§ 1603 TITLE 25—INDIANS Page 422

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.

(Pub. L. 94–437, §3, Sept. 30, 1976, 90 Stat. 1401;

Pub. L. 102–573, §3(b), Oct. 29, 1992, 106 Stat.

4526.)

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.’’

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1616l, 1621,

1621b, 1621m, 1665g, 1671 of this title.

§ 1603. Definitions

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,
Page 423 TITLE 25—INDIANS § 1612

(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.

(Pub. L. 94–437, §4, Sept. 30, 1976, 90 Stat. 1401;

Pub. L. 96–537, §2, Dec. 17, 1980, 94 Stat. 3173;

Pub. L. 100–713, title II, §§201(b), 203(b), title V,

§502, Nov. 23, 1988, 102 Stat. 4803, 4804, 4824; Pub.

L. 102–573, §3(c), title IX, §902(1), Oct. 29, 1992, 106

Stat. 4529, 4591; Pub. L. 104–313, §2(a), Oct. 19,

1996, 110 Stat. 3820.)

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 (§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 (§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.

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, §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, §3(c), added subsecs. (m) to (q).

1988—Subsec. (h). Pub. L. 100–713, §502, inserted

‘‘urban’’ after ‘‘governed by an’’.

Subsec. (i). Pub. L. 100–713, §201(b), added subsec. (i)

and struck out former subsec. (i) which defined ‘‘rural

Indian’’.

Subsec. (j). Pub. L. 100–713, §201(b), added subsec. (j)

and struck out former subsec. (j) which defined ‘‘rural

community’’.

Subsec. (k). Pub. L. 100–713, §§201(b), 203(b), added subsec. (k) and struck out former subsec. (k) which defined

‘‘rural Indian organization’’.

Subsec. (l). Pub. L. 100–713, §203(b), added subsec. (l).

1980—Subsec. (a). Pub. L. 96–537, §2(a), substituted

‘‘Secretary of Health and Human Services’’ for ‘‘Secretary of Health, Education, and Welfare’’.

Subsec. (h). Pub. L. 96–537, §2(b), substituted ‘‘governed by an Indian controlled board of directors’’ for

‘‘composed of urban Indians’’.

Subsecs. (i) to (k). Pub. L. 96–537, §2(c), added subsecs.

(i) to (k).

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1656, 1934, 2403

of this title; title 42 sections 1395qq, 1396d, 1396j, 1396s.

SUBCHAPTER I—INDIAN HEALTH

PROFESSIONAL PERSONNEL

SUBCHAPTER REFERRED TO IN OTHER SECTIONS

This subchapter is referred to in sections 1621h, 1661

of this title.

§ 1611. Congressional statement of purpose

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.

(Pub. L. 94–437, title I, §101, Sept. 30, 1976, 90

Stat. 1402; Pub. L. 102–573, title I, §101, Oct. 29,

1992, 106 Stat. 4530.)

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, §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.

§ 1612. Health professions recruitment program

for Indians

(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