Page 439 TITLE 25—INDIANS § 1616m

nity 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.

(Pub. L. 94–437, title I, §119, as added Pub. L.

102–573, title I, §111, Oct. 29, 1992, 106 Stat. 4539.)

§ 1616m. Matching grants to tribes for scholarship programs

(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);
§ 1616n TITLE 25—INDIANS Page 440

(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.

(Pub. L. 94–437, title I, §120, as added Pub. L.

102–573, title I, §112, Oct. 29, 1992, 106 Stat. 4540.)

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 (§1395 et seq.) and XIX (§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 (§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.

§ 1616n. Tribal health program administration

The Secretary shall, by contract or otherwise,

provide training for individuals in the administration and planning of tribal health programs.

(Pub. L. 94–437, title I, §121, as added Pub. L.

102–573, title I, §113, Oct. 29, 1992, 106 Stat. 4542.)

§ 1616o. University of South Dakota pilot program

(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—