§ 1637 TITLE 25—INDIANS Page 462

(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.

(Pub. L. 94–437, title III, §306, as added Pub. L.

100–713, title III, §304, Nov. 23, 1988, 102 Stat. 4817;

amended Pub. L. 102–573, title III, §303, Oct. 29,

1992, 106 Stat. 4561.)

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 (§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

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.

§ 1637. Indian health care delivery demonstration

project

(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
Page 463 TITLE 25—INDIANS § 1638

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.

(Pub. L. 94–437, title III, §307, as added Pub. L.

101–630, title V, §504, Nov. 28, 1990, 104 Stat. 4562;

amended Pub. L. 102–573, title III, §§304, 307(b)(2),

title VII, §701(c)(2), title IX, §902(4)(A), Oct. 29,

1992, 106 Stat. 4562, 4564, 4572, 4591.)

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 (§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

1992—Pub. L. 102–573, §902(4)(A), made technical

amendment to section catchline.

Subsec. (c)(1)(A). Pub. L. 102–573, §304(a)(1), inserted

‘‘or program’’ after ‘‘facility’’ in two places.

Subsec. (c)(3)(A). Pub. L. 102–573, §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, §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, §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, §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, §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.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1636, 1671 of this

title.

§ 1638. Land transfer

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.