ter’s Degrees, and less than 1 percent of indi-
viduals who earned doctoral degrees at the Uni-
versity of Hawaii.
‘‘SEC. 3. DEFINITIONS.
‘‘In this Act:
‘‘(1) DEPARTMENT.—The term ‘department’
means the Department of Health and Human Serv-
ices.
‘‘(2) DISEASE PREVENTION.—The term ‘disease
prevention’ includes—
‘‘(A) immunizations;
‘‘(B) control of high blood pressure;
‘‘(C) control of sexually transmittable dis-
eases;
‘‘(D) prevention and control of chronic dis-
eases;
‘‘(E) control of toxic agents;
‘‘(F) occupational safety and health;
‘‘(G) injury prevention;
‘‘(H) fluoridation of water;
‘‘(I) control of infectious agents; and
‘‘(J) provision of mental health care.
‘‘(3) HEALTH PROMOTION.—The term ‘health
promotion’ includes—
‘‘(A) pregnancy and infant care, including
prevention of fetal alcohol syndrome;
‘‘(B) cessation of tobacco smoking;
‘‘(C) reduction in the misuse of alcohol and
harmful illicit drugs;
‘‘(D) improvement of nutrition;
‘‘(E) improvement in physical fitness;
‘‘(F) family planning;
‘‘(G) control of stress;
‘‘(H) reduction of major behavioral risk
factors and promotion of healthy lifestyle prac-
tices; and
‘‘(I) integration of cultural approaches to
health and well-being, including traditional
practices relating to the atmosphere (lewa lani),
land (‘aina), water (wai), and ocean (kai).
‘‘(4) NATIVE
HAWAIIAN.—The term ‘Native
Hawaiian’ means any individual who is Kanaka
Maoli (a descendant of the aboriginal people who,
prior to 1778, occupied and exercised sovereignty in
the area that now constitutes the State of Hawaii)
as evidenced by—
‘‘(A) genealogical records,
‘‘(B) kama‘aina witness verification from
Native Hawaiian Kupuna (elders); or
‘‘(C) birth records of the State of Hawaii
or any State or territory of the United States.
‘‘(5) NATIVE
HAWAIIAN
HEALTH
CARE
SYS-
TEM.—The term ‘Native Hawaiian health care sys-
tem’ means an entity—
‘‘(A) which is organized under the laws of
the State of Hawaii;
‘‘(B) which provides or arranges for health
care services through practitioners licensed by
the State of Hawaii, where licensure require-
ments are applicable;
‘‘(C) which is a public or nonprofit private
entity;
‘‘(D) in which Native Hawaiian health
practitioners significantly participate in the
planning, management, monitoring, and evalua-
tion of health care services;
‘‘(E) which may be composed of as many
as 8 Native Hawaiian health care systems as
necessary to meet the health care needs of each
island’s Native Hawaiians; and
‘‘(F) which is—
‘‘(i) recognized by Papa Ola Lokahi
for the purpose of planning, conducting, or
administering programs, or portions of
programs, authorized by this chapter for
the benefit of Native Hawaiians; and
‘‘(ii) certified by Papa Ola Lokahi as
having the qualifications and the capacity
to provide the services and meet the re-
quirements under the contract the Native
Hawaiian health care system enters into
with the Secretary or the grant the Native
Hawaiian health care system receives from
the Secretary pursuant to this Act.
‘‘(6) NATIVE HAWAIIAN HEALTH CENTER.—The
term ‘Native Hawaiian Health Center’ means any
organization that is a primary care provider and
that—
‘‘(A) has a governing board that is com-
posed of individuals, at least 50 percent of
whom are Native Hawaiians;
‘‘(B) has demonstrated cultural com-
petency in a predominantly Native Hawaiian
community;
‘‘(C) serves a patient population that—
‘‘(i) is made up of individuals at least
50 percent of whom are Native Hawaiian;
or
‘‘(ii) has not less than 2,500 Native
Hawaiians as annual users of services; and
‘‘(D) is recognized by Papa Ola Lokahi has
having met all the criteria of this paragraph.
‘‘(7) 
NATIVE
HAWAIIAN
HEALTH
TASK
FORCE.—The term ‘Native Hawaiian Health Task
Force’ means a task force established by the State
Council of Hawaiian Homestead Associations to im-
plement health and wellness strategies in Native Ha-
waiian communities.
‘‘(8) NATIVE
HAWAIIAN
ORGANIZATION.—The
term ‘Native Hawaiian organization’ means any
organization—
‘‘(A) which serves the interests of Native
Hawaiians; and
‘‘(B) which is—
‘‘(i) recognized by Papa Ola Lokahi
for the purpose of planning, conducting, or
administering programs (or portions of
programs) authorized under this Act for
the benefit of Native Hawaiians; and
‘‘(ii) a public or nonprofit private enti-
ty.
‘‘(9) OFFICE
OF
HAWAIIAN
AFFAIRS.—The
terms ‘Office of Hawaiian Affairs’ and ‘OHA’ mean
the governmental entity established under Article
XII, sections 5 and 6 of the Hawaii State Constitu-
tion and charged with the responsibility to formulate
policy relating to the affairs of Native Hawaiians.
‘‘(10) PAPA OLA LOKAHI.—
‘‘(A) IN GENERAL.—The term ‘Papa Ola
Lokahi’ means an organization that is com-
posed of public agencies and private organiza-
tions focusing on improving the health status of
Native Hawaiians. Board members of such or-
ganization may include representation from—
‘‘(i) E Ola Mau;
‘‘(ii) the Office of Hawaiian Affairs of
the State of Hawaii;
‘‘(iii) Alu Like, Inc.;
‘‘(iv) the University of Hawaii;
‘‘(v) the Hawaii State Department of
Health;
‘‘(vi) the Kamehameha Schools, or
other Native Hawaiian organization re-
sponsible for the administration of the Na-
tive Hawaiian Health Scholarship Pro-
gram;
‘‘(vii) the Hawaii State Primary Care
Association, or Native Hawaiian Health
Centers whose patient populations are pre-
dominantly Native Hawaiian;
‘‘(viii) Ahahui O Na Kauka, the Na-
tive Hawaiian Physicians Association;
‘‘(ix) Ho‘ola Lahui Hawaii, or a
health care system serving the islands of
Kaua‘i or Ni‘ihau, and which may be com-
posed of as many health care centers as
are necessary to meet the health care
needs of the Native Hawaiians of those is-
lands;
‘‘(x) Ke Ola Mamo, or a health care
system serving the island of O‘ahu and
which may be composed of as many health
care centers as are necessary to meet the
health care needs of the Native Hawaiians
of that island;
‘‘(xi) Na Pu‘uwai or a health care sys-
tem serving the islands of Moloka‘i or
Lana‘i, and which may be composed of as
many health care centers as are necessary
to meet the health care needs of the Native
Hawaiians of those islands;
‘‘(xii) Hui No Ke Ola Pono, or a
health care system serving the island of
Maui, and which may be composed of as
many health care centers as are necessary
to meet the health care needs of the Native
Hawaiians of that island;
‘‘(xiii) Hui Malama Ola Na ‘Oiwi, or
a health care system serving the island of
Hawaii, and which may be composed of as
many health care centers as are necessary
to meet the health care needs of the Native
Hawaiians of that island;
‘‘(xiv) other Native Hawaiian health
care systems as certified and recognized by
Papa Ola Lokahi in accordance with this
Act; and
‘‘(xv) such other member organiza-
tions as the Board of Papa Ola Lokahi will
admit from time to time, based upon satis-
factory demonstration of a record of con-
tribution to the health and well-being of
Native Hawaiians.
‘‘(B) LIMITATION.—Such term does not in-
clude any organization described in subpara-
graph (A) if the Secretary determines that such
organization has not developed a mission state-
ment with clearly defined goals and objectives
for the contributions the organization will make
to the Native Hawaiian health care systems, the
national policy as set forth in section 4, and an
action plan for carrying out those goals and ob-
jectives.
‘‘(11) PRIMARY HEALTH SERVICES.—The term
‘primary health services’ means—
‘‘(A) services of physicians, physicians’ as-
sistants, nurse practitioners, and other health
professionals;
‘‘(B) diagnostic laboratory and radiologic
services;
‘‘(C) preventive health services including
perinatal services, well child services, family
planning services, nutrition services, home
health services, and, generally, all those services
associated with enhanced health and wellness.
‘‘(D) emergency medical services;
‘‘(E) transportation services as required
for adequate patient care;
‘‘(F) preventive dental services;
‘‘(G) pharmaceutical and medicament serv-
ices;
‘‘(H) primary care services that may lead
to specialty or tertiary care; and
‘‘(I) complimentary healing practices, in-
cluding those performed by traditional Native
Hawaiian healers.
‘‘(12) 
SECRETARY.—The 
term 
‘Secretary’
means the Secretary of Health and Human Services.
‘‘(13) TRADITIONAL NATIVE HAWAIIAN HEAL-
ER.—The term ‘traditional Native Hawaiian healer’
means a practitioner—
‘‘(A) who—
‘‘(i) is of Native Hawaiian ancestry;
and
‘‘(ii) has the knowledge, skills, and ex-
perience in direct personal health care of
individuals; and
‘‘(B) whose knowledge, skills, and experi-
ence are based on demonstrated learning of Na-
tive Hawaiian healing practices acquired by—
‘‘(i) direct practical association with
Native Hawaiian elders; and
‘‘(ii) oral traditions transmitted from
generation to generation.
‘‘SEC. 4. DECLARATION OF NATIONAL NATIVE HAWAIIAN
HEALTH POLICY.
‘‘(a) CONGRESS.—Congress hereby declares that it is
the policy of the United States in fulfillment of its special
responsibilities and legal obligations to the indigenous peo-
ples of Hawaii resulting from the unique and historical
relationship between the United States and the indigenous
peoples of Hawaii—
‘‘(1) to raise the health status of Native Hawai-
ians to the highest possible health level; and
‘‘(2) to provide existing Native Hawaiian health
care programs with all resources necessary to effec-
tuate this policy.
‘‘(b) INTENT OF CONGRESS.—It is the intent of the
Congress that—
‘‘(1) health care programs having a dem-
onstrated effect of substantially reducing or elimi-
nating the over-representation of Native Hawaiians
among those suffering from chronic and acute dis-
ease and illness and addressing the health needs, in-
cluding perinatal, early child development, and fam-
ily-based health education, of Native Hawaiians shall
be established and implemented; and
‘‘(2) the Nation raise the health status of Na-
tive Hawaiians by the year 2010 to at least the lev-
els set forth in the goals contained within Healthy
People 2010 or successor standards and to incor-
porate within health programs, activities defined and
identified by Kanaka Maoli which may include—
‘‘(A) incorporating and supporting the in-
tegration of cultural approaches to health and
well-being, including programs using traditional
practices relating to the atmosphere (lewa lani),
land (’aina), water (wai), or ocean (kai);
‘‘(B) increasing the number of health and
allied-health care providers who are trained to
provide culturally competent care to Native Ha-
waiians;
‘‘(C) increasing the use of traditional Na-
tive Hawaiian foods in peoples’ diets and die-
tary preferences including those of students and
the use of these traditional foods in school feed-
ing programs;
‘‘(D) identifying and instituting Native
Hawaiian cultural values and practices within
the ‘corporate cultures’ of organizations and
agencies providing health services to Native Ha-
waiians;
‘‘(E) facilitating the provision of Native
Hawaiian healing practices by Native Hawaiian
healers for those clients desiring such assist-
ance; and
‘‘(F) supporting training and education ac-
tivities and programs in traditional Native Ha-
Hawaiian community in carrying out this sec-
tion.
‘‘(B) MEMORANDA OF UNDERSTANDING.—
Papa Ola Lokahi and the Office of Hawaiian
Affairs may enter into memoranda of under-
standing or agreement for the purposes of ac-
quiring joint funding and for other issues as
may be necessary to accomplish the objectives
of this section.
‘‘(3) HEALTH
CARE
FINANCING
STUDY
RE-
PORT.—Not later than 18 months after the date of
enactment of this Act, Papa Ola Lokahi in coopera-
tion with the Office of Hawaiian Affairs and other
appropriate agencies of the State of Hawaii, includ-
ing the Department of Health and the Department
of Human Services and the Native Hawaiian health
care systems and Native Hawaiian health centers,
shall submit to Congress a report detailing the im-
pact of current Federal and State health care fi-
nancing mechanisms and policies on the health and
well-being of Native Hawaiians. Such report shall
include—
‘‘(A) information concerning the impact of
cultural competency, risk assessment data, eligi-
bility requirements and exemptions, and reim-
bursement policies and capitation rates cur-
rently in effect for service providers;
‘‘(B) any other such information as may be
important to improving the health status of Na-
tive Hawaiians as such information relates to
health care financing including barriers to
health care; and
‘‘(C) the recommendations for submission
to the Secretary for review and consultation
with Native Hawaiians.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There
are authorized to be appropriated such sums as may be
necessary to carry out subsection (a).
‘‘SEC. 6. FUNCTIONS OF PAPA OLA LOKAHI AND OFFICE OF
HAWAIIAN AFFAIRS.
‘‘(a) RESPONSIBILITY.—Papa Ola Lokahi shall be re-
sponsible for the—
‘‘(1) coordination, implementation, and updat-
ing, as appropriate, of the comprehensive health care
master plan developed pursuant to section 5;
‘‘(2) training for the persons described in sub-
paragraphs (B) and (C) of section 7(c)(1);
‘‘(3) identification of and research into the dis-
eases that are most prevalent among Native Hawai-
ians, including behavioral, biomedical, epidemiolog-
ical, and health services;
‘‘(4) development and maintenance of an insti-
tutional review board for all research projects involv-
ing all aspects of Native Hawaiian health, including
behavioral, biomedical, epidemiological, and health
services studies; and
‘‘(5) the maintenance of an action plan out-
lining the contributions that each member organiza-
tion of Papa Ola Lokahi will make in carrying out
the policy of this Act.
‘‘(b) SPECIAL PROJECT FUNDS.—Papa Ola Lokahi
may receive special project funds that may be appro-
priated for the purpose of research on the health status
of Native Hawaiians or for the purpose of addressing the
health care needs of Native Hawaiians, including being eli-
gible to receive research endowments under section 736
of the Public Health Service Act.
‘‘(c) CLEARINGHOUSE.—
‘‘(1) IN
GENERAL.—Papa Ola Lokahi shall
serve as a clearinghouse for—
‘‘(A) the collection and maintenance of
data associated with the health status of Native
Hawaiians;
‘‘(B) the identification and research into
diseases affecting Native Hawaiians;
‘‘(C) the availability of Native Hawaiian
project funds, research projects and publica-
tions;
‘‘(D) the collaboration of research in the
area of Native Hawaiian health; and
‘‘(E) the timely dissemination of informa-
tion pertinent to the Native Hawaiian health
care systems.
‘‘(2) CONSULTATION.—The Secretary shall pro-
vide Papa Ola Lokahi and the Office of Hawaiian
Affairs, at least once annually, an accounting of
funds and services provided to States and to non-
profit groups and organizations from the Depart-
ment for the purposes set forth in section 4. Such
accounting shall include—
‘‘(A) the amount of funds expended explic-
itly for and benefiting Native Hawaiians;
‘‘(B) the number of Native Hawaiians im-
pacted by these funds;
‘‘(C) the identification of collaborations
made with Native Hawaiian groups and organi-
zations in the expenditure of these funds; and
‘‘(D) the amount of funds used for Federal
administrative purposes and for the provision of
direct services to Native Hawaiians.
‘‘(d) FISCAL ALLOCATION AND COORDINATION OF
PROGRAMS AND SERVICES.—
‘‘(1) RECOMMENDATIONS.—Papa Ola Lokahi
shall provide annual recommendations to the Sec-
retary with respect to the allocation of all amounts
appropriated under this Act.
‘‘(2) COORDINATION.—Papa Ola Lokahi shall,
to the maximum extent possible, coordinate and as-
sist the health care programs and services provided
to Native Hawaiians.
‘‘(3) REPRESENTATION ON COMMISSION.—The
Secretary, in consultation with Papa Ola Lokahi,
shall make recommendations for Native Hawaiian
representation on the President’s Advisory Commis-
sion on Asian Americans and Pacific Islanders.
‘‘(e) TECHNICAL SUPPORT.—Papa Ola Lokahi may
act as a statewide infrastructure to provide technical sup-
port and coordination of training and technical assistance
to the Native Hawaiian health care systems and to Native
Hawaiian health centers.
‘‘(f) RELATIONSHIPS WITH OTHER AGENCIES.—
‘‘(1) AUTHORITY.—Papa Ola Lokahi may enter
into agreements or memoranda of understanding
with relevant institutions, agencies or organizations
that are capable of providing health-related re-
sources or services to Native Hawaiians and the Na-
tive Hawaiian health care systems or of providing
resources or services for the implementation of the
National policy as set forth in section 4.
‘‘(2) HEALTH CARE FINANCING.—
‘‘(A) FEDERAL
CONSULTATION.—Federal
agencies providing health care financing and
carrying out health care programs, including
the Health Care Financing Administration,
shall consult with Native Hawaiians and organi-
zations providing health care services to Native
Hawaiians prior to the adoption of any policy
or regulation that may impact on the provision
of services or health insurance coverage. Such
consultation shall include the identification of
the impact of any proposed policy, rule, or reg-
ulation.
‘‘(B) STATE
CONSULTATION.—The State
of Hawaii shall engage in meaningful consulta-
tion with Native Hawaiians and organizations
providing health care services to Native Hawai-
ians in the State of Hawaii prior to making any
changes or initiating new programs.
‘‘(C) 
CONSULTATION
ON
FEDERAL
HEALTH INSURANCE PROGRAMS.
‘‘(i) IN GENERAL.—The Office of Ha-
waiian Affairs, in collaboration with Papa
Ola Lokahi, may develop consultative, con-
tractual or other arrangements, including
memoranda of understanding or agree-
ment, with—
‘‘(I) the Health Care Financing
Administration;
‘‘(II) the agency of the State of
Hawaii that administers or supervises
the administration of the State plan
or waiver approved under title XVIII,
XIX, or XXI of the Social Security
Act for the payment of all or a part
of the health care services provided to
Native Hawaiians who are eligible for
medical assistance under the State
plan or waiver; or
‘‘(III) any other Federal agency
or agencies providing full or partial
health insurance to Native Hawaiians.
shall submit to the Secretary and to Papa Ola
Lokahi an annual report—
‘‘(A) on the activities conducted by the en-
tity under the grant or contract;
‘‘(B) on the amounts and purposes for
which Federal funds were expended; and
‘‘(C) containing such other information as
the Secretary may request.
‘‘(2) AUDITS.—The reports and records of any
entity concerning any grant or contract under this
Act shall be subject to audit by the Secretary, the
Inspector General of the Department of Health and
Human Services, and the Comptroller General of the
United States.
‘‘(f) ANNUAL PRIVATE AUDIT.—The Secretary shall
allow as a cost of any grant made or contract entered into
under this Act the cost of an annual private audit con-
ducted by a certified public accountant.
‘‘SEC. 10. ASSIGNMENT OF PERSONNEL.
‘‘(a) IN GENERAL.—The Secretary may enter into an
agreement with any entity under which the Secretary may
assign personnel of the Department of Health and Human
Services with expertise identified by such entity to such
entity on detail for the purposes of providing comprehen-