II

108TH CONGRESS 

1ST SESSION S. 285

To authorize the integration and consolidation of alcohol and substance abuse 

programs and services provided by Indian tribal governments, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 4, 2003

Mr. CAMPBELL introduced the following bill; which was read twice and 

referred to the Committee on Indian Affairs 

A BILL

To authorize the integration and consolidation of alcohol 

and substance abuse programs and services provided by 

Indian tribal governments, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Native American Alco5 hol and Substance Abuse Program Consolidation Act of 

6 2003’’. 

7 SEC. 2. PURPOSES. 

8 The purposes of this Act are—
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1 (1) to enable Indian tribes to consolidate and 

2 integrate alcohol and other substance abuse preven3 tion, diagnosis, and treatment programs, and mental 

4 health and related programs, to provide unified and 

5 more effective and efficient services to Indians af6 flicted with mental health, alcohol, or other sub7 stance abuse problems; 

8 (2) to recognize that Indian tribes can best de9 termine the goals and methods for establishing and 

10 implementing prevention, diagnosis, and treatment 

11 programs for their communities, consistent with the 

12 policy of self-determination; 

13 (3) to encourage and facilitate the implementa14 tion of an automated clinical information system to 

15 complement the Indian health care delivery system; 

16 (4) to authorize the use of Federal funds to 

17 purchase, lease, license, or provide training for tech18 nology for an automated clinical information system 

19 that incorporates clinical, financial, and reporting 

20 capabilities for Indian behavioral health care pro21 grams; 

22 (5) to encourage quality assurance policies and 

23 procedures, and empower Indian tribes through 

24 training and use of technology, to significantly en-
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1 hance the delivery of, and treatment results from, 

2 Indian behavioral health care programs; 

3 (6) to assist Indian tribes in maximizing use of 

4 public, tribal, human, and financial resources in de5 veloping effective, understandable, and meaningful 

6 practices under Indian behavioral health care pro7 grams; and 

8 (7) to encourage and facilitate timely and effec9 tive analysis and evaluation of Indian behavioral 

10 health care programs. 

11 SEC. 3. DEFINITIONS. 

12 In this Act: 

13 (1) AUTOMATED CLINICAL INFORMATION SYS14 TEM.—The term ‘‘automated clinical information 

15 system’’ means an automated computer software 

16 system that can be used to manage clinical, finan17 cial, and reporting information for Indian behavioral 

18 health care programs. 

19 (2) FEDERAL AGENCY.—The term ‘‘Federal 

20 agency’’ has the meaning given the term ‘‘agency’’ 

21 in section 551 of title 5, United States Code. 

22 (3) INDIAN.—The term ‘‘Indian’’ has the mean23 ing given the term in section 4 of the Indian Self24 Determination and Education Assistance Act (25 

25 U.S.C. 450b). 
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1 (4) INDIAN BEHAVIORAL HEALTH CARE PRO2 GRAM.—The term ‘‘Indian behavioral health care 

3 program’’ means a federally funded program, for the 

4 benefit of Indians, to prevent, diagnose, or treat, or 

5 enhance the ability to prevent, diagnose, or treat—

6 (A) mental health problems; or 

7 (B) alcohol or other substance abuse prob8 lems. 

9 (5) INDIAN TRIBE.—

10 (A) IN GENERAL.—The term ‘‘Indian 

11 tribe’’ has the meaning given the term in sec12 tion 4 of the Indian Self Determination and 

13 Education Assistance Act (25 U.S.C. 450b). 

14 (B) INCLUSIONS.—The term ‘‘Indian 

15 tribe’’, in a case in which an intertribal consor16 tium, tribal organization, or Indian health cen17 ter is authorized to carry out 1 or more pro18 grams, services, functions, or activities of an In19 dian tribe under this Act, includes the inter20 tribal consortium, tribal organization, or Indian 

21 health center. 

22 (6) SECRETARY.—The term ‘‘Secretary’’ means 

23 the Secretary of Health and Human Services. 

24 (7) SUBSTANCE ABUSE.—The term ‘‘substance 

25 abuse’’ includes—
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1 (A) the illegal use or abuse of a drug or 

2 an inhalant; and

3 (B) the abuse of tobacco or a related prod4 uct. 

5 SEC. 4. PLANS. 

6 The Secretary, in cooperation with the Secretary of 

7 Labor, the Secretary of the Interior, the Secretary of Edu8 cation, the Secretary of Housing and Urban Development, 

9 the Attorney General, and the Secretary of Transpor10 tation, as appropriate, shall, on receipt of a plan accept11 able to the Secretary that is submitted by an Indian tribe, 

12 authorize the Indian tribe to carry out a demonstration 

13 project to coordinate, in accordance with the plan, the In14 dian behavioral health care programs of the Indian tribe 

15 in a manner that integrates the program services into a 

16 single, coordinated, comprehensive program that uses, to 

17 the extent necessary, an automated clinical information 

18 system to better manage administrative and clinical serv19 ices, costs, and reporting requirements through the con20 solidation and integration of administrative and clinical 

21 functions. 

22 SEC. 5. PROGRAMS AFFECTED. 

23 Programs that may be integrated in a demonstration 

24 project described in section 4 are—
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1 (1) an Indian behavioral health care program 

2 under which an Indian tribe is eligible for the receipt 

3 of funds under a statutory or administrative for4 mula; 

5 (2) an Indian behavioral health care program 

6 under which an Indian tribe is eligible for receipt of 

7 funds through competitive or other grants, if—

8 (A)(i) the Indian tribe provides notice to 

9 the appropriate agency regarding the intentions 

10 of the Indian tribe to include the Indian behav11 ioral health care program in the plan that the 

12 Indian tribe submits to the Secretary; and 

13 (ii) the agency consents to the inclusion of 

14 the grant in the plan; or 

15 (B)(i) the Indian tribe elects to include the 

16 Indian behavioral health care program in the 

17 plan; and 

18 (ii) the administrative requirements con19 tained in the plan are essentially the same as 

20 the administrative requirements applicable to a 

21 grant under the Indian behavioral health care 

22 program; and 

23 (3) an Indian behavioral health care program 

24 under which an Indian tribe is eligible to receive 

25 funds under any other funding scheme. 
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1 SEC. 6. PLAN REQUIREMENTS. 

2 A plan of an Indian tribe submitted under section 4 

3 shall—

4 (1) identify the programs to be integrated; 

5 (2) be consistent with this Act; 

6 (3) describe a comprehensive strategy that—

7 (A) identifies the full range of existing and 

8 potential alcohol and substance abuse and men9 tal health treatment and prevention programs 

10 available on and near the service area of the In11 dian tribe; and 

12 (B) may include site and technology as13 sessments and any necessary computer hard14 ware installation and support; 

15 (4) describe the manner in which services are to 

16 be integrated and delivered and the results expected 

17 under the plan (including, if implemented, the man18 ner and expected results of implementation of an 

19 automated clinical information system); 

20 (5) identify the projected expenditures under 

21 the plan in a single budget; 

22 (6) identify the agency or agencies in the In23 dian tribe to be involved in the delivery of the serv24 ices integrated under the plan; 

25 (7) identify any statutory provisions, regula26 tions, policies, or procedures that the Indian tribe 
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1 requests be waived in order to implement the plan; 

2 and 

3 (8) be approved by the governing body of the 

4 Indian tribe. 

5 SEC. 7. PLAN REVIEW. 

6 (a) CONSULTATION.—On receipt of a plan from an 

7 Indian tribe under section 4, the Secretary shall consult 

8 with—

9 (1) the head of each Federal agency providing 

10 funds to be used to implement the plan; and 

11 (2) the Indian tribe. 

12 (b) IDENTIFICATION OF WAIVERS.—Each party con13 sulting on the implementation of a plan under section 4 

14 shall identify any waivers of statutory requirements or of 

15 Federal agency regulations, policies, or procedures that 

16 the party determines to be necessary to enable the Indian 

17 tribe to implement the plan. 

18 (c) WAIVERS.—Notwithstanding any other provision 

19 of law, the head of a Federal agency may waive any statu20 tory requirement, regulation, policy, or procedure promul21 gated by the Federal agency is identified by the Indian 

22 tribe or the Federal agency under subsection (b) unless 

23 the head of the affected Federal agency determines that 

24 a waiver is inconsistent with—

25 (1) this Act;
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1 (2) any statutory requirement applicable to the 

2 program to be integrated under the plan that is spe3 cifically applicable to Indian programs; and 

4 (3) any underlying statutory objective or pur5 pose of a program to be consolidated under the plan, 

6 to such a degree as would render ineffectual activi7 ties funded under the program. 

8 SEC. 8. PLAN APPROVAL. 

9 (a) IN GENERAL.—Not later than 90 days after the 

10 date of receipt by the Secretary of a plan under section 

11 4, the Secretary shall inform the Indian tribe that sub12 mitted the plan, in writing, of the approval or disapproval 

13 of the plan (including any request for a waiver that is 

14 made as part of the plan). 

15 (b) DISAPPROVAL.—

16 (1) IN GENERAL.—The Secretary may dis17 approve a plan if—

18 (A) the plan does not provide sufficient in19 formation for the Secretary to adequately re20 view the plan for compliance with this Act; 

21 (B) the plan does not comply with this 

22 Act; 

23 (C) the plan provides for the purchase, 

24 lease, license, or training for, an automated 

25 clinical information system, but the purchase, 
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1 lease, license, or training would require aggre2 gate expenditures of program funding at such a 

3 level as would render other program substan4 tially ineffectual; or 

5 (D)(i) the plan identifies waivers that can6 not be waived under section 7(c); and 

7 (ii) the plan would be rendered substan8 tially ineffectual without the waivers. 

9 (2) NOTICE.—If a plan is disapproved under 

10 subsection (a), the Secretary shall—

11 (A) inform the Indian tribe, in writing, of 

12 the reasons for the disapproval; and 

13 (B) provide the Indian tribe an oppor14 tunity—

15 (i) to amend and resubmit the plan; 

16 or 

17 (ii) to petition the Secretary to recon18 sider the disapproval (including reconsid19 ering the disapproval of any waiver re20 quested by the Indian tribe). 

21 SEC. 9. USE OF FUNDS FOR TECHNOLOGY. 

22 Notwithstanding any requirement applicable to an In23 dian behavioral health care program of an Indian tribe 

24 that is integrated under a demonstration project described 

25 in section 4, the Indian tribe may use funds made avail-
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1 able under the program to purchase, lease, license, or pro2 vide training for technology for an automated clinical in3 formation system if the purchase, lease, licensing of, or 

4 provision of training is conducted in accordance with a 

5 plan approved by the Secretary under section 8. 

6 SEC. 10. FEDERAL RESPONSIBILITIES. 

7 (a) RESPONSIBILITIES OF THE INDIAN HEALTH

8 SERVICE.— 

9 (1) MEMORANDUM OF UNDERSTANDING.—Not 

10 later than 180 days after the date of enactment of 

11 this Act, the Secretary, the Secretary of the Interior, 

12 the Secretary of Labor, the Secretary of Education, 

13 the Secretary of Housing and Urban Development, 

14 the Attorney General, and the Secretary of Trans15 portation shall enter into a memorandum of agree16 ment providing for the implementation of the plans 

17 approved under section 8. 

18 (2) LEAD AGENCY.—The lead agency under 

19 this Act shall be the Indian Health Service. 

20 (3) RESPONSIBILITIES.—The responsibilities of 

21 the lead agency under this Act shall include—

22 (A) the development of a single reporting 

23 format—

24 (i) relating to each plan for a dem25 onstration project submitted under section 
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1 4, which shall be used by an Indian tribe 

2 to report activities carried out under the 

3 plan; and 

4 (ii) relating to the projected expendi5 tures for the individual plan, which shall 

6 be used by an Indian tribe to report all 

7 plan expenditures; 

8 (B) the development of a single system of 

9 Federal oversight for the plan, which shall be 

10 implemented by the lead agency; 

11 (C) the provision of, or arrangement for 

12 provision of, technical assistance to an Indian 

13 tribe that is appropriate to support and imple14 ment the plan, delivered under an arrangement 

15 subject to the approval of the Indian tribe par16 ticipating in the project (except that an Indian 

17 tribe shall have the authority to accept or reject 

18 the plan for providing the technical assistance 

19 and the technical assistance provider); and 

20 (D) the convening by an appropriate offi21 cial of the lead agency (who shall be an official 

22 appointed by and with the advice and consent 

23 of the Senate) and a representative of the In24 dian tribes that carry out projects under this 

25 Act, in consultation with each of the Indian
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1 tribes that participate in projects under this 

2 Act, of a meeting at least twice during each fis3 cal year, for the purpose of providing an oppor4 tunity for all Indian tribes that carry out 

5 projects under this Act to discuss issues relat6 ing to the implementation of this Act with offi7 cials of each agency specified in paragraph (1). 

8 (b) REPORT REQUIREMENTS.—

9 (1) IN GENERAL.—The single reporting formats 

10 described in subsection (a)(3)(A) shall be developed 

11 by the Secretary in accordance with this Act. 

12 (2) INFORMATION.—The single reporting for13 mat, together with records maintained on the con14 solidated program at the tribal level, shall contain 

15 such information as the Secretary determines will—

16 (A) allow the Secretary to determine 

17 whether the Indian tribe has complied with the 

18 requirements incorporated in the approved plan 

19 of the Indian tribe; and 

20 (B) provide assurances to the Secretary 

21 that the Indian tribe has complied with all—

22 (i) applicable statutory requirements; 

23 and 

24 (ii) applicable regulatory requirements 

25 that have not been waived. 
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1 SEC. 11. NO REDUCTION IN AMOUNTS. 

2 In no case shall the amount of Federal funds avail3 able to an Indian tribe involved in any project under this 

4 Act be reduced as a result of the enactment of this Act. 

5 SEC. 12. INTERAGENCY FUND TRANSFERS. 

6 The Secretary, the Secretary of the Interior, the Sec7 retary of Labor, the Secretary of Education, the Secretary 

8 of Housing and Urban Development, the Attorney Gen9 eral, or the Secretary of Transportation, as appropriate, 

10 may take such action as is necessary to provide for the 

11 interagency transfer of funds otherwise available to an In12 dian tribe in order to carry out this Act. 

13 SEC. 13. ADMINISTRATION OF FUNDS; EXCESS FUNDS. 

14 (a) ADMINISTRATION OF FUNDS.— 

15 (1) IN GENERAL.—Program funds shall be ad16 ministered under this Act in such a manner as to 

17 allow for a determination by the Secretary that 

18 funds made available for specific programs (or an 

19 amount equal to the amount used from each pro20 gram) are expended on activities authorized under 

21 the program. 

22 (2) SEPARATE RECORDS NOT REQUIRED.—

23 Nothing in this section requires an Indian tribe—

24 (A) to maintain separate records tracing 

25 any service provided or activity conducted under 

26 the approved plan of the Indian tribe to the in-
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1 dividual programs under which funds were au2 thorized; or 

3 (B) to allocate expenditures among indi4 vidual programs. 

5 (b) EXCESS FUNDS.—With respect to administrative 

6 costs of carrying out the approved plan of an Indian tribe 

7 under this Act—

8 (1) all administrative costs under the approved 

9 plan may be commingled; 

10 (2) an Indian tribe that carries out a dem11 onstration program under such an approved plan 

12 shall be entitled to receive reimbursement for the 

13 full amount of those costs in accordance with regula14 tions of each program or department; and 

15 (3) if the Indian tribe, after paying administra16 tive costs associated with carrying out the approved 

17 plans, realizes excess administrative funds, those 

18 funds shall not be counted for Federal audit pur19 poses if the excess funds are used for the purposes 

20 provided for under this Act. 

21 SEC. 14. FISCAL ACCOUNTABILITY. 

22 Nothing in this Act affects the authority of the Sec23 retary or the lead agency to safeguard Federal funds in 

24 accordance with chapter 75 of title 31, United States 

25 Code. 
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1 SEC. 15. REPORT ON STATUTORY AND OTHER BARRIERS TO 

2 INTEGRATION. 

3 (a) PRELIMINARY REPORT.—Not later than 2 years 

4 after the date of enactment of this Act, the Secretary shall 

5 submit to the Committee on Indian Affairs of the Senate 

6 and the Committee on Resources of the House of Rep7 resentatives a preliminary report that describes the imple8 mentation of this Act. 

9 (b) FINAL REPORT.—Not later than 5 years after the 

10 date of enactment of this Act, the Secretary shall submit 

11 to the Committee on Indian Affairs of the Senate and the 

12 Committee on Resources of the House of Representatives 

13 a final report that—

14 (1) describes the results of implementation of 

15 this Act; and 

16 (2) identifies statutory barriers to the ability of 

17 Indian tribes to integrate more effectively alcohol 

18 and substance abuse services in a manner consistent 

19 with this Act. 

20 SEC. 15. ASSIGNMENT OF FEDERAL PERSONNEL TO STATE 

21 INDIAN ALCOHOL AND DRUG TREATMENT OR 

22 MENTAL HEALTH PROGRAMS. 

23 Any State with an alcohol and substance abuse or 

24 mental health program targeted toward Indian tribes shall 

25 be eligible to receive, at no cost to the State, such Federal 

26 personnel assignments as the Secretary, in accordance 
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1 with the applicable provisions of subchapter IV of chapter 

2 33 of title 5, United States Code, determines to be appro3 priate to help ensure the success of the program.

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