Page 469 TITLE 25—INDIANS § 1653

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’’.

§ 1653. Contracts and grants for provision of

health care and referral services

(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 pro-
§ 1653 TITLE 25—INDIANS Page 470

vide 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).

(Pub. L. 94–437, title V, §503, as added Pub. L.

100–713, title V, §501, Nov. 23, 1988, 102 Stat. 4821;

amended Pub. L. 101–630, title V, §505, Nov. 28,

1990, 104 Stat. 4564; Pub. L. 102–573, title V,

§§501(b)(1), 505(b)(1), Oct. 29, 1992, 106 Stat. 4567,

4570.)

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 (§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.

PRIOR PROVISIONS

A prior section 1653, Pub. L. 94–437, title V, §503, Sept.

30, 1976, 90 Stat. 1410; Pub. L. 96–537, §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, §501(b)(1)(G), inserted ‘‘and

grants’’ in section catchline.

Subsec. (a). Pub. L. 102–573, §501(b)(1)(A), inserted

‘‘, or make grants to,’’ after ‘‘contracts with’’ and ‘‘or

grant’’ after ‘‘such contract’’.

Subsec. (b). Pub. L. 102–573, §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, §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, §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, §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, §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, §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, §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.
Page 471 TITLE 25—INDIANS § 1655

Subsec. (f)(1). Pub. L. 102–573, §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, §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.’’

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1603, 1654, 1655,

1657 of this title.

§ 1654. Contracts and grants for determination of

unmet health care needs

(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.

(Pub. L. 94–437, title V, §504, as added Pub. L.

100–713, title V, §501, Nov. 23, 1988, 102 Stat. 4822;

amended Pub. L. 102–573, title V, §501(b)(2), Oct.

29, 1992, 106 Stat. 4567.)

PRIOR PROVISIONS

A prior section 1654, Pub. L. 94–437, title V, §504, Sept.

30, 1976, 90 Stat. 1411; Pub. L. 96–537, §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, §501(b)(2)(D), inserted ‘‘and

grants’’ in section catchline.

Subsec. (a). Pub. L. 102–573, §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, §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, §501(b)(2)(C), inserted

‘‘, or grant made,’’ after ‘‘entered into’’.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 1655 of this title.

§ 1655. Evaluations; renewals

(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.