or indirectly affected by alcohol and substance abuse and the
      financial and human cost;
        (2) an assessment of the existing and needed resources
      necessary for the prevention of alcohol and substance abuse and
      the treatment of Indians affected by alcohol and substance abuse;
      and
        (3) an estimate of the funding necessary to adequately support
      a program of prevention of alcohol and substance abuse and
      treatment of Indians affected by alcohol and substance abuse.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 701, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4572.)

-End-



-CITE-
    25 USC Sec. 1665a                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665a. Indian Health Service program

-STATUTE-
    (a) Comprehensive prevention and treatment program
      (1) The Secretary, acting through the Service, shall provide a
    program of comprehensive alcohol and substance abuse prevention and
    treatment which shall include - 
        (A) prevention, through educational intervention, in Indian
      communities;
        (B) acute detoxification and treatment;
        (C) community-based rehabilitation;
        (D) community education and involvement, including extensive
      training of health care, educational, and community-based
      personnel; and
        (E) residential treatment programs for pregnant and post partum
      women and their children.

      (2) The target population of such program shall be members of
    Indian tribes. Efforts to train and educate key members of the
    Indian community shall target employees of health, education,
    judicial, law enforcement, legal, and social service programs.
    (b) Contract health services
      (1) The Secretary, acting through the Service, may enter into
    contracts with public or private providers of alcohol and substance
    abuse treatment services for the purpose of assisting the Service
    in carrying out the program required under subsection (a) of this
    section.
      (2) In carrying out this subsection, the Secretary shall provide
    assistance to Indian tribes to develop criteria for the
    certification of alcohol and substance abuse service providers and
    accreditation of service facilities which meet minimum standards
    for such services and facilities as may be determined pursuant to
    section 2411(a)(3) of this title.
    (c) Grants for model program
      (1) The Secretary, acting through the Service shall make a grant
    to the Standing Rock Sioux Tribe to develop a community-based
    demonstration project to reduce drug and alcohol abuse on the
    Standing Rock Sioux Reservation and to rehabilitate Indian families
    afflicted by such abuse.
      (2) Funds shall be used by the Tribe to - 
        (A) develop and coordinate community-based alcohol and
      substance abuse prevention and treatment services for Indian
      families;
        (B) develop prevention and intervention models for Indian
      families;
        (C) conduct community education on alcohol and substance abuse;
      and
        (D) coordinate with existing Federal, State, and tribal
      services on the reservation to develop a comprehensive alcohol
      and substance abuse program that assists in the rehabilitation of
      Indian families that have been or are afflicted by alcoholism.

      (3) The Secretary shall submit to the President for inclusion in
    the report to be transmitted to the Congress under section 1671 of
    this title for fiscal year 1995 an evaluation of the demonstration
    project established under paragraph (1).

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 702, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4573.)

-End-



-CITE-
    25 USC Sec. 1665b                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665b. Indian women treatment programs

-STATUTE-
    (a) Grants
      The Secretary may make grants to Indian tribes and tribal
    organizations to develop and implement a comprehensive alcohol and
    substance abuse program of prevention, intervention, treatment, and
    relapse prevention services that specifically addresses the
    cultural, historical, social, and child care needs of Indian women,
    regardless of age.
    (b) Use of grants
      Grants made pursuant to this section may be used to - 
        (1) develop and provide community training, education, and
      prevention programs for Indian women relating to alcohol and
      substance abuse issues, including fetal alcohol syndrome and
      fetal alcohol effect;
        (2) identify and provide appropriate counseling, advocacy,
      support, and relapse prevention to Indian women and their
      families; and
        (3) develop prevention and intervention models for Indian women
      which incorporate traditional healers, cultural values, and
      community and family involvement.
    (c) Criteria for review and approval of grant applications
      The Secretary shall establish criteria for the review and
    approval of applications for grants under this section.
    (d) Authorization of appropriations
      (1) There are authorized to be appropriated to carry out this
    section $10,000,000 for fiscal year 1993 and such sums as are
    necessary for each of the fiscal years 1994, 1995, 1996, 1997,
    1998, 1999, and 2000.
      (2) Twenty percent of the funds appropriated pursuant to this
    subsection shall be used to make grants to urban Indian
    organizations funded under subchapter IV of this chapter.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 703, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4573.)

-End-



-CITE-
    25 USC Sec. 1665c                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665c. Indian Health Service youth program

-STATUTE-
    (a) Detoxification and rehabilitation
      The Secretary shall develop and implement a program for acute
    detoxification and treatment for Indian youth who are alcohol and
    substance abusers. The program shall include regional treatment
    centers designed to include detoxification and rehabilitation for
    both sexes on a referral basis. These regional centers shall be
    integrated with the intake and rehabilitation programs based in the
    referring Indian community.
    (b) Treatment centers or facilities
      (1) The Secretary shall construct, renovate, or, as necessary,
    purchase, and appropriately staff and operate, a youth regional
    treatment center in each area under the jurisdiction of an area
    office. For the purposes of this subsection, the area offices of
    the Service in Tucson and Phoenix, Arizona, shall be considered one
    area office and the area office in California shall be considered
    to be two area offices, one office whose jurisdiction shall be
    considered to encompass the northern area of the State of
    California, and one office whose jurisdiction shall be considered
    to encompass the remainder of the State of California.
      (2) For the purpose of staffing and operating such centers or
    facilities, funding shall be pursuant to section 13 of this title.
      (3) A youth treatment center constructed or purchased under this
    subsection shall be constructed or purchased at a location within
    the area described in paragraph (1) agreed upon (by appropriate
    tribal resolution) by a majority of the tribes to be served by such
    center.
      (4)(A) Notwithstanding any other provision of this subchapter,
    the Secretary may, from amounts authorized to be appropriated for
    the purposes of carrying out this section, make funds available to -
     
        (i) the Tanana Chiefs Conference, Incorporated, for the purpose
      of leasing, constructing, renovating, operating and maintaining a
      residential youth treatment facility in Fairbanks, Alaska; and
        (ii) the Southeast Alaska Regional Health Corporation to staff
      and operate a residential youth treatment facility without regard
      to the proviso set forth in section 450b(l) of this title.

      (B) Until additional residential youth treatment facilities are
    established in Alaska pursuant to this section, the facilities
    specified in subparagraph (A) shall make every effort to provide
    services to all eligible Indian youth residing in such State.
    (c) Federally owned structures
      (1) The Secretary, acting through the Service, shall, in
    consultation with Indian tribes - 
        (A) identify and use, where appropriate, federally owned
      structures suitable as local residential or regional alcohol and
      substance abuse treatment centers for Indian youth; and
        (B) establish guidelines for determining the suitability of any
      such federally owned structure to be used as a local residential
      or regional alcohol and substance abuse treatment center for
      Indian youth.

      (2) Any structure described in paragraph (1) may be used under
    such terms and conditions as may be agreed upon by the Secretary
    and the agency having responsibility for the structure.
    (d) Rehabilitation and aftercare services
      (1) The Secretary, in cooperation with the Secretary of the
    Interior, shall develop and implement within each Service service
    unit community-based rehabilitation and follow-up services for
    Indian youth who are alcohol or substance abusers which are
    designed to integrate long-term treatment and to monitor and
    support the Indian youth after their return to their home
    community.
      (2) Services under paragraph (1) shall be administered within
    each service unit by trained staff within the community who can
    assist the Indian youth in continuing development of self-image,
    positive problem-solving skills, and nonalcohol or substance
    abusing behaviors. Such staff shall include alcohol and substance
    abuse counselors, mental health professionals, and other health
    professionals and paraprofessionals, including community health
    representatives.
    (e) Inclusion of family in youth treatment program
      In providing the treatment and other services to Indian youth
    authorized by this section, the Secretary shall provide for the
    inclusion of family members of such youth in the treatment programs
    or other services as may be appropriate. Not less than 10 percent
    of the funds appropriated for the purposes of carrying out
    subsection (d) of this section shall be used for outpatient care of
    adult family members related to the treatment of an Indian youth
    under that subsection.
    (f) Multidrug abuse study
      (1) The Secretary shall conduct a study to determine the
    incidence and prevalence of the abuse of multiple forms of drugs,
    including alcohol, among Indian youth residing on Indian
    reservations and in urban areas and the interrelationship of such
    abuse with the incidence of mental illness among such youth.
      (2) The Secretary shall submit a report detailing the findings of
    such study, together with recommendations based on such findings,
    to the Congress no later than two years after October 29, 1992.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 704, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4574.)

-End-



-CITE-
    25 USC Sec. 1665d                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665d. Training and community education

-STATUTE-
    (a) Community education
      The Secretary, in cooperation with the Secretary of the Interior,
    shall develop and implement within each service unit a program of
    community education and involvement which shall be designed to
    provide concise and timely information to the community leadership
    of each tribal community. Such program shall include education in
    alcohol and substance abuse to political leaders, tribal judges,
    law enforcement personnel, members of tribal health and education
    boards, and other critical members of each tribal community.
    (b) Training
      The Secretary shall, either directly or by contract, provide
    instruction in the area of alcohol and substance abuse, including
    instruction in crisis intervention and family relations in the
    context of alcohol and substance abuse, youth alcohol and substance
    abuse, and the causes and effects of fetal alcohol syndrome to
    appropriate employees of the Bureau of Indian Affairs and the
    Service, and to personnel in schools or programs operated under any
    contract with the Bureau of Indian Affairs or the Service,
    including supervisors of emergency shelters and halfway houses
    described in section 2433 of this title.
    (c) Community-based training models
      In carrying out the education and training programs required by
    this section, the Secretary, acting through the Service and in
    consultation with tribes and Indian alcohol and substance abuse
    prevention experts, shall develop and provide community-based
    training models. Such models shall address - 
        (1) the elevated risk of alcohol and substance abuse faced by
      children of alcoholics;
        (2) the cultural and multigenerational aspects of alcohol and
      substance abuse prevention and recovery; and
        (3) community-based and multidisciplinary strategies for
      preventing and treating alcohol and substance abuse.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 705, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4576.)

-End-



-CITE-
    25 USC Sec. 1665e                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665e. Gallup alcohol and substance abuse treatment center

-STATUTE-
    (a) Grants for residential treatment
      The Secretary shall make grants to the Navajo Nation for the
    purpose of providing residential treatment for alcohol and
    substance abuse for adult and adolescent members of the Navajo
    Nation and neighboring tribes.
    (b) Purposes of grants
      Grants made pursuant to this section shall (to the extent
    appropriations are made available) be used to - 
        (1) provide at least 15 residential beds each year for adult
      long-term treatment, including beds for specialized services such
      as polydrug abusers, dual diagnosis, and specialized services for
      women with fetal alcohol syndrome children;
        (2) establish clinical assessment teams consisting of a
      clinical psychologist, a part-time addictionologist, a master's
      level assessment counselor, and a certified medical records
      technician which shall be responsible for conducting individual
      assessments and matching Indian clients with the appropriate
      available treatment;
        (3) provide at least 12 beds for an adolescent shelterbed
      program in the city of Gallup, New Mexico, which shall serve as a
      satellite facility to the Acoma/Canoncito/Laguna Hospital and the
      adolescent center located in Shiprock, New Mexico, for emergency
      crisis services, assessment, and family intervention;
        (4) develop a relapse program for the purposes of identifying
      sources of job training and job opportunity in the Gallup area
      and providing vocational training, job placement, and job
      retention services to recovering substance abusers; and
        (5) provide continuing education and training of treatment
      staff in the areas of intensive outpatient services, development
      of family support systems, and case management in cooperation
      with regional colleges, community colleges, and universities.
    (c) Contract for residential treatment
      The Navajo Nation, in carrying out the purposes of this section,
    shall enter into a contract with an institution in the Gallup, New
    Mexico, area which is accredited by the Joint Commission of the
    Accreditation of Health Care Organizations to provide comprehensive
    alcohol and drug treatment as authorized in subsection (b) of this
    section.
    (d) Authorization of appropriations
      There are authorized to be appropriated, for each of fiscal years
    1996 through 2000, such sums as may be necessary to carry out
    subsection (b) of this section.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 706, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4576; amended Pub.
    L. 104-313, Sec. 2(e), Oct. 19, 1996, 110 Stat. 3822.)


-MISC1-
                                AMENDMENTS                            
      1996 - Subsec. (d). Pub. L. 104-313 amended heading and text of
    subsec. (d) generally, extending appropriation authorization for
    programs under subsection (b) of this section through fiscal year
    2000.

-End-



-CITE-
    25 USC Sec. 1665f                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665f. Reports

-STATUTE-
    (a) Compilation of data
      The Secretary, with respect to the administration of any health
    program by a service unit, directly or through contract, including
    a contract under the Indian Self-Determination Act [25 U.S.C. 450f
    et seq.], shall require the compilation of data relating to the
    number of cases or incidents in which any Service personnel or
    services were involved and which were related, either directly or
    indirectly, to alcohol or substance abuse. Such report shall
    include the type of assistance provided and the disposition of
    these cases.
    (b) Referral of data
      The data compiled under subsection (a) of this section shall be
    provided annually to the affected Indian tribe and Tribal
    Coordinating Committee to assist them in developing or modifying a
    Tribal Action Plan under section 2412 of this title.
    (c) Comprehensive report
      Each service unit director shall be responsible for assembling
    the data compiled under this section and section 2434 of this title
    into an annual tribal comprehensive report. Such report shall be
    provided to the affected tribe and to the Director of the Service
    who shall develop and publish a biennial national report based on
    such tribal comprehensive reports.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 707, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4577.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-End-



-CITE-
    25 USC Sec. 1665g                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665g. Fetal alcohol syndrome and fetal alcohol effect grants

-STATUTE-
    (a) Award; use; review criteria
      (1) The Secretary may make grants to Indian tribes and tribal
    organizations to establish fetal alcohol syndrome and fetal alcohol
    effect programs as provided in this section for the purposes of
    meeting the health status objectives specified in section 1602(b)
    of this title.
      (2) Grants made pursuant to this section shall be used to - 
        (A) develop and provide community and in-school training,
      education, and prevention programs relating to FAS and FAE;
        (B) identify and provide alcohol and substance abuse treatment
      to high-risk women;
        (C) identify and provide appropriate educational and vocational
      support, counseling, advocacy, and information to FAS and FAE
      affected persons and their families or caretakers;
        (D) develop and implement counseling and support programs in
      schools for FAS and FAE affected children;
        (E) develop prevention and intervention models which
      incorporate traditional healers, cultural values and community
      involvement;
        (F) develop, print, and disseminate education and prevention
      materials on FAS and FAE; and
        (G) develop and implement, through the tribal consultation
      process, culturally sensitive assessment and diagnostic tools for
      use in tribal and urban Indian communities.

      (3) The Secretary shall establish criteria for the review and
    approval of applications for grants under this section.
    (b) Plan; study; national clearinghouse
      The Secretary, acting through the Service, shall - 
        (1) develop an annual plan for the prevention, intervention,
      treatment, and aftercare for those affected by FAS and FAE in
      Indian communities;
        (2) conduct a study, directly or by contract with any
      organization, entity, or institution of higher education with
      significant knowledge of FAS and FAE and Indian communities, of
      the special educational, vocational, school-to-work transition,
      and independent living needs of adolescent and adult Indians and
      Alaska Natives with FAS or FAE; and
        (3) establish a national clearinghouse for prevention and
      educational materials and other information on FAS and FAE effect
      in Indian and Alaska Native communities and ensure access to
      clearinghouse materials by any Indian tribe or urban Indian
      organization.
    (c) Task force
      The Secretary shall establish a task force to be known as the
    FAS/FAE Task Force to advise the Secretary in carrying out
    subsection (b) of this section. Such task force shall be composed
    of representatives from the National Institute on Drug Abuse, the
    National Institute on Alcohol and Alcoholism, the Office of
    Substance Abuse Prevention, the National Institute of Mental
    Health, the Service, the Office of Minority Health of the
    Department of Health and Human Services, the Administration for
    Native Americans, the Bureau of Indian Affairs, Indian tribes,
    tribal organizations, urban Indian communities, and Indian FAS/FAE
    experts.
    (d) Cooperative projects; research projects
      The Secretary, acting through the Substance Abuse and Mental
    Health Services Administration, shall make grants to Indian tribes,
    tribal organizations, universities working with Indian tribes on
    cooperative projects, and urban Indian organizations for applied
    research projects which propose to elevate the understanding of
    methods to prevent, intervene, treat, or provide aftercare for
    Indians and urban Indians affected by FAS or FAE.
    (e) Report
      (1) The Secretary shall submit to the President, for inclusion in
    each report required to be transmitted to the Congress under
    section 1671 of this title, a report on the status of FAS and FAE
    in the Indian population. Such report shall include, in addition to
    the information required under section 1602(d) of this title with
    respect to the health status objective specified in section
    1602(b)(27) of this title, the following:
        (A) The progress of implementing a uniform assessment and
      diagnostic methodology in Service and tribally based service
      delivery systems.
        (B) The incidence of FAS and FAE babies born for all births by
      reservation and urban-based sites.
        (C) The prevalence of FAS and FAE affected Indian persons in
      Indian communities, their primary means of support, and
      recommendations to improve the support system for these
      individuals and their families or caretakers.
        (D) The level of support received from the entities specified
      in subsection (c) of this section in the area of FAS and FAE.
        (E) The number of inpatient and outpatient substance abuse
      treatment resources which are specifically designed to meet the
      unique needs of Indian women, and the volume of care provided to
      Indian women through these means.
        (F) Recommendations regarding the prevention, intervention, and
      appropriate vocational, educational and other support services
      for FAS and FAE affected individuals in Indian communities.

      (2) The Secretary may contract the production of this report to a
    national organization specifically addressing FAS and FAE in Indian
    communities.
    (f) Authorization of appropriations
      (1) There are authorized to be appropriated to carry out this
    section $22,000,000 for fiscal year 1993 and such sums as may be
    necessary for each of the fiscal years 1994, 1995, 1996, 1997,
    1998, 1999, and 2000.
      (2) Ten percent of the funds appropriated pursuant to this
    section shall be used to make grants to urban Indian organizations
    funded under subchapter IV of this chapter.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 708, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4578.)

-End-



-CITE-
    25 USC Sec. 1665h                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665h. Pueblo substance abuse treatment project for San Juan
      Pueblo, New Mexico

-STATUTE-
      The Secretary, acting through the Service, shall continue to make
    grants, through fiscal year 1995, to the 8 Northern Indian Pueblos
    Council, San Juan Pueblo, New Mexico, for the purpose of providing
    substance abuse treatment services to Indians in need of such
    services.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 709, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4579.)

-End-



-CITE-
    25 USC Sec. 1665i                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665i. Thunder Child Treatment Center

-STATUTE-
      (a) The Secretary, acting through the Service, shall make a grant
    to the Intertribal Addictions Recovery Organization, Inc. (commonly
    known as the Thunder Child Treatment Center) at Sheridan, Wyoming,
    for the completion of construction of a multiple approach substance
    abuse treatment center which specializes in the treatment of
    alcohol and drug abuse of Indians.
      (b) For the purposes of carrying out subsection (a) of this
    section, there are authorized to be appropriated $2,000,000 for
    fiscal years 1993 and 1994. No funding shall be available for
    staffing or operation of this facility. None of the funding
    appropriated to carry out subsection (a) of this section shall be
    used for administrative purposes.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 710, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4580.)

-End-



-CITE-
    25 USC Sec. 1665j                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665j. Substance abuse counselor education demonstration
      project

-STATUTE-
    (a) Contracts and grants
      The Secretary, acting through the Service, may enter into
    contracts with, or make grants to, accredited tribally controlled
    community colleges, tribally controlled postsecondary vocational
    institutions, and eligible community colleges to establish
    demonstration projects to develop educational curricula for
    substance abuse counseling.
    (b) Use of funds
      Funds provided under this section shall be used only for
    developing and providing educational curricula for substance abuse
    counseling (including paying salaries for instructors). Such
    curricula may be provided through satellite campus programs.
    (c) Effective period of contract or grant; renewal
      A contract entered into or a grant provided under this section
    shall be for a period of one year. Such contract or grant may be
    renewed for an additional one year period upon the approval of the
    Secretary.
    (d) Criteria for review and approval of applications
      Not later than 180 days after October 29, 1992, the Secretary,
    after consultation with Indian tribes and administrators of
    accredited tribally controlled community colleges, tribally
    controlled postsecondary vocational institutions, and eligible
    community colleges, shall develop and issue criteria for the review
    and approval of applications for funding (including applications
    for renewals of funding) under this section. Such criteria shall
    ensure that demonstration projects established under this section
    promote the development of the capacity of such entities to educate
    substance abuse counselors.
    (e) Assistance to recipients
      The Secretary shall provide such technical and other assistance
    as may be necessary to enable grant recipients to comply with the
    provisions of this section.
    (f) Report
      The Secretary shall submit to the President, for inclusion in the
    report which is required to be submitted under section 1671 of this
    title for fiscal year 1999, a report on the findings and
    conclusions derived from the demonstration projects conducted under
    this section.
    (g) Definitions
      For the purposes of this section, the following definitions
    apply:
        (1) The term "educational curriculum" means one or more of the
      following:
          (A) Classroom education.
          (B) Clinical work experience.
          (C) Continuing education workshops.

        (2) The term "eligible community college" means an accredited
      community college that - 
          (i) is located on or near an Indian reservation;
          (ii) has entered into a cooperative agreement with the
        governing body of such Indian reservation to carry out a
        demonstration project under this section; and
          (iii) has a student enrollment of not less than 10 percent
        Indian.

        (3) The term "tribally controlled community college" has the
      meaning given such term in section 1801(a)(4) (!1) of this title.

        (4) The term "tribally controlled postsecondary vocational
      institution" has the meaning given such term in section 2397h(2)
      (!1) of title 20.
    (h) Authorization of appropriations
      There are authorized to be appropriated for each of fiscal years
    1996 through 2000,(!2) such sums as may be necessary to carry out
    the purposes of this section. Such sums shall remain available
    until expended.


-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 711, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4580; amended Pub.
    L. 104-313, Sec. 2(f), Oct. 19, 1996, 110 Stat. 3822; Pub. L. 105-
    244, title IX, Sec. 901(d), Oct. 7, 1998, 112 Stat. 1828; Pub. L.
    105-256, Sec. 13(a), Oct. 14, 1998, 112 Stat. 1900.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      Section 1801(a)(4) of this title, referred to in subsec. (g)(3),
    was amended by Pub. L. 105-244, title IX, Sec. 901(b)(5), Oct. 7,
    1998, 112 Stat. 1828, and, as so amended, no longer defines the
    term "tribally controlled community college".
      Section 2397h of title 20, referred to in subsec. (g)(4), was
    omitted in the general amendment of chapter 44 (Sec. 2301 et seq.)
    of Title 20, Education, by Pub. L. 105-332, Sec. 1(b), Oct. 31,
    1998, 112 Stat. 3076.


-MISC1-
                                AMENDMENTS                            
      1998 - Subsec. (g)(3). Pub. L. 105-244 made technical amendment
    to reference in original act which appears in text as reference to
    section 1801(a)(4) of this title.
      Subsec. (h). Pub. L. 105-256 substituted "of fiscal years" for
    "of the fiscal years" in first sentence.
      1996 - Subsec. (h). Pub. L. 104-313 substituted "1996 through
    2000" for "1993, 1994, 1995, 1996, and 1997".

                     EFFECTIVE DATE OF 1998 AMENDMENT                 
      Amendment by Pub. L. 105-244 effective Oct. 1, 1998, except as
    otherwise provided in Pub. L. 105-244, see section 3 of Pub. L. 105-
    244, set out as a note under section 1001 of Title 20, Education.

-FOOTNOTE-
    (!1) See References in Text note below.

    (!2) So in original. The comma probably should not appear.


-End-



-CITE-
    25 USC Sec. 1665k                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665k. Gila River alcohol and substance abuse treatment
      facility

-STATUTE-
    (a) Regional center
      The Secretary, acting through the Service, shall establish a
    regional youth alcohol and substance abuse prevention and treatment
    center in Sacaton, Arizona, on the Gila River Indian Reservation.
    The center shall be established within facilities leased, with the
    consent of the Gila River Indian Community, by the Service from
    such Community.
    (b) Name of regional center
      The center established pursuant to this section shall be known as
    the "Regional Youth Alcohol and Substance Abuse Prevention and
    Treatment Center".
    (c) Unit of regional center
      The Secretary, acting through the Service, shall establish, as a
    unit of the regional center, a youth alcohol and substance abuse
    prevention and treatment facility in Fallon, Nevada.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 712, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4581.)

-End-



-CITE-
    25 USC Sec. 1665l                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665l. Alaska Native drug and alcohol abuse demonstration
      project

-STATUTE-
      (a) The Secretary, acting through the Service, shall make grants
    to the Alaska Native Health Board for the conduct of a two-part
    community-based demonstration project to reduce drug and alcohol
    abuse in Alaska Native villages and to rehabilitate families
    afflicted by such abuse. Sixty percent of such grant funds shall be
    used by the Health Board to stimulate coordinated community
    development programs in villages seeking to organize to combat
    alcohol and drug use. Forty percent of such grant funds shall be
    transferred to a qualified nonprofit corporation providing alcohol
    recovery services in the village of St. Mary's, Alaska, to enlarge
    and strengthen a family life demonstration program of
    rehabilitation for families that have been or are afflicted by
    alcoholism.
      (b) The Secretary shall submit to the President for inclusion in
    the report required to be submitted to the Congress under section
    1671 of this title for fiscal year 1995 an evaluation of the
    demonstration project established under subsection (a) of this
    section.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 713, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4581.)

-End-



-CITE-
    25 USC Sec. 1665m                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS

-HEAD-
    Sec. 1665m. Authorization of appropriations

-STATUTE-
      Except as provided in sections 1665b, 1665e, 1665g, 1665i, and
    1665j of this title, there are authorized to be appropriated such
    sums as may be necessary for each fiscal year through fiscal year
    2000 to carry out the provisions of this subchapter.

-SOURCE-
    (Pub. L. 94-437, title VII, Sec. 714, as added Pub. L. 102-573,
    title VII, Sec. 702(a), Oct. 29, 1992, 106 Stat. 4581.)

-End-


-CITE-
    25 USC SUBCHAPTER VI - MISCELLANEOUS                        01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
                       SUBCHAPTER VI - MISCELLANEOUS                   

-COD-
                               CODIFICATION                           
      This subchapter was in the original title VIII, formerly VII, of
    Pub. L. 94-437, as renumbered by Pub. L. 102-573. Titles IV, V, VI,
    and VII of Pub. L. 94-437 are classified to subchapters III-A, IV,
    V, and V-A of this chapter, respectively.

-End-



-CITE-
    25 USC Sec. 1671                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1671. Reports

-STATUTE-
      The President shall, at the time the budget is submitted under
    section 1105 of title 31, for each fiscal year transmit to the
    Congress a report containing - 
        (1) a report on the progress made in meeting the objectives of
      this chapter, including a review of programs established or
      assisted pursuant to this chapter and an assessment and
      recommendations of additional programs or additional assistance
      necessary to, at a minimum, provide health services to Indians,
      and ensure a health status for Indians, which are at a parity
      with the health services available to and the health status of,
      the general population;
        (2) a report on whether, and to what extent, new national
      health care programs, benefits, initiatives, or financing systems
      have had an impact on the purposes of this chapter and any steps
      that the Secretary may have taken to consult with Indian tribes
      to address such impact;
        (3) a report on the use of health services by Indians - 
          (A) on a national and area or other relevant geographical
        basis;
          (B) by gender and age;
          (C) by source of payment and type of service; and
          (D) comparing such rates of use with rates of use among
        comparable non-Indian populations.(!1)


        (4) a separate statement which specifies the amount of funds
      requested to carry out the provisions of section 1621 of this
      title;
        (5) a separate statement of the total amount obligated or
      expended in the most recently completed fiscal year to achieve
      each of the objectives described in section 1680d of this title,
      relating to infant and maternal mortality and fetal alcohol
      syndrome;
        (6) the reports required by sections 1602(d), 1616a(n),
      1621b(b), 1621h(j), 1631(c), 1632(g), 1634(a)(3), 1643, 1665g(e),
      and 1680g(a), and 1680l(f) of this title;
        (7) for fiscal year 1995, the report required by sections
      1665a(c)(3) and 1665l(b) of this title;
        (8) for fiscal year 1997, the interim report required by
      section 1637(h)(1) of this title; and
        (9) for fiscal year 1999, the reports required by sections
      1637(h)(2), 1660b(b), 1665j(f), and 1680k(g) of this title.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 801, formerly title VII, Sec.
    701, Sept. 30, 1976, 90 Stat. 1413; renumbered title VIII, Sec.
    801, and amended Pub. L. 102-573, title VII, Sec. 701(a), (b),
    title VIII, Sec. 801, Oct. 29, 1992, 106 Stat. 4572, 4584.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 801, amended section generally.
    Prior to amendment, section read as follows: "The Secretary shall
    report annually to the President and the Congress on progress made
    in effecting the purposes of this chapter. Within three months
    after the end of fiscal year 1979, the Secretary shall review
    expenditures and progress made under this chapter and make
    recommendations to the Congress concerning any additional
    authorizations for fiscal years 1981 through 1984 for programs
    authorized under this chapter which he deems appropriate. In the
    event the Congress enacts legislation authorizing appropriations
    for programs under this chapter for fiscal years 1981 through 1984,
    within three months after the end of fiscal year 1983, the
    Secretary shall review programs established or assisted pursuant to
    this chapter and shall submit to the Congress his assessment and
    recommendations of additional programs or additional assistance
    necessary to, at a minimum, provide health services to Indians, and
    insure a health status for Indians, which are at a parity with the
    health services available to, and the health status, of the general
    population."

            COMMISSION ON INDIAN AND NATIVE ALASKAN HEALTH CARE        
      Pub. L. 106-310, div. B, title XXXIII, Sec. 3307, Oct. 17, 2000,
    114 Stat. 1216, provided that:
      "(a) In General. - There is established a commission to be known
    as the Commission on Indian and Native Alaskan Health Care that
    shall examine the health concerns of Indians and Native Alaskans
    who reside on reservations and tribal lands (hereafter in this
    section referred to as the 'Commission').
      "(b) Membership. - 
        "(1) In general. - The Commission established under subsection
      (a) shall consist of - 
          "(A) the Secretary;
          "(B) 15 members who are experts in the health care field and
        issues that the Commission is established to examine; and
          "(C) the Director of the Indian Health Service and the
        Commissioner of Indian Affairs, who shall be nonvoting members.
        "(2) Appointing authority. - Of the 15 members of the
      Commission described in paragraph (1)(B) - 
          "(A) two shall be appointed by the Speaker of the House of
        Representatives;
          "(B) two shall be appointed by the Minority Leader of the
        House of Representatives;
          "(C) two shall be appointed by the Majority Leader of the
        Senate;
          "(D) two shall be appointed by the Minority Leader of the
        Senate; and
          "(E) seven shall be appointed by the Secretary.
        "(3) Limitation. - Not fewer than 10 of the members appointed
      to the Commission shall be Indians or Native Alaskans.
        "(4) Chairperson. - The Secretary shall serve as the
      Chairperson of the Commission.
        "(5) Experts. - The Commission may seek the expertise of any
      expert in the health care field to carry out its duties.
      "(c) Period of Appointment. - Members shall be appointed for the
    life of the Commission. Any vacancy in the Commission shall not
    affect its powers, but shall be filed [sic] in the same manner as
    the original appointment.
      "(d) Duties of the Commission. - The Commission shall - 
        "(1) study the health concerns of Indians and Native Alaskans;
      and
        "(2) prepare the reports described in subsection (i).
      "(e) Powers of the Commission. - 
        "(1) Hearings. - The Commission may hold such hearings,
      including hearings on reservations, sit and act at such times and
      places, take such testimony, and receive such information as the
      Commission considers advisable to carry out the purpose for which
      the Commission was established.
        "(2) Information from federal agencies. - The Commission may
      secure directly from any Federal department or agency such
      information as the Commission considers necessary to carry out
      the purpose for which the Commission was established. Upon
      request of the Chairperson of the Commission, the head of such
      department or agency shall furnish such information to the
      Commission.
      "(f) Compensation of Members. - 
        "(1) In general. - Except as provided in subparagraph (B), each
      member of the Commission may be compensated at a rate not to
      exceed the daily equivalent of the annual rate of basic pay
      prescribed for level IV of the Executive Schedule under section
      5315 of title 5, United States Code, for each day (including
      travel time), during which that member is engaged in the actual
      performance of the duties of the Commission.
        "(2) Limitation. - Members of the Commission who are officers
      or employees of the United States shall receive no additional pay
      on account of their service on the Commission.
      "(g) Travel Expenses of Members. - The members of the Commission
    shall be allowed travel expenses, including per diem in lieu of
    subsistence, at rates authorized for employees of agencies under
    section 5703 of title 5, United States Code, while away from their
    homes or regular places of business in the performance of services
    for the Commission.
      "(h) Commission Personnel Matters. - 
        "(1) In general. - The Secretary, in accordance with rules
      established by the Commission, may select and appoint a staff
      director and other personnel necessary to enable the Commission
      to carry out its duties.
        "(2) Compensation of personnel. - The Secretary, in accordance
      with rules established by the Commission, may set the amount of
      compensation to be paid to the staff director and any other
      personnel that serve the Commission.
        "(3) Detail of government employees. - Any Federal Government
      employee may be detailed to the Commission without reimbursement,
      and the detail shall be without interruption or loss of civil
      service status or privilege.
        "(4) Consultant services. - The Chairperson of the Commission
      is authorized to procure the temporary and intermittent services
      of experts and consultants in accordance with section 3109 of
      title 5, United States Code, at rates not to exceed the daily
      equivalent of the annual rate of basic pay prescribed for level
      IV of the Executive Schedule under section 5315 of such title.
      "(i) Report. - 
        "(1) In general. - Not later than 3 years after the date of the
      enactment of the Youth Drug and Mental Health Services Act [Oct.
      17, 2000], the Secretary shall prepare and submit, to the
      Committee on Health, Education, Labor, and Pensions of the
      Senate, a report that shall - 
          "(A) detail the health problems faced by Indians and Native
        Alaskans who reside on reservations;
          "(B) examine and explain the causes of such problems;
          "(C) describe the health care services available to Indians
        and Native Alaskans who reside on reservations and the adequacy
        of such services;
          "(D) identify the reasons for the provision of inadequate
        health care services for Indians and Native Alaskans who reside
        on reservations, including the availability of resources;
          "(E) develop measures for tracking the health status of
        Indians and Native Americans who reside on reservations; and
          "(F) make recommendations for improvements in the health care
        services provided for Indians and Native Alaskans who reside on
        reservations, including recommendations for legislative change.
        "(2) Exception. - In addition to the report required under
      paragraph (1), not later than 2 years after the date of the
      enactment of the Youth Drug and Mental Health Services Act [Oct.
      17, 2000], the Secretary shall prepare and submit, to the
      Committee on Health, Education, Labor, and Pensions of the
      Senate, a report that describes any alcohol and drug abuse among
      Indians and Native Alaskans who reside on reservations.
      "(j) Permanent Commission. - Section 14 of the Federal Advisory
    Committee Act (5 U.S.C. App.) shall not apply to the Commission.
      "(k) Authorization of Appropriations. - There is authorized to be
    appropriated to carry out this section $5,000,000 for fiscal year
    2001, and such sums as may be necessary for fiscal years 2002 and
    2003."

          REFERENCES TO SECTIONS 701 TO 720 OF PUBLIC LAW 94-437      
      Section 701(d) of Pub. L. 102-573 provided that: "Any reference
    in a provision of law other than the Indian Health Care Improvement
    Act [25 U.S.C. 1601 et seq.] to sections redesignated by subsection
    (b) [renumbering sections 701 to 720 of Pub. L. 94-437 as sections
    801 to 820 of Pub. L. 94-437, which are classified to sections 1671
    to 1680j of this title] shall be deemed to refer to the section as
    so redesignated."

-FOOTNOTE-               

    (!1) So in original. The period probably should be a semicolon.


-End-



-CITE-
    25 USC Sec. 1672                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1672. Regulations

-STATUTE-
      Prior to any revision of or amendment to rules or regulations
    promulgated pursuant to this chapter, the Secretary shall consult
    with Indian tribes and appropriate national or regional Indian
    organizations and shall publish any proposed revision or amendment
    in the Federal Register not less than sixty days prior to the
    effective date of such revision or amendment in order to provide
    adequate notice to, and receive comments from, other interested
    parties.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 802, formerly title VII, Sec.
    702, Sept. 30, 1976, 90 Stat. 1413; renumbered title VIII, Sec.
    802, and amended Pub. L. 102-573, title VII, Sec. 701(a), (b),
    title VIII, Sec. 802, Oct. 29, 1992, 106 Stat. 4572, 4585.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 802, amended section generally,
    substituting present provisions for former provisions relating in
    subsec. (a) to consideration, formulation, proposal, and
    promulgation of regulations and in subsec. (b) to revision and
    amendment of regulations.

-End-



-CITE-
    25 USC Sec. 1673                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1673. Repealed.

-MISC1-
    Sec. 1673. Repealed. Pub. L. 102-573, title IX, Sec. 901(4), Oct.
      29, 1992, 106 Stat. 4591.
      Section, Pub. L. 94-437, title VIII, Sec. 803, formerly title
    VII, Sec. 703, Sept. 30, 1976, 90 Stat. 1413; renumbered title
    VIII, Sec. 803, Pub. L. 102-573, title VII, Sec. 701(a), (b), Oct.
    29, 1992, 106 Stat. 4572, related to submission by Secretary to
    Congress of plan to implement provisions of this chapter.

-End-



-CITE-
    25 USC Sec. 1674                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1674. Leases with Indian tribes

-STATUTE-
      (a) Notwithstanding any other provision of law, the Secretary is
    authorized, in carrying out the purposes of this chapter, to enter
    into leases with Indian tribes for periods not in excess of twenty
    years. Property leased by the Secretary from an Indian tribe may be
    reconstructed or renovated by the Secretary pursuant to an
    agreement with such Indian tribe.
      (b) The Secretary may enter into leases, contracts, and other
    legal agreements with Indian tribes or tribal organizations which
    hold - 
        (1) title to;
        (2) a leasehold interest in; or
        (3) a beneficial interest in (where title is held by the United
      States in trust for the benefit of a tribe);

    facilities used for the administration and delivery of health
    services by the Service or by programs operated by Indian tribes or
    tribal organizations to compensate such Indian tribes or tribal
    organizations for costs associated with the use of such facilities
    for such purposes. Such costs include rent, depreciation based on
    the useful life of the building, principal and interest paid or
    accrued, operation and maintenance expenses, and other expenses
    determined by regulation to be allowable.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 804, formerly title VII, Sec.
    704, Sept. 30, 1976, 90 Stat. 1414; Pub. L. 96-537, Sec. 8(a), Dec.
    17, 1980, 94 Stat. 3179; Pub. L. 100-713, title VII, Sec. 701, Nov.
    23, 1988, 102 Stat. 4826; renumbered title VIII, Sec. 804, Pub. L.
    102-573, title VII, Sec. 701(a), (b), Oct. 29, 1992, 106 Stat.
    4572.)


-MISC1-
                                AMENDMENTS                            
      1988 - Pub. L. 100-713 designated existing provisions as subsec.
    (a) and added subsec. (b).
      1980 - Pub. L. 96-537 inserted provision that property leased by
    the Secretary from an Indian tribe may be reconstructed or
    renovated by the Secretary pursuant to an agreement with such
    Indian tribe.

-End-



-CITE-
    25 USC Sec. 1675                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1675. Availability of funds

-STATUTE-
      The funds appropriated pursuant to this chapter shall remain
    available until expended.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 805, formerly title VII, Sec.
    705, Sept. 30, 1976, 90 Stat. 1414; renumbered title VIII, Sec.
    805, Pub. L. 102-573, title VII, Sec. 701(a), (b), Oct. 29, 1992,
    106 Stat. 4572.)

-End-



-CITE-
    25 USC Sec. 1676                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1676. Limitation on use of funds appropriated to Indian Health
      Service

-STATUTE-
      Any limitation on the use of funds contained in an Act providing
    appropriations for the Department of Health and Human Services for
    a period with respect to the performance of abortions shall apply
    for that period with respect to the performance of abortions using
    funds contained in an Act providing appropriations for the Indian
    Health Service.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 806, formerly title VII, Sec.
    706, as added Pub. L. 96-537, Sec. 8(b), Dec. 17, 1980, 94 Stat.
    3179; amended Pub. L. 100-713, title VII, Sec. 718, Nov. 23, 1988,
    102 Stat. 4837; renumbered title VIII, Sec. 806, Pub. L. 102-573,
    title VII, Sec. 701(a), (b), Oct. 29, 1992, 106 Stat. 4572.)


-MISC1-
                                AMENDMENTS                            
      1988 - Pub. L. 100-713 inserted section catchline and amended
    text generally. Prior to amendment, text read as follows: "Within
    one year from December 17, 1980, the Secretary shall submit to the
    Congress a resource allocation plan. Such plan shall explain the
    future allocation of services and funds among the service
    population of the Service and shall provide a schedule for reducing
    deficiencies in resources of tribes and nontribal specific
    entities."

-End-



-CITE-
    25 USC Sec. 1677                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1677. Nuclear resource development health hazards

-STATUTE-
    (a) Study
      The Secretary and the Service shall conduct, in conjunction with
    other appropriate Federal agencies and in consultation with
    concerned Indian tribes and organizations, a study of the health
    hazards to Indian miners and Indians on or near Indian reservations
    and in Indian communities as a result of nuclear resource
    development. Such study shall include - 
        (1) an evaluation of the nature and extent of nuclear resource
      development related health problems currently exhibited among
      Indians and the causes of such health problems;
        (2) an analysis of the potential effect of ongoing and future
      nuclear resource development on or near Indian reservations and
      communities;
        (3) an evaluation of the types and nature of activities,
      practices, and conditions causing or affecting such health
      problems, including uranium mining and milling, uranium mine
      tailing deposits, nuclear powerplant operation and construction,
      and nuclear waste disposal;
        (4) a summary of any findings and recommendations provided in
      Federal and State studies, reports, investigations, and
      inspections during the five years prior to December 17, 1980,
      that directly or indirectly relate to the activities, practices,
      and conditions affecting the health or safety of such Indians;
      and
        (5) the efforts that have been made by Federal and State
      agencies and mining and milling companies to effectively carry
      out an education program for such Indians regarding the health
      and safety hazards of such nuclear resource development.
    (b) Health care plan; development
      Upon completion of such study the Secretary and the Service shall
    take into account the results of such study and develop a health
    care plan to address the health problems studied under subsection
    (a) of this section. The plan shall include - 
        (1) methods for diagnosing and treating Indians currently
      exhibiting such health problems;
        (2) preventive care for Indians who may be exposed to such
      health hazards, including the monitoring of the health of
      individuals who have or may have been exposed to excessive
      amounts of radiation, or affected by other nuclear development
      activities that have had or could have a serious impact upon the
      health of such individuals; and
        (3) a program of education for Indians who, by reason of their
      work or geographic proximity to such nuclear development
      activities, may experience health problems.
    (c) Reports to Congress
      The Secretary and the Service shall submit to Congress the study
    prepared under subsection (a) of this section no later than the
    date eighteen months after December 17, 1980. The health care plan
    prepared under subsection (b) of this section shall be submitted in
    a report no later than the date one year after the date that the
    study prepared under subsection (a) of this section is submitted to
    Congress. Such report shall include recommended activities for the
    implementation of the plan, as well as an evaluation of any
    activities previously undertaken by the Service to address such
    health problems.
    (d) Intergovernmental Task Force; establishment and functions
      (1) There is established an Intergovernmental Task Force to be
    composed of the following individuals (or their designees): the
    Secretary of Energy, the Administrator of the Environmental
    Protection Agency, the Director of the United States Bureau of
    Mines, the Assistant Secretary for Occupational Safety and Health,
    and the Secretary of the Interior.
      (2) The Task Force shall identify existing and potential
    operations related to nuclear resource development that affect or
    may affect the health of Indians on or near an Indian reservation
    or in an Indian community and enter into activities to correct
    existing health hazards and insure that current and future health
    problems resulting from nuclear resource development activities are
    minimized or reduced.
      (3) The Secretary shall be Chairman of the Task Force. The Task
    Force shall meet at least twice each year. Each member of the Task
    Force shall furnish necessary assistance to the Task Force.
    (e) Medical care
      In the case of any Indian who - 
        (1) as a result of employment in or near a uranium mine or
      mill, suffers from a work related illness or condition;
        (2) is eligible to receive diagnosis and treatment services
      from a Service facility; and
        (3) by reason of such Indian's employment, is entitled to
      medical care at the expense of such mine or mill operator;

    the Service shall, at the request of such Indian, render
    appropriate medical care to such Indian for such illness or
    condition and may recover the costs of any medical care so rendered
    to which such Indian is entitled at the expense of such operator
    from such operator. Nothing in this subsection shall affect the
    rights of such Indian to recover damages other than such costs paid
    to the Service from the employer for such illness or condition.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 807, formerly title VII, Sec.
    707, as added Pub. L. 96-537, Sec. 8(b), Dec. 17, 1980, 94 Stat.
    3179; amended Pub. L. 102-285, Sec. 10(b), May 18, 1992, 106 Stat.
    172; renumbered title VIII, Sec. 807, and amended Pub. L. 102-573,
    title VII, Sec. 701(a), (b), title VIII, Sec. 813(b), Oct. 29,
    1992, 106 Stat. 4572, 4590.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (f). Pub. L. 102-573, Sec. 813(b), struck out
    subsec. (f) which authorized appropriation of $300,000 to carry out
    the study as provided in subsec. (a), such amount to be expended by
    the date eighteen months after Dec. 17, 1980.

-CHANGE-
                              CHANGE OF NAME                          
      "United States Bureau of Mines" substituted for "Bureau of Mines"
    in subsec. (d)(1) pursuant to section 10(b) of Pub. L. 102-285, set
    out as a note under section 1 of Title 30, Mineral Lands and
    Mining. For provisions relating to closure and transfer of
    functions of the United States Bureau of Mines, see note set out
    under section 1 of Title 30, Minerals and Mining.


-MISC2-
       NUCLEAR RESOURCE DEVELOPMENT HEALTH HAZARDS; STUDY AND REPORT   
      Pub. L. 100-713, title VII, Sec. 717, Nov. 23, 1988, 102 Stat.
    4837, provided that:
      "(a) The Secretary of Health and Human Services (acting through
    the Indian Health Service), the Secretary of the Interior (acting
    through the Bureau of Indian Affairs), and the Secretary of Energy
    shall jointly conduct a study for the purpose of determining - 
        "(1) the number of active nuclear resource development sites on
      Indian lands in the United States;
        "(2) the Federal agencies that carry out Federal
      responsibilities with respect to each such site;
        "(3) the health hazards that exist as a result of such sites;
        "(4) the remedial actions which have been undertaken with
      respect to such health hazards;
        "(5) remedial actions that are needed with respect to such
      health hazards; and
        "(6) the amount of funds that would be necessary each year to
      implement and maintain such needed remedial actions and the date
      by which the remedial actions would be implemented if sufficient
      funds were to provide for the remedial actions.
      "(b) By no later than the date that is 2 years after the date of
    enactment of this Act [Nov. 23, 1988], a report shall be submitted
    to the Congress describing the findings and conclusions made as a
    result of carrying out the study required in subsection (a)."

-End-



-CITE-
    25 USC Sec. 1678                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1678. Arizona as a contract health service delivery area

-STATUTE-
    (a) Designation
      For the fiscal years beginning with the fiscal year ending
    September 30, 1982, and ending with the fiscal year ending
    September 30, 2000, the State of Arizona shall be designated as a
    contract health service delivery area by the Service for the
    purpose of providing contract health care services to members of
    federally recognized Indian tribes of Arizona.
    (b) Curtailment of health services prohibited
      The Service shall not curtail any health care services provided
    to Indians residing on Federal reservations in the State of Arizona
    if such curtailment is due to the provision of contract services in
    such State pursuant to the designation of such State as a contract
    health service delivery area pursuant to subsection (a) of this
    section.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 808, formerly title VII, Sec.
    708, as added Pub. L. 96-537, Sec. 8(b), Dec. 17, 1980, 94 Stat.
    3181; amended Pub. L. 100-713, title VII, Sec. 702, Nov. 23, 1988,
    102 Stat. 4827; renumbered title VIII, Sec. 808, and amended Pub.
    L. 102-573, title VII, Sec. 701(a), (b), title VIII, Sec. 803, Oct.
    29, 1992, 106 Stat. 4572, 4585.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 803, substituted "2000"
    for "1991".
      1988 - Subsec. (a). Pub. L. 100-713, Sec. 702(a), substituted
    "1991" for "1984" and "members of federally recognized Indian
    tribes of Arizona" for "Indians in such State".
      Subsec. (c). Pub. L. 100-713, Sec. 702(b), struck out subsec. (c)
    which authorized appropriations for fiscal years 1982 to 1984.

-End-



-CITE-
    25 USC Sec. 1679                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1679. Eligibility of California Indians

-STATUTE-
    (a) Report to Congress
      (1) In order to provide the Congress with sufficient data to
    determine which Indians in the State of California should be
    eligible for health services provided by the Service, the Secretary
    shall, by no later than the date that is 3 years after November 23,
    1988, prepare and submit to the Congress a report which sets forth -
     
        (A) a determination by the Secretary of the number of Indians
      described in subsection (b)(2) of this section, and the number of
      Indians described in subsection (b)(3) of this section, who are
      not members of an Indian tribe recognized by the Federal
      Government,
        (B) the geographic location of such Indians,
        (C) the Indian tribes of which such Indians are members,
        (D) an assessment of the current health status, and health care
      needs, of such Indians, and
        (E) an assessment of the actual availability and accessibility
      of alternative resources for the health care of such Indians that
      such Indians would have to rely on if the Service did not provide
      for the health care of such Indians.

      (2) The report required under paragraph (1) shall be prepared by
    the Secretary - 
        (A) in consultation with the Secretary of the Interior, and
        (B) with the assistance of the tribal health programs providing
      services to the Indians described in paragraph (2) or (3) of
      subsection (b) of this section who are not members of any Indian
      tribe recognized by the Federal Government.
    (b) Eligible Indians
      Until such time as any subsequent law may otherwise provide, the
    following California Indians shall be eligible for health services
    provided by the Service:
        (1) Any member of a federally recognized Indian tribe.
        (2) Any descendant of an Indian who was residing in California
      on June 1, 1852, but only if such descendant - 
          (A) is living in California,
          (B) is a member of the Indian community served by a local
        program of the Service, and
          (C) is regarded as an Indian by the community in which such
        descendant lives.

        (3) Any Indian who holds trust interests in public domain,
      national forest, or Indian reservation allotments in California.
        (4) Any Indian in California who is listed on the plans for
      distribution of the assets of California rancherias and
      reservations under the Act of August 18, 1958 (72 Stat. 619), and
      any descendant of such an Indian.
    (c) Scope of eligibility
      Nothing in this section may be construed as expanding the
    eligibility of California Indians for health services provided by
    the Service beyond the scope of eligibility for such health
    services that applied on May 1, 1986.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 809, formerly title VII, Sec.
    709, as added Pub. L. 96-537, Sec. 8(b), Dec. 17, 1980, 94 Stat.
    3181; amended Pub. L. 100-713, title VII, Sec. 703, Nov. 23, 1988,
    102 Stat. 4827; renumbered title VIII, Sec. 809, Pub. L. 102-573,
    title VII, Sec. 701(a), (b), Oct. 29, 1992, 106 Stat. 4572.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      Act of August 18, 1958, referred to in subsec. (b)(4), is Pub. L.
    85-671, Aug. 18, 1958, 72 Stat. 619, which was not classified to
    the Code.


-MISC1-
                                AMENDMENTS                            
      1988 - Pub. L. 100-713 inserted section catchline and amended
    text generally. Prior to amendment, text read as follows: "Indians
    in the State of California who are members or descendants of
    members of former federally recognized tribes of the State of
    California shall be eligible for services from the Service in the
    fiscal years beginning with the fiscal year ending September 30,
    1982, and ending with the fiscal year ending September 30, 1984."

-End-



-CITE-
    25 USC Sec. 1680                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680. California as a contract health service delivery area

-STATUTE-
      The State of California, excluding the counties of Alameda,
    Contra Costa, Los Angeles, Marin, Orange, Sacramento, San
    Francisco, San Mateo, Santa Clara, Kern, Merced, Monterey, Napa,
    San Benito, San Joaquin, San Luis Obispo, Santa Cruz, Solano,
    Stanislaus, and Ventura shall be designated as a contract health
    service delivery area by the Service for the purpose of providing
    contract health services to Indians in such State.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 810, formerly title VII, Sec.
    710, as added Pub. L. 96-537, Sec. 8(b), Dec. 17, 1980, 94 Stat.
    3181; amended Pub. L. 100-713, title VII, Sec. 704, Nov. 23, 1988,
    102 Stat. 4828; renumbered title VIII, Sec. 810, Pub. L. 102-573,
    title VII, Sec. 701(a), (b), Oct. 29, 1992, 106 Stat. 4572.)


-MISC1-
                                AMENDMENTS                            
      1988 - Pub. L. 100-713 inserted section catchline and amended
    text generally, substituting provisions designating parts of
    California as a contract health service delivery area for former
    provisions which authorized a demonstration project for lifting
    personnel ceilings for the Indian Health Service.

-End-



-CITE-
    25 USC Sec. 1680a                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680a. Contract health facilities

-STATUTE-
      The Service shall provide funds for health care programs and
    facilities operated by tribes and tribal organizations under
    contracts with the Service entered into under the Indian Self-
    Determination Act [25 U.S.C. 450f et seq.] - 
        (1) for the maintenance and repair of clinics owned or leased
      by such tribes or tribal organizations,
        (2) for employee training,
        (3) for cost-of-living increases for employees, and
        (4) for any other expenses relating to the provision of health
      services,

    on the same basis as such funds are provided to programs and
    facilities operated directly by the Service.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 811, formerly title VII, Sec.
    711, as added Pub. L. 100-713, title VII, Sec. 705, Nov. 23, 1988,
    102 Stat. 4828; renumbered title VIII, Sec. 811, Pub. L. 102-573,
    title VII, Sec. 701(a), (b), Oct. 29, 1992, 106 Stat. 4572.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in text, is title
    I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which
    is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-End-



-CITE-
    25 USC Sec. 1680b                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680b. National Health Service Corps

-STATUTE-
      The Secretary of Health and Human Services shall not - 
        (1) remove a member of the National Health Service Corps from a
      health facility operated by the Indian Health Service or by a
      tribe or tribal organization under contract with the Indian
      Health Service under the Indian Self-Determination Act [25 U.S.C.
      450f et seq.], or
        (2) withdraw funding used to support such member,

    unless the Secretary, acting through the Service, has ensured that
    the Indians receiving services from such member will experience no
    reduction in services.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 812, formerly title VII, Sec.
    712, as added Pub. L. 100-713, title VII, Sec. 706, Nov. 23, 1988,
    102 Stat. 4828; renumbered title VIII, Sec. 812, Pub. L. 102-573,
    title VII, Sec. 701(a), (b), Oct. 29, 1992, 106 Stat. 4572.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in par. (1), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.

-End-



-CITE-
    25 USC Sec. 1680c                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680c. Health services for ineligible persons

-STATUTE-
    (a) Individuals not otherwise eligible
      (1) Any individual who - 
        (A) has not attained 19 years of age,
        (B) is the natural or adopted child, step-child, foster-child,
      legal ward, or orphan of an eligible Indian, and
        (C) is not otherwise eligible for the health services provided
      by the Service,

    shall be eligible for all health services provided by the Service
    on the same basis and subject to the same rules that apply to
    eligible Indians until such individual attains 19 years of age. The
    existing and potential health needs of all such individuals shall
    be taken into consideration by the Service in determining the need
    for, or the allocation of, the health resources of the Service. If
    such an individual has been determined to be legally incompetent
    prior to attaining 19 years of age, such individual shall remain
    eligible for such services until one year after the date such
    disability has been removed.
      (2) Any spouse of an eligible Indian who is not an Indian, or who
    is of Indian descent but not otherwise eligible for the health
    services provided by the Service, shall be eligible for such health
    services if all of such spouses are made eligible, as a class, by
    an appropriate resolution of the governing body of the Indian tribe
    of the eligible Indian. The health needs of persons made eligible
    under this paragraph shall not be taken into consideration by the
    Service in determining the need for, or allocation of, its health
    resources.
    (b) Health facilities providing health service
      (1)(A) The Secretary is authorized to provide health services
    under this subsection through health facilities operated directly
    by the Service to individuals who reside within the service area of
    a service unit and who are not eligible for such health services
    under any other subsection of this section or under any other
    provision of law if - 
        (i) the Indian tribe (or, in the case of a multi-tribal service
      area, all the Indian tribes) served by such service unit requests
      such provision of health services to such individuals, and
        (ii) the Secretary and the Indian tribe or tribes have jointly
      determined that - 
          (I) the provision of such health services will not result in
        a denial or diminution of health services to eligible Indians,
        and
          (II) there is no reasonable alternative health facility or
        services, within or without the service area of such service
        unit, available to meet the health needs of such individuals.

      (B) In the case of health facilities operated under a contract
    entered into under the Indian Self-Determination Act [25 U.S.C.
    450f et seq.], the governing body of the Indian tribe or tribal
    organization providing health services under such contract is
    authorized to determine whether health services should be provided
    under such contract to individuals who are not eligible for such
    health services under any other subsection of this section or under
    any other provision of law. In making such determinations, the
    governing body of the Indian tribe or tribal organization shall
    take into account the considerations described in subparagraph
    (A)(ii).
      (2)(A) Persons receiving health services provided by the Service
    by reason of this subsection shall be liable for payment of such
    health services under a schedule of charges prescribed by the
    Secretary which, in the judgment of the Secretary, results in
    reimbursement in an amount not less than the actual cost of
    providing the health services. Notwithstanding section 1880(c) of
    the Social Security Act [42 U.S.C. 1395qq(c)], section 1642(a) of
    this title, or any other provision of law, amounts collected under
    this subsection, including medicare or medicaid reimbursements
    under titles XVIII and XIX of the Social Security Act [42 U.S.C.
    1395 et seq., 1396 et seq.], shall be credited to the account of
    the facility providing the service and shall be used solely for the
    provision of health services within that facility. Amounts
    collected under this subsection shall be available for expenditure
    within such facility for not to exceed one fiscal year after the
    fiscal year in which collected.
      (B) Health services may be provided by the Secretary through the
    Service under this subsection to an indigent person who would not
    be eligible for such health services but for the provisions of
    paragraph (1) only if an agreement has been entered into with a
    State or local government under which the State or local government
    agrees to reimburse the Service for the expenses incurred by the
    Service in providing such health services to such indigent person.
      (3)(A) In the case of a service area which serves only one Indian
    tribe, the authority of the Secretary to provide health services
    under paragraph (1)(A) shall terminate at the end of the fiscal
    year succeeding the fiscal year in which the governing body of the
    Indian tribe revokes its concurrence to the provision of such
    health services.
      (B) In the case of a multi-tribal service area, the authority of
    the Secretary to provide health services under paragraph (1)(A)
    shall terminate at the end of the fiscal year succeeding the fiscal
    year in which at least 51 percent of the number of Indian tribes in
    the service area revoke their concurrence to the provision of such
    health services.
    (c) Purposes served in providing health services to otherwise
      ineligible individuals
      The Service may provide health services under this subsection to
    individuals who are not eligible for health services provided by
    the Service under any other subsection of this section or under any
    other provision of law in order to - 
        (1) achieve stability in a medical emergency,
        (2) prevent the spread of a communicable disease or otherwise
      deal with a public health hazard,
        (3) provide care to non-Indian women pregnant with an eligible
      Indian's child for the duration of the pregnancy through post
      partum, or
        (4) provide care to immediate family members of an eligible
      person if such care is directly related to the treatment of the
      eligible person.
    (d) Extension of hospital privileges to non-Service health care
      practitioners
      Hospital privileges in health facilities operated and maintained
    by the Service or operated under a contract entered into under the
    Indian Self-Determination Act [25 U.S.C. 450f et seq.] may be
    extended to non-Service health care practitioners who provide
    services to persons described in subsection (a) or (b) of this
    section. Such non-Service health care practitioners may be regarded
    as employees of the Federal Government for purposes of section
    1346(b) and chapter 171 of title 28 (relating to Federal tort
    claims) only with respect to acts or omissions which occur in the
    course of providing services to eligible persons as a part of the
    conditions under which such hospital privileges are extended.
    (e) "Eligible Indian" defined
      For purposes of this section, the term "eligible Indian" means
    any Indian who is eligible for health services provided by the
    Service without regard to the provisions of this section.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 813, formerly title VII, Sec.
    713, as added Pub. L. 100-713, title VII, Sec. 707(a), Nov. 23,
    1988, 102 Stat. 4829; renumbered title VIII, Sec. 813, and amended
    Pub. L. 102-573, title VII, Sec. 701(a), (b), title IX, Sec.
    902(8), Oct. 29, 1992, 106 Stat. 4572, 4592.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsecs.
    (b)(1)(B) and (d), is title I of Pub. L. 93-638, Jan. 4, 1975, 88
    Stat. 2206, as amended, which is classified principally to part A
    (Sec. 450f et seq.) of subchapter II of chapter 14 of this title.
    For complete classification of this Act to the Code, see Short
    Title note set out under section 450 of this title and Tables.
      The Social Security Act, referred to in subsec. (b)(2)(A), is act
    Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles XIII and
    XIX of the Social Security Act are classified generally to
    subchapters XVIII (Sec. 1395 et seq.) and XIX (Sec. 1396 et seq.)
    of chapter 7 of Title 42, The Public Health and Welfare. For
    complete classification of this Act to the Code, see section 1305
    of Title 42 and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (b)(2)(A). Pub. L. 102-573, Sec. 902(8),
    substituted "section 1642(a) of this title" for "section 402(c) of
    this Act".

-End-



-CITE-
    25 USC Sec. 1680d                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680d. Infant and maternal mortality; fetal alcohol syndrome

-STATUTE-
      By no later than January 1, 1990, the Secretary shall develop and
    begin implementation of a plan to achieve the following objectives
    by January 1, 1994:
        (1) reduction of the rate of Indian infant mortality in each
      area office of the Service to the lower of - 
          (A) twelve deaths per one thousand live births, or
          (B) the rate of infant mortality applicable to the United
        States population as a whole;

        (2) reduction of the rate of maternal mortality in each area
      office of the Service to the lower of - 
          (A) five deaths per one hundred thousand live births, or
          (B) the rate of maternal mortality applicable to the United
        States population as a whole; and

        (3) reduction of the rate of fetal alcohol syndrome among
      Indians served by, or on behalf of, the Service to one per one
      thousand live births.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 814, formerly title VII, Sec.
    714, as added Pub. L. 100-713, title VII, Sec. 708, Nov. 23, 1988,
    102 Stat. 4831; renumbered title VIII, Sec. 814, and amended Pub.
    L. 102-573, title VII, Sec. 701(a), (b), title VIII, Sec. 804, Oct.
    29, 1992, 106 Stat. 4572, 4585.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 804, struck out subsec. (a)
    designation before "By no later" and struck out subsec. (b) which
    read as follows: "The President shall include with the budget
    submitted under section 1105 of title 31 for each fiscal year a
    separate statement which specifies the total amount obligated or
    expended in the most recently completed fiscal year to achieve each
    of the objectives described in subsection (a) of this section."

-End-



-CITE-
    25 USC Sec. 1680e                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680e. Contract health services for the Trenton Service Area

-STATUTE-
    (a) Service to Turtle Mountain Band
      The Secretary, acting through the Service, is directed to provide
    contract health services to members of the Turtle Mountain Band of
    Chippewa Indians that reside in the Trenton Service Area of Divide,
    McKenzie, and Williams counties in the State of North Dakota and
    the adjoining counties of Richland, Roosevelt, and Sheridan in the
    State of Montana.
    (b) Band member eligibility not expanded
      Nothing in this section may be construed as expanding the
    eligibility of members of the Turtle Mountain Band of Chippewa
    Indians for health services provided by the Service beyond the
    scope of eligibility for such health services that applied on May
    1, 1986.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 815, formerly title VII, Sec.
    715, as added Pub. L. 100-713, title VII, Sec. 709, Nov. 23, 1988,
    102 Stat. 4831; renumbered title VIII, Sec. 815, Pub. L. 102-573,
    title VII, Sec. 701(a), (b), Oct. 29, 1992, 106 Stat. 4572.)

-End-



-CITE-
    25 USC Sec. 1680f                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680f. Indian Health Service and Department of Veterans
      Affairs health facilities and services sharing

-STATUTE-
    (a) Feasibility study and report
      The Secretary shall examine the feasibility of entering into an
    arrangement for the sharing of medical facilities and services
    between the Indian Health Service and the Department of Veterans
    Affairs and shall, in accordance with subsection (b) of this
    section, prepare a report on the feasibility of such an arrangement
    and submit such report to the Congress by no later than September
    30, 1990.
    (b) Nonimpairment of service quality, eligibility, or priority of
      access
      The Secretary shall not take any action under this section or
    under subchapter IV of chapter 81 of title 38 which would impair - 
        (1) the priority access of any Indian to health care services
      provided through the Indian Health Service;
        (2) the quality of health care services provided to any Indian
      through the Indian Health Service;
        (3) the priority access of any veteran to health care services
      provided by the Department of Veterans Affairs;
        (4) the quality of health care services provided to any veteran
      by the Department of Veterans Affairs;
        (5) the eligibility of any Indian to receive health services
      through the Indian Health Service; or
        (6) the eligibility of any Indian who is a veteran to receive
      health services through the Department of Veterans Affairs.
    (c) Cross utilization of services
      (1) Not later than December 23, 1988, the Director of the Indian
    Health Service and the Secretary of Veterans Affairs shall
    implement an agreement under which - 
        (A) individuals in the vicinity of Roosevelt, Utah, who are
      eligible for health care from the Department of Veterans Affairs
      could obtain health care services at the facilities of the Indian
      Health Service located at Fort Duchesne, Utah; and
        (B) individuals eligible for health care from the Indian Health
      Service at Fort Duchesne, Utah, could obtain health care services
      at the George E. Wahlen Department of Veterans Affairs Medical
      Center located in Salt Lake City, Utah.

      (2) Not later than November 23, 1990, the Secretary and the
    Secretary of Veterans Affairs shall jointly submit a report to the
    Congress on the health care services provided as a result of
    paragraph (1).
    (d) Right to health services
      Nothing in this section may be construed as creating any right of
    a veteran to obtain health services from the Indian Health Service
    except as provided in an agreement under subsection (c) of this
    section.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 816, formerly title VII, Sec.
    716, as added Pub. L. 100-713, title VII, Sec. 710, Nov. 23, 1988,
    102 Stat. 4832; amended Pub. L. 102-54, Sec. 13(j)(2), June 13,
    1991, 105 Stat. 276; renumbered title VIII, Sec. 816, and amended
    Pub. L. 102-573, title VII, Sec. 701(a), (b), title IX, Sec.
    902(9), Oct. 29, 1992, 106 Stat. 4572, 4592; Pub. L. 108-170, title
    II, Sec. 244, Dec. 6, 2003, 117 Stat. 2054.)


-MISC1-
                                AMENDMENTS                            
      2003 - Subsec. (c)(1)(B). Pub. L. 108-170 substituted "George E.
    Wahlen Department of Veterans Affairs Medical Center" for
    "Department of Veterans Affairs medical center".
      1992 - Pub. L. 102-573, Sec. 902(9), amended section catchline.
      1991 - Subsecs. (a), (b)(3), (4), (6). Pub. L. 102-54, Sec.
    13(j)(2)(A), substituted "Department of Veterans Affairs" for
    "Veterans' Administration".
      Subsec. (c)(1). Pub. L. 102-54, Sec. 13(j)(2)(B), substituted
    "Not later than December 23, 1988, the Director of the Indian
    Health Service and the Secretary of Veterans Affairs shall" for
    "Within 30 days after November 23, 1988, the Director of the Indian
    Health Service and the Administrator of Veterans' Affairs are
    authorized and directed to".
      Subsec. (c)(1)(A), (B). Pub. L. 102-54, Sec. 13(j)(2)(A),
    substituted "Department of Veterans Affairs" for "Veterans'
    Administration".
      Subsec. (c)(2). Pub. L. 102-54, Sec. 13(j)(2)(C), substituted
    "Not later than November 23, 1990, the Secretary and the Secretary
    of Veterans Affairs shall" for "Not later than 2 years after
    November 23, 1988, the Secretary and the Administrator of Veterans'
    Affairs shall".

      DESIGNATION OF GEORGE E. WAHLEN DEPARTMENT OF VETERANS AFFAIRS
                              MEDICAL CENTER
      Pub. L. 108-170, title II, Sec. 244, Dec. 6, 2003, 117 Stat.
    2054, provided that: "The Department of Veterans Affairs Medical
    Center in Salt Lake City, Utah, shall after the date of the
    enactment of this Act [Dec. 6, 2003] be known and designated as the
    'George E. Wahlen Department of Veterans Affairs Medical Center'.
    Any references to such facility in any law, regulation, map,
    document, record, or other paper of the United States shall be
    considered to be a reference to the George E. Wahlen Department of
    Veterans Affairs Medical Center."

-End-



-CITE-
    25 USC Sec. 1680g                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680g. Reallocation of base resources

-STATUTE-
    (a) Report to Congress
      Notwithstanding any other provision of law, any allocation of
    Service funds for a fiscal year that reduces by 5 percent or more
    from the previous fiscal year the funding for any recurring
    program, project, or activity of a service unit may be implemented
    only after the Secretary has submitted to the President, for
    inclusion in the report required to be transmitted to the Congress
    under section 1671 of this title, a report on the proposed change
    in allocation of funding, including the reasons for the change and
    its likely effects.
    (b) Appropriated amounts
      Subsection (a) of this section shall not apply if the total
    amount appropriated to the Service for a fiscal year is less than
    the amount appropriated to the Service for previous fiscal year.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 817, formerly title VII, Sec.
    717, as added Pub. L. 100-713, title VII, Sec. 711, Nov. 23, 1988,
    102 Stat. 4833; renumbered title VIII, Sec. 817, and amended Pub.
    L. 102-573, title VII, Sec. 701(a), (b), title VIII, Sec. 805, Oct.
    29, 1992, 106 Stat. 4572, 4585.)


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (a). Pub. L. 102-573, Sec. 805, substituted
    "Secretary has submitted to the President, for inclusion in the
    report required to be transmitted to the Congress under section
    1671 of this title," for "Secretary has submitted to the Congress".

-End-



-CITE-
    25 USC Sec. 1680h                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680h. Demonstration projects for tribal management of health
      care services

-STATUTE-
    (a) Establishment; grants
      (1) The Secretary, acting through the Service, shall make grants
    to Indian tribes to establish demonstration projects under which
    the Indian tribe will develop and test a phased approach to
    assumption by the Indian tribe of the health care delivery system
    of the Service for members of the Indian tribe living on or near
    the reservations of the Indian tribe through the use of Service,
    tribal, and private sector resources.
      (2) A grant may be awarded to an Indian tribe under paragraph (1)
    only if the Secretary determines that the Indian tribe has the
    administrative and financial capabilities necessary to conduct a
    demonstration project described in paragraph (1).
    (b) Health care contracts
      During the period in which a demonstration project established
    under subsection (a) of this section is being conducted by an
    Indian tribe, the Secretary shall award all health care contracts,
    including community, behavioral, and preventive health care
    contracts, to the Indian tribe in the form of a single grant to
    which the regulations prescribed under part A of title XIX of the
    Public Health Service Act [42 U.S.C. 300w et seq.] (as modified as
    necessary by any agreement entered into between the Secretary and
    the Indian tribe to achieve the purposes of the demonstration
    project established under subsection (a) of this section) shall
    apply.
    (c) Waiver of procurement laws
      The Secretary may waive such provisions of Federal procurement
    law as are necessary to enable any Indian tribe to develop and test
    administrative systems under the demonstration project established
    under subsection (a) of this section, but only if such waiver does
    not diminish or endanger the delivery of health care services to
    Indians.
    (d) Termination; evaluation and report
      (1) The demonstration project established under subsection (a) of
    this section shall terminate on September 30, 1993, or, in the case
    of a demonstration project for which a grant is made after
    September 30, 1990, three years after the date on which such grant
    is made.
      (2) By no later than September 30, 1996, the Secretary shall
    evaluate the performance of each Indian tribe that has participated
    in a demonstration project established under subsection (a) of this
    section and shall submit to the Congress a report on such
    evaluations and demonstration projects.
    (e) Joint venture demonstration projects
      (1) The Secretary, acting through the Service, shall make
    arrangements with Indian tribes to establish joint venture
    demonstration projects under which an Indian tribe shall expend
    tribal, private, or other available nontribal funds, for the
    acquisition or construction of a health facility for a minimum of
    20 years, under a no-cost lease, in exchange for agreement by the
    Service to provide the equipment, supplies, and staffing for the
    operation and maintenance of such a health facility. A tribe may
    utilize tribal funds, private sector, or other available resources,
    including loan guarantees, to fulfill its commitment under this
    subsection.
      (2) The Secretary shall make such an arrangement with an Indian
    tribe only if the Secretary first determines that the Indian tribe
    has the administrative and financial capabilities necessary to
    complete the timely acquisition or construction of the health
    facility described in paragraph (1).
      (3) An Indian tribe or tribal organization that has entered into
    a written agreement with the Secretary under this subsection, and
    that breaches or terminates without cause such agreement, shall be
    liable to the United States for the amount that has been paid to
    the tribe, or paid to a third party on the tribe's behalf, under
    the agreement. The Secretary has the right to recover tangible
    property (including supplies), and equipment, less depreciation,
    and any funds expended for operations and maintenance under this
    section. The preceding sentence does not apply to any funds
    expended for the delivery of health care services, or for personnel
    or staffing, shall be recoverable.(!1)


-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 818, formerly title VII, Sec.
    718, as added Pub. L. 100-713, title VII, Sec. 713, Nov. 23, 1988,
    102 Stat. 4833; renumbered title VIII, Sec. 818, and amended Pub.
    L. 102-573, title VII, Sec. 701(a), (b), title VIII, Sec. 808, Oct.
    29, 1992, 106 Stat. 4572, 4586.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Public Health Service Act, referred to in subsec. (b), is act
    July 1, 1944, ch. 373, 58 Stat. 682, as amended. Part A of title
    XIX of the Public Health Service Act is classified generally to
    part A (Sec. 300w et seq.) of subchapter XVII of chapter 6A of
    Title 42, The Public Health and Welfare. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 201 of Title 42 and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Subsec. (d)(1). Pub. L. 102-573, Sec. 808(1)(A), inserted
    before period at end ", or, in the case of a demonstration project
    for which a grant is made after September 30, 1990, three years
    after the date on which such grant is made".
      Subsec. (d)(2). Pub. L. 102-573, Sec. 808(1)(B), substituted
    "1996" for "1994".
      Subsec. (e). Pub. L. 102-573, Sec. 808(2), amended subsec. (e)
    generally. Prior to amendment, subsec. (e) read as follows: "There
    are authorized to be appropriated such sums as may be necessary to
    carry out the purposes of this section."

-FOOTNOTE-               

    (!1) So in original. The words ", shall be recoverable" probably
         should not appear.


-End-



-CITE-
    25 USC Sec. 1680i                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680i. Child sexual abuse treatment programs

-STATUTE-
    (a) Continuation of existing demonstration programs
      The Secretary and the Secretary of the Interior shall, for each
    fiscal year through fiscal year 1995, continue the demonstration
    programs involving treatment for child sexual abuse provided
    through the Hopi Tribe and the Assiniboine and Sioux Tribes of the
    Fort Peck Reservation.
    (b) Establishment of new demonstration programs
      Beginning October 1, 1995, the Secretary and the Secretary of the
    Interior may establish, in any service area, demonstration programs
    involving treatment for child sexual abuse, except that the
    Secretaries may not establish a greater number of such programs in
    one service area than in any other service area until there is an
    equal number of such programs established with respect to all
    service areas from which the Secretary receives qualified
    applications during the application period (as determined by the
    Secretary).

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 819, formerly title VII, Sec.
    719, as added Pub. L. 100-713, title VII, Sec. 715, Nov. 23, 1988,
    102 Stat. 4836; renumbered title VIII, Sec. 819, and amended Pub.
    L. 102-573, title VII, Sec. 701(a), (b), title VIII, Sec. 806, Oct.
    29, 1992, 106 Stat. 4572, 4586.)


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 806, amended section generally.
    Prior to amendment, section read as follows:
      "(a) The Secretary and the Secretary of the Interior shall, for
    each of the fiscal years 1989, 1990, and 1991, continue to provide
    through the Hopi Tribe and the Asiniboine and Sioux Tribes of the
    Fort Peck Reservation the demonstration programs involving
    treatment for child sexual abuse that were conducted during fiscal
    year 1988 through such tribes.
      "(b) There are authorized to be appropriated for each of the
    fiscal years 1989, 1990, and 1991 such sums as may be necessary to
    carry out the provisions of this section."

-End-



-CITE-
    25 USC Sec. 1680j                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680j. Tribal leasing

-STATUTE-
      Indian tribes providing health care services pursuant to a
    contract entered into under the Indian Self-Determination Act [25
    U.S.C. 450f et seq.] may lease permanent structures for the purpose
    of providing such health care services without obtaining advance
    approval in appropriation Acts.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 820, formerly title VII, Sec.
    720, as added Pub. L. 100-713, title VII, Sec. 716, Nov. 23, 1988,
    102 Stat. 4837; renumbered title VIII, Sec. 820, and amended Pub.
    L. 102-573, title VII, Sec. 701(a), (b), title VIII, Sec. 807, Oct.
    29, 1992, 106 Stat. 4572, 4586.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in text, is title
    I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which
    is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1992 - Pub. L. 102-573, Sec. 807, amended section generally.
    Prior to amendment, section read as follows:
      "(a) The Secretary, through the Service, shall make grants to the
    Eight Northern Indian Pueblos Council, San Juan Pueblo, New Mexico,
    for the purpose of providing substance abuse treatment services to
    Indians in need of such services.
      "(b) There are authorized to be appropriated to carry out this
    section $250,000 for each of the fiscal years 1990 and 1991."

-End-



-CITE-
    25 USC Sec. 1680k                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680k. Home- and community-based care demonstration project

-STATUTE-
    (a) Authority of Secretary
      The Secretary, acting through the Service, is authorized to enter
    into contracts with, or make grants to, Indian tribes or tribal
    organizations providing health care services pursuant to a contract
    entered into under the Indian Self-Determination Act [25 U.S.C.
    450f et seq.], to establish demonstration projects for the delivery
    of home- and community-based services to functionally disabled
    Indians.
    (b) Use of funds
      (1) Funds provided for a demonstration project under this section
    shall be used only for the delivery of home- and community-based
    services (including transportation services) to functionally
    disabled Indians.
      (2) Such funds may not be used - 
        (A) to make cash payments to functionally disabled Indians;
        (B) to provide room and board for functionally disabled
      Indians;
        (C) for the construction or renovation of facilities or the
      purchase of medical equipment; or
        (D) for the provision of nursing facility services.
    (c) Criteria for approval of applications
      Not later than 180 days after October 29, 1992, the Secretary,
    after consultation with Indian tribes and tribal organizations,
    shall develop and issue criteria for the approval of applications
    submitted under this section. Such criteria shall ensure that
    demonstration projects established under this section promote the
    development of the capacity of tribes and tribal organizations to
    deliver, or arrange for the delivery of, high quality, culturally
    appropriate home- and community-based services to functionally
    disabled Indians; (!1)

    (d) Assistance to applicants
      The Secretary shall provide such technical and other assistance
    as may be necessary to enable applicants to comply with the
    provisions of this section.
    (e) Services to ineligible persons
      At the discretion of the tribe or tribal organization, services
    provided under a demonstration project established under this
    section may be provided (on a cost basis) to persons otherwise
    ineligible for the health care benefits of the Service.
    (f) Maximum number of demonstration projects
      The Secretary shall establish not more than 24 demonstration
    projects under this section. The Secretary may not establish a
    greater number of demonstration projects under this section in one
    service area than in any other service area until there is an equal
    number of such demonstration projects established with respect to
    all service areas from which the Secretary receives applications
    during the application period (as determined by the Secretary)
    which meet the criteria issued pursuant to subsection (c) of this
    section.
    (g) Report
      The Secretary shall submit to the President, for inclusion in the
    report which is required to be submitted under section 1671 of this
    title for fiscal year 1999, a report on the findings and
    conclusions derived from the demonstration projects conducted under
    this section, together with legislative recommendations.
    (h) Definitions
      For the purposes of this section, the following definitions shall
    apply:
        (1) The term "home- and community-based services" means one or
      more of the following:
          (A) Homemaker/home health aide services.
          (B) Chore services.
          (C) Personal care services.
          (D) Nursing care services provided outside of a nursing
        facility by, or under the supervision of, a registered nurse.
          (E) Respite care.
          (F) Training for family members in managing a functionally
        disabled individual.
          (G) Adult day care.
          (H) Such other home- and community-based services as the
        Secretary may approve.

        (2) The term "functionally disabled" means an individual who is
      determined to require home- and community-based services based on
      an assessment that uses criteria (including, at the discretion of
      the tribe or tribal organization, activities of daily living)
      developed by the tribe or tribal organization.
    (i) Authorization of appropriations
      There are authorized to be appropriated for each of the fiscal
    years 1996 through 2000 such sums as may be necessary to carry out
    this section. Such sums shall remain available until expended.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 821, as added Pub. L. 102-573,
    title VIII, Sec. 809, Oct. 29, 1992, 106 Stat. 4587; amended Pub.
    L. 104-313, Sec. 2(g), Oct. 19, 1996, 110 Stat. 3822.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination Act, referred to in subsec. (a), is
    title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended,
    which is classified principally to part A (Sec. 450f et seq.) of
    subchapter II of chapter 14 of this title. For complete
    classification of this Act to the Code, see Short Title note set
    out under section 450 of this title and Tables.


-MISC1-
                                AMENDMENTS                            
      1996 - Subsec. (i). Pub. L. 104-313 substituted "1996 through
    2000" for "1993, 1994, 1995, 1996, and 1997".

-FOOTNOTE-               

    (!1) So in original. The semicolon probably should be a period.


-End-



-CITE-
    25 USC Sec. 1680l                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680l. Shared services demonstration project

-STATUTE-
    (a) Authority of Secretary
      The Secretary, acting through the Service and notwithstanding any
    other provision of law, is authorized to enter into contracts with
    Indian tribes or tribal organizations to establish not more than 6
    shared services demonstration projects for the delivery of long-
    term care to Indians. Such projects shall provide for the sharing
    of staff or other services between a Service facility and a nursing
    facility owned and operated (directly or by contract) by such
    Indian tribe or tribal organization.
    (b) Contract requirements
      A contract entered into pursuant to subsection (a) of this
    section - 
        (1) may, at the request of the Indian tribe or tribal
      organization, delegate to such tribe or tribal organization such
      powers of supervision and control over Service employees as the
      Secretary deems necessary to carry out the purposes of this
      section;
        (2) shall provide that expenses (including salaries) relating
      to services that are shared between the Service facility and the
      tribal facility be allocated proportionately between the Service
      and the tribe or tribal organization; and
        (3) may authorize such tribe or tribal organization to
      construct, renovate, or expand a nursing facility (including the
      construction of a facility attached to a Service facility),
      except that no funds appropriated for the Service shall be
      obligated or expended for such purpose.
    (c) Eligibility
      To be eligible for a contract under this section, a tribe or
    tribal organization, shall, as of October 29, 1992 - 
        (1) own and operate (directly or by contract) a nursing
      facility;
        (2) have entered into an agreement with a consultant to develop
      a plan for meeting the long-term needs of the tribe or tribal
      organization; or
        (3) have adopted a tribal resolution providing for the
      construction of a nursing facility.
    (d) Nursing facilities
      Any nursing facility for which a contract is entered into under
    this section shall meet the requirements for nursing facilities
    under section 1396r of title 42.
    (e) Assistance to applicants
      The Secretary shall provide such technical and other assistance
    as may be necessary to enable applicants to comply with the
    provisions of this section.
    (f) Report
      The Secretary shall submit to the President, for inclusion in
    each report required to be transmitted to the Congress under
    section 1671 of this title, a report on the findings and
    conclusions derived from the demonstration projects conducted under
    this section.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 822, as added Pub. L. 102-573,
    title VIII, Sec. 810, Oct. 29, 1992, 106 Stat. 4588.)

-COD-
                               CODIFICATION                           
      October 29, 1992, referred to in subsec. (c), was in the original
    "the date of the enactment of this Act", which was translated as
    meaning the date of enactment of Pub. L. 102-573, which enacted
    this section, to reflect the probable intent of Congress.

-End-



-CITE-
    25 USC Sec. 1680m                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680m. Results of demonstration projects

-STATUTE-
      The Secretary shall provide for the dissemination to Indian
    tribes of the findings and results of demonstration projects
    conducted under this chapter.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 823, as added Pub. L. 102-573,
    title VIII, Sec. 811, Oct. 29, 1992, 106 Stat. 4589.)

-End-



-CITE-
    25 USC Sec. 1680n                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680n. Priority for Indian reservations

-STATUTE-
    (a) Facilities and projects
      Beginning on October 29, 1992, the Bureau of Indian Affairs and
    the Service shall, in all matters involving the reorganization or
    development of Service facilities, or in the establishment of
    related employment projects to address unemployment conditions in
    economically depressed areas, give priority to locating such
    facilities and projects on Indian lands if requested by the Indian
    tribe with jurisdiction over such lands.
    (b) "Indian lands" defined
      For purposes of this section, the term "Indian lands" means - 
        (1) all lands within the limits of any Indian reservation; and
        (2) any lands title which is held in trust by the United States
      for the benefit of any Indian tribe or individual Indian, or held
      by any Indian tribe or individual Indian subject to restriction
      by the United States against alienation and over which an Indian
      tribe exercises governmental power.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 824, as added Pub. L. 102-573,
    title VIII, Sec. 812, Oct. 29, 1992, 106 Stat. 4589.)

-End-



-CITE-
    25 USC Sec. 1680o                                           01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1680o. Authorization of appropriations

-STATUTE-
      Except as provided in section 1680k of this title, there are
    authorized to be appropriated such sums as may be necessary for
    each fiscal year through fiscal year 2000 to carry out this
    subchapter.

-SOURCE-
    (Pub. L. 94-437, title VIII, Sec. 825, as added Pub. L. 102-573,
    title VIII, Sec. 813(a), Oct. 29, 1992, 106 Stat. 4590.)

-End-



-CITE-
    25 USC Sec. 1681                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1681. Omitted

-COD-
                               CODIFICATION                           
      Section, Pub. L. 104-134, title I, Sec. 101(c) [title II], Apr.
    26, 1996, 110 Stat. 1321-156, 1321-190; renumbered title I, Pub. L.
    104-140, Sec. 1(a), May 2, 1996, 110 Stat. 1327, which provided
    that the Indian Health Service was to neither bill nor charge those
    Indians who may have economic means to pay unless and until
    Congress directs Service to implement policy to do so, was from the
    Department of the Interior and Related Agencies Appropriations Act,
    1996, and was not repeated in subsequent appropriations acts.
    Provisions similar to those in this section were contained in the
    following prior appropriation acts:
      Pub. L. 103-332, title II, Sept. 30, 1994, 108 Stat. 2529.
      Pub. L. 103-138, title II, Nov. 11, 1993, 107 Stat. 1409.
      Pub. L. 102-381, title II, Oct. 5, 1992, 106 Stat. 1409.
      Pub. L. 102-154, title II, Nov. 13, 1991, 105 Stat. 1027.
      Pub. L. 101-512, title II, Nov. 5, 1990, 104 Stat. 1952.
      Pub. L. 101-121, title II, Oct. 23, 1989, 103 Stat. 734.
      Pub. L. 100-446, title II, Sept. 27, 1988, 102 Stat. 1816.
      Pub. L. 100-202, Sec. 101(g) [title II], Dec. 22, 1987, 101 Stat.
    1329-213, 1329-245.
      Pub. L. 99-500, Sec. 101(h) [title II], Oct. 18, 1986, 100 Stat.
    1783-242, 1783-277, and Pub. L. 99-591, Sec. 101(h) [title II],
    Oct. 30, 1986, 100 Stat. 3341-242, 3341-277.
      Pub. L. 99-190, Sec. 101(d) [title II], Dec. 19, 1985, 99 Stat.
    1224, 1256.
      Pub. L. 98-473, title I, Sec. 101(c) [title II], Oct. 12, 1984,
    98 Stat. 1837, 1865.

-End-



-CITE-
    25 USC Sec. 1682                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1682. Subrogation of claims by Indian Health Service

-STATUTE-
      On and after October 18, 1986, the Indian Health Service may seek
    subrogation of claims including but not limited to auto accident
    claims, including no-fault claims, personal injury, disease, or
    disability claims, and worker's compensation claims, the proceeds
    of which shall be credited to the funds established by sections 401
    and 402 (!1) of the Indian Health Care Improvement Act.


-SOURCE-
    (Pub. L. 99-500, Sec. 101(h) [title II], Oct. 18, 1986, 100 Stat.
    1783-242, 1783-277, and Pub. L. 99-591, Sec. 101(h) [title II],
    Oct. 30, 1986, 100 Stat. 3341-242, 3341-277.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      Sections 401 and 402 of the Indian Health Care Improvement Act,
    referred to in text, probably means former sections 401 and 402 of
    Pub. L. 94-437, title IV, Sept. 30, 1976, 90 Stat. 1408, 1409,
    which enacted sections 1395qq and 1396j of Title 42, The Public
    Health and Welfare, amended sections 1395f, 1395n, and 1396d of
    Title 42, and enacted provisions set out as notes under sections
    1395qq and 1396j of Title 42. Sections 401 and 402 of the Act were
    amended generally by section 401(a), (b)(1) of Pub. L. 102-573,
    title IV, Oct. 29, 1992, 106 Stat. 4565, and are classified to
    sections 1641 and 1642 of this title, respectively.

-COD-
                               CODIFICATION                           
      Pub. L. 99-591 is a corrected version of Pub. L. 99-500.
      Section was enacted as part of the Department of the Interior and
    Related Agencies Appropriations Act, 1987, as enacted by Pub. L. 99-
    500 and Pub. L. 99-591, and not as part of the Indian Health Care
    Improvement Act which comprises this chapter.


-MISC1-
                             PRIOR PROVISIONS                         
      A prior section 1682, Pub. L. 98-473, title I, Sec. 101(c) [title
    II], Oct. 12, 1984, 98 Stat. 1837, 1865, which related to
    subrogation of claims by Indian Health Service, was omitted as
    superseded by section 101(h) [title II] of Pub. L. 99-500 and Pub.
    L. 99-591.

-FOOTNOTE-
    (!1) See References in Text note below.


-End-



-CITE-
    25 USC Sec. 1683                                            01/03/2007

-EXPCITE-
    TITLE 25 - INDIANS
    CHAPTER 18 - INDIAN HEALTH CARE
    SUBCHAPTER VI - MISCELLANEOUS

-HEAD-
    Sec. 1683. Indian Catastrophic Health Emergency Fund

-STATUTE-
      $10,000,000 shall remain available until expended, for the
    establishment of an Indian Catastrophic Health Emergency Fund
    (hereinafter referred to as the "Fund"). On and after October 18,
    1986, the Fund is to cover the Indian Health Service portion of the
    medical expenses of catastrophic illness falling within the
    responsibility of the Service and shall be administered by the
    Secretary of Health and Human Services, acting through the central
    office of the Indian Health Service. No part of the Fund or its
    administration shall be subject to contract or grant under the
    Indian Self-Determination and Education Assistance Act (Public Law
    93-638) [25 U.S.C. 450 et seq.]. There shall be deposited into the
    Fund all amounts recovered under the authority of the Federal
    Medical Care Recovery Act (42 U.S.C. 2651 et seq.), which shall
    become available for obligation upon receipt and which shall remain
    available for obligation until expended. The Fund shall not be used
    to pay for health services provided to eligible Indians to the
    extent that alternate Federal, State, local, or private insurance
    resources for payment: (1) are available and accessible to the
    beneficiary; or (2) would be available and accessible if the
    beneficiary were to apply for them; or (3) would be available and
    accessible to other citizens similarly situated under Federal,
    State, or local law or regulation or private insurance program
    notwithstanding Indian Health Service eligibility or residency on
    or off a Federal Indian reservation.

-SOURCE-
    (Pub. L. 99-500, Sec. 101(h) [title II], Oct. 18, 1986, 100 Stat.
    1783-242, 1783-276, and Pub. L. 99-591, Sec. 101(h) [title II],
    Oct. 30, 1986, 100 Stat. 3341-242, 3341-276.)

-REFTEXT-
                            REFERENCES IN TEXT                        
      The Indian Self-Determination and Education Assistance Act
    (Public Law 93-638), referred to in text, is Pub. L. 93-638, Jan.
    4, 1975, 88 Stat. 2203, as amended, which is classified principally
    to subchapter II (Sec. 450 et seq.) of chapter 14 of this title.
    For complete classification of this Act to the Code, see Short
    Title note set out under section 450 of this title and Tables.
      The Federal Medical Care Recovery Act (42 U.S.C. 2651 et seq.),
    referred to in text, probably means Pub. L. 87-693, Sept. 25, 1962,
    76 Stat. 593, which is classified generally to chapter 32 (Sec.
    2651 et seq.) of Title 42, The Public Health and Welfare. For
    complete classification of this Act to the Code, see Tables.

-COD-
                               CODIFICATION                           
      Pub. L. 99-591 is a corrected version of Pub. L. 99-500.
      Section was enacted as part of the Department of the Interior and
    Related Agencies Appropriations Act, 1987, as enacted by Pub. L. 99-
    500 and Pub. L. 99-591, and not as part of the Indian Health Care
    Improvement Act which comprises this chapter.

-End-