160 
‘‘(c) PUBLICATION.—Each memorandum of agree-
ment entered into or renewed (and amendments or modi-
fications thereto) under subsection (a) shall be published 
in the Federal Register. At the same time as publication 
in the Federal Register, the Secretary shall provide a copy 
of such memoranda, amendment, or modification to each 
Indian tribe, tribal organization, and urban Indian organi-
zation. 
‘‘SEC. 704. COMPREHENSIVE BEHAVIORAL HEALTH PRE-
VENTION AND TREATMENT PROGRAM. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Service, shall provide a program of com-
prehensive behavioral health, prevention, treatment, 
and aftercare, which may include, if feasible and ap-
propriate, systems of care, and shall include— 
‘‘(A) prevention, through educational inter-
vention, in Indian communities; 
‘‘(B) acute detoxification, psychiatric hos-
pitalization, residential, and intensive outpatient 
treatment; 
‘‘(C) community-based rehabilitation and 
aftercare; 
‘‘(D) community education and involve-
ment, including extensive training of health 
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care, educational, and community-based per-
sonnel; 
‘‘(E) specialized residential treatment pro-
grams for high-risk populations, including preg-
nant and postpartum women and their children; 
and 
‘‘(F) diagnostic services. 
‘‘(2) TARGET POPULATIONS.—The target popu-
lation of such programs shall be members of Indian 
tribes. Efforts to train and educate key members of 
the Indian community shall also target employees of 
health, education, judicial, law enforcement, legal, 
and social service programs. 
‘‘(b) CONTRACT HEALTH SERVICES.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Service, may enter into contracts with 
public or private providers of behavioral health treat-
ment services for the purpose of carrying out the 
program required under subsection (a). 
‘‘(2) PROVISION OF ASSISTANCE.—In carrying 
out this subsection, the Secretary shall provide as-
sistance to Indian tribes and tribal organizations to 
develop criteria for the certification of behavioral 
health service providers and accreditation of service 
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facilities which meet minimum standards for such 
services and facilities. 
‘‘SEC. 705. MENTAL HEALTH TECHNICIAN PROGRAM. 
‘‘(a) IN GENERAL.—Pursuant to the Act of Novem-
ber 2, 1921 (25 U.S.C. 13) (commonly known as the ‘Sny-
der Act’), the Secretary shall establish and maintain a 
mental health technician program within the Service 
which— 
‘‘(1) provides for the training of Indians as 
mental health technicians; and 
‘‘(2) employs such technicians in the provision 
of community-based mental health care that includes 
identification, prevention, education, referral, and 
treatment services. 
‘‘(b) PARAPROFESSIONAL TRAINING.—In carrying 
out subsection (a), the Secretary, acting through the Serv-
ice, shall provide high-standard paraprofessional training 
in mental health care necessary to provide quality care to 
the Indian communities to be served. Such training shall 
be based upon a curriculum developed or approved by the 
Secretary which combines education in the theory of men-
tal health care with supervised practical experience in the 
provision of such care. 
‘‘(c) SUPERVISION AND EVALUATION OF TECHNI-
CIANS.—The Secretary, acting through the Service, shall 
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supervise and evaluate the mental health technicians in 
the training program. 
‘‘(d) TRADITIONAL HEALTH CARE PRACTICES.—The 
Secretary, acting through the Service, shall ensure that 
the program established pursuant to this section involves 
the use and promotion of the traditional health care prac-
tices of the Indian tribes to be served. 
‘‘SEC. 
706. 
LICENSING 
REQUIREMENT 
FOR 
MENTAL 
HEALTH CARE WORKERS. 
‘‘(a) IN GENERAL.—Subject to section 221, and ex-
cept as provided in subsection (b), any individual employed 
as a psychologist, social worker, or marriage and family 
therapist for the purpose of providing mental health care 
services to Indians in a clinical setting under this Act is 
required to be licensed as a psychologist, social worker, 
or marriage and family therapist, respectively. 
‘‘(b) TRAINEES.—An individual may be employed as 
a trainee in psychology, social work, or marriage and fam-
ily therapy to provide mental health care services de-
scribed in subsection (a) if such individual— 
‘‘(1) works under the direct supervision of a li-
censed psychologist, social worker, or marriage and 
family therapist, respectively; 
‘‘(2) is enrolled in or has completed at least 2 
years of course work at a post-secondary, accredited 
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education program for psychology, social work, mar-
riage and family therapy, or counseling; and 
‘‘(3) meets such other training, supervision, and 
quality review requirements as the Secretary may es-
tablish. 
‘‘SEC. 707. INDIAN WOMEN TREATMENT PROGRAMS. 
‘‘(a) GRANTS.—The Secretary, consistent with sec-
tion 702, may make grants to Indian tribes, tribal organi-
zations, and urban Indian organizations to develop and 
implement a comprehensive behavioral health program of 
prevention, intervention, treatment, and relapse preven-
tion services that specifically addresses the cultural, his-
torical, social, and child care needs of Indian women, re-
gardless of age. 
‘‘(b) USE OF GRANT FUNDS.—A grant made pursu-
ant to this section may be used— 
‘‘(1) to develop and provide community train-
ing, education, and prevention programs for Indian 
women relating to behavioral health issues, including 
fetal alcohol spectrum disorders; 
‘‘(2) to identify and provide psychological serv-
ices, counseling, advocacy, support, and relapse pre-
vention to Indian women and their families; and 
‘‘(3) to develop prevention and intervention 
models for Indian women which incorporate tradi-
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tional health care practices, cultural values, and 
community and family involvement. 
‘‘(c) CRITERIA.—The Secretary, in consultation with 
Indian tribes and tribal organizations, shall establish cri-
teria for the review and approval of applications and pro-
posals for funding under this section. 
‘‘(d) ALLOCATION OF FUNDS FOR URBAN INDIAN 
ORGANIZATIONS.—Twenty percent of the funds appro-
priated pursuant to this section shall be used to make 
grants to urban Indian organizations. 
‘‘SEC. 708. INDIAN YOUTH PROGRAM. 
‘‘(a) DETOXIFICATION AND REHABILITATION.—The 
Secretary, acting through the Service, consistent with sec-
tion 702, shall develop and implement a program for acute 
detoxification and treatment for Indian youths, including 
behavioral health services. The program shall include re-
gional treatment centers designed to include detoxification 
and rehabilitation for both sexes on a referral basis and 
programs developed and implemented by Indian tribes or 
tribal organizations at the local level under the Indian 
Self-Determination and Education Assistance Act (25 
U.S.C. 450 et seq.). Regional centers shall be integrated 
with the intake and rehabilitation programs based in the 
referring Indian community. 
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‘‘(b) ALCOHOL AND SUBSTANCE ABUSE TREATMENT 
CENTERS OR FACILITIES.— 
‘‘(1) ESTABLISHMENT.— 
‘‘(A) IN GENERAL.—The Secretary, acting 
through the Service, shall construct, renovate, 
or, as necessary, purchase, and appropriately 
staff and operate, at least 1 youth regional 
treatment center or treatment network in each 
area under the jurisdiction of an area office. 
‘‘(B) AREA OFFICE IN CALIFORNIA.—For 
the purposes of this subsection, the area office 
in California shall be considered to be 2 area 
offices, 1 office whose jurisdiction shall be con-
sidered to encompass the northern area of the 
State of California, and 1 office whose jurisdic-
tion shall be considered to encompass the re-
mainder of the State of California for the pur-
pose of implementing California treatment net-
works. 
‘‘(2) FUNDING.—For the purpose of staffing 
and operating such centers or facilities, funding 
shall be pursuant to the Act of November 2, 1921 
(25 U.S.C. 13). 
‘‘(3) LOCATION.—A youth treatment center 
constructed or purchased under this subsection shall 
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be constructed or purchased at a location within the 
area described in paragraph (1) agreed upon (by ap-
propriate tribal resolution) by a majority of the In-
dian tribes to be served by such center. 
‘‘(4) SPECIFIC PROVISION OF FUNDS.— 
‘‘(A) IN GENERAL.—Notwithstanding any 
other provision of this title, the Secretary may, 
from amounts authorized to be appropriated for 
the purposes of carrying out this section, make 
funds available to— 
‘‘(i) the Tanana Chiefs Conference, 
Incorporated, for the purpose of leasing, 
constructing, renovating, operating, and 
maintaining a residential youth treatment 
facility in Fairbanks, Alaska; and 
‘‘(ii) the Southeast Alaska Regional 
Health Corporation to staff and operate a 
residential youth treatment facility without 
regard to the proviso set forth in section 
4(l) of the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 
450b(l)). 
‘‘(B) PROVISION OF SERVICES TO ELIGI-
BLE
YOUTHS.—Until 
additional 
residential 
youth treatment facilities are established in 
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Alaska pursuant to this section, the facilities 
specified in subparagraph (A) shall make every 
effort to provide services to all eligible Indian 
youths residing in Alaska. 
‘‘(c) INTERMEDIATE
ADOLESCENT
BEHAVIORAL 
HEALTH SERVICES.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Service, may provide intermediate be-
havioral health services, which may , if feasible and 
appropriate, incorporate systems of care, to Indian 
children and adolescents, including— 
‘‘(A) pretreatment assistance; 
‘‘(B) inpatient, outpatient, and aftercare 
services; 
‘‘(C) emergency care; 
‘‘(D) suicide prevention and crisis interven-
tion; and 
‘‘(E) prevention and treatment of mental 
illness and dysfunctional and self-destructive 
behavior, including child abuse and family vio-
lence. 
‘‘(2) USE OF FUNDS.—Funds provided under 
this subsection may be used— 
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‘‘(A) to construct or renovate an existing 
health facility to provide intermediate behav-
ioral health services; 
‘‘(B) to hire behavioral health profes-
sionals; 
‘‘(C) to staff, operate, and maintain an in-
termediate mental health facility, group home, 
sober housing, transitional housing or similar 
facilities, or youth shelter where intermediate 
behavioral health services are being provided; 
‘‘(D) to make renovations and hire appro-
priate staff to convert existing hospital beds 
into adolescent psychiatric units; and 
‘‘(E) for intensive home- and community- 
based services. 
‘‘(3) CRITERIA.—The Secretary, acting through 
the Service, shall, in consultation with Indian tribes 
and tribal organizations, establish criteria for the re-
view and approval of applications or proposals for 
funding made available pursuant to this subsection. 
‘‘(d) FEDERALLY OWNED STRUCTURES.— 
‘‘(1) IN GENERAL.—The Secretary, in consulta-
tion with Indian tribes and tribal organizations, 
shall— 
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‘‘(A) identify and use, where appropriate, 
federally owned structures suitable for local res-
idential or regional behavioral health treatment 
for Indian youths; and 
‘‘(B) establish guidelines for determining 
the suitability of any such federally owned 
structure to be used for local residential or re-
gional behavioral health treatment for Indian 
youths. 
‘‘(2) TERMS
AND
CONDITIONS
FOR
USE
OF 
STRUCTURE.—Any structure described in paragraph 
(1) may be used under such terms and conditions as 
may be agreed upon by the Secretary and the agency 
having responsibility for the structure and any In-
dian tribe or tribal organization operating the pro-
gram. 
‘‘(e) REHABILITATION AND AFTERCARE SERVICES.— 
‘‘(1) IN
GENERAL.—The Secretary, Indian 
tribes, or tribal organizations, in cooperation with 
the Secretary of the Interior, shall develop and im-
plement within each Service unit, community-based 
rehabilitation and follow-up services for Indian 
youths who are having significant behavioral health 
problems, and require long-term treatment, commu-
nity reintegration, and monitoring to support the In-
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dian youths after their return to their home commu-
nity. 
‘‘(2) ADMINISTRATION.—Services under para-
graph (1) shall be provided by trained staff within 
the community who can assist the Indian youths in 
their continuing development of self-image, positive 
problem-solving skills, and nonalcohol or substance 
abusing behaviors. Such staff may include alcohol 
and substance abuse counselors, mental health pro-
fessionals, and other health professionals and para-
professionals, including community health represent-
atives. 
‘‘(f) INCLUSION OF FAMILY IN YOUTH TREATMENT 
PROGRAM.—In providing the treatment and other services 
to Indian youths authorized by this section, the Secretary, 
acting through the Service, shall provide for the inclusion 
of family members of such youths in the treatment pro-
grams or other services as may be appropriate. Not less 
than 10 percent of the funds appropriated for the pur-
poses of carrying out subsection (e) shall be used for out-
patient care of adult family members related to the treat-
ment of an Indian youth under that subsection. 
‘‘(g) MULTIDRUG ABUSE PROGRAM.—The Secretary, 
acting through the Service, shall provide, consistent with 
section 702, programs and services to prevent and treat 
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the abuse of multiple forms of substances, including alco-
hol, drugs, inhalants, and tobacco, among Indian youths 
residing in Indian communities, on or near reservations, 
and in urban areas and provide appropriate mental health 
services to address the incidence of mental illness among 
such youths. 
‘‘(h) INDIAN YOUTH MENTAL HEALTH.—The Sec-
retary, acting through the Service, shall collect data for 
the report under section 801 with respect to— 
‘‘(1) the number of Indian youth who are being 
provided mental health services through the Service 
and tribal health programs; 
‘‘(2) a description of, and costs associated with, 
the mental health services provided for Indian youth 
through the Service and tribal health programs; 
‘‘(3) the number of youth referred to the Serv-
ice or tribal health programs for mental health serv-
ices; 
‘‘(4) the number of Indian youth provided resi-
dential treatment for mental health and behavioral 
problems through the Service and tribal health pro-
grams, reported separately for on- and off-reserva-
tion facilities; and 
‘‘(5) the costs of the services described in para-
graph (4). 
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‘‘SEC. 709. INPATIENT AND COMMUNITY-BASED MENTAL 
HEALTH 
FACILITIES 
DESIGN, 
CONSTRUC-
TION, AND STAFFING. 
‘‘Not later than 1 year after the date of enactment 
of the Indian Healthcare Improvement Act of 2011, the 
Secretary, acting through the Service, may provide, in 
each area of the Service, not less than 1 inpatient mental 
health care facility, or the equivalent, for Indians with be-
havioral health problems. For the purposes of this sub-
section, California shall be considered to be 2 area offices, 
1 office whose location shall be considered to encompass 
the northern area of the State of California and 1 office 
whose jurisdiction shall be considered to encompass the 
remainder of the State of California. The Secretary shall 
consider the possible conversion of existing, underused 
Service hospital beds into psychiatric units to meet such 
need. 
‘‘SEC. 710. TRAINING AND COMMUNITY EDUCATION. 
‘‘(a) PROGRAM.—The Secretary, in cooperation with 
the Secretary of the Interior, shall develop and implement 
or assist Indian tribes and tribal organizations to develop 
and implement, within each Service unit or tribal program, 
a program of community education and involvement which 
shall be designed to provide concise and timely information 
to the community leadership of each tribal community. 
Such program shall include education about behavioral 
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health issues to political leaders, tribal judges, law en-
forcement personnel, members of tribal health and edu-
cation boards, health care providers including traditional 
practitioners, and other critical members of each tribal 
community. Such program may also include community- 
based training to develop local capacity and tribal commu-
nity provider training for prevention, intervention, treat-
ment, and aftercare. 
‘‘(b) INSTRUCTION.—The Secretary, acting through 
the Service, shall provide instruction in the area of behav-
ioral health issues, including instruction in crisis interven-
tion and family relations in the context of alcohol and sub-
stance abuse, child sexual abuse, youth alcohol and sub-
stance abuse, and the causes and effects of fetal alcohol 
spectrum disorders to appropriate employees of the Bu-
reau of Indian Affairs and the Service, and to personnel 
in schools or programs operated under any contract with 
the Bureau of Indian Affairs or the Service, including su-
pervisors of emergency shelters and halfway houses de-
scribed in section 4213 of the Indian Alcohol and Sub-
stance Abuse Prevention and Treatment Act of 1986 (25 
U.S.C. 2433). 
‘‘(c) TRAINING MODELS.—In carrying out the edu-
cation and training programs required by this section, the 
Secretary, in consultation with Indian tribes, tribal organi-
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zations, Indian behavioral health experts, and Indian alco-
hol and substance abuse prevention experts, shall develop 
and provide community-based training models. Such mod-
els shall address— 
‘‘(1) the elevated risk of alcohol abuse and 
other behavioral health problems faced by children of 
alcoholics; 
‘‘(2) the cultural, spiritual, and multigenera-
tional aspects of behavioral health problem preven-
tion and recovery; and 
‘‘(3) community-based and multidisciplinary 
strategies for preventing and treating behavioral 
health problems. 
‘‘SEC. 711. BEHAVIORAL HEALTH PROGRAM. 
‘‘(a) INNOVATIVE PROGRAMS.—The Secretary, acting 
through the Service, consistent with section 702, may 
plan, develop, implement, and carry out programs to de-
liver innovative community-based behavioral health serv-
ices to Indians. 
‘‘(b) AWARDS; CRITERIA.—The Secretary may award 
a grant for a project under subsection (a) to an Indian 
tribe or tribal organization and may consider the following 
criteria: 
‘‘(1) The project will address significant unmet 
behavioral health needs among Indians. 
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‘‘(2) The project will serve a significant number 
of Indians. 
‘‘(3) The project has the potential to deliver 
services in an efficient and effective manner. 
‘‘(4) The Indian tribe or tribal organization has 
the administrative and financial capability to admin-
ister the project. 
‘‘(5) The project may deliver services in a man-
ner consistent with traditional health care practices. 
‘‘(6) The project is coordinated with, and avoids 
duplication of, existing services. 
‘‘(c) EQUITABLE TREATMENT.—For purposes of this 
subsection, the Secretary shall, in evaluating project appli-
cations or proposals, use the same criteria that the Sec-
retary uses in evaluating any other application or proposal 
for such funding. 
‘‘SEC. 712. FETAL ALCOHOL SPECTRUM DISORDERS PRO-
GRAMS. 
‘‘(a) PROGRAMS.— 
‘‘(1) ESTABLISHMENT.—The Secretary, con-
sistent with section 702, acting through the Service, 
Indian Tribes, and Tribal Organizations, is author-
ized to establish and operate fetal alcohol spectrum 
disorders programs as provided in this section for 
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the purposes of meeting the health status objectives 
specified in section 3. 
‘‘(2) USE OF FUNDS.— 
‘‘(A) IN
GENERAL.—Funding provided 
pursuant to this section shall be used for the 
following: 
‘‘(i) To develop and provide for Indi-
ans community and in-school training, edu-
cation, and prevention programs relating 
to fetal alcohol spectrum disorders. 
‘‘(ii) To identify and provide behav-
ioral health treatment to high-risk Indian 
women and high-risk women pregnant with 
an Indian’s child. 
‘‘(iii) To identify and provide appro-
priate psychological services, educational 
and vocational support, counseling, advo-
cacy, and information to fetal alcohol spec-
trum disorders-affected Indians and their 
families or caretakers. 
‘‘(iv) To develop and implement coun-
seling and support programs in schools for 
fetal alcohol spectrum disorders-affected 
Indian children. 
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‘‘(v) To develop prevention and inter-
vention models which incorporate practi-
tioners of traditional health care practices, 
cultural values, and community involve-
ment. 
‘‘(vi) To develop, print, and dissemi-
nate education and prevention materials on 
fetal alcohol spectrum disorders. 
‘‘(vii) To develop and implement, in 
consultation with Indian Tribes and Tribal 
Organizations, and in conference with 
urban Indian Organizations, culturally sen-
sitive assessment and diagnostic tools in-
cluding dysmorphology clinics and multi-
disciplinary fetal alcohol spectrum dis-
orders clinics for use in Indian commu-
nities and urban Centers. 
‘‘(viii) To develop and provide training 
on fetal alcohol spectrum disorders to pro-
fessionals providing services to Indians, in-
cluding medical and allied health practi-
tioners, social service providers, educators, 
and law enforcement, court officials and 
corrections personnel in the juvenile and 
criminal justice systems. 
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‘‘(B) ADDITIONAL USES.—In addition to 
any purpose under subparagraph (A), funding 
provided pursuant to this section may be used 
for 1 or more of the following: 
‘‘(i) 
Early 
childhood 
intervention 
projects from birth on to mitigate the ef-
fects of fetal alcohol spectrum disorders 
among Indians. 
‘‘(ii) Community-based support serv-
ices for Indians and women pregnant with 
Indian children. 
‘‘(iii) Community-based housing for 
adult Indians with fetal alcohol spectrum 
disorders. 
‘‘(3) CRITERIA FOR APPLICATIONS.—The Sec-
retary shall establish criteria for the review and ap-
proval of applications for funding under this section. 
‘‘(b) SERVICES.—The Secretary, acting through the 
Service, Indian Tribes, and Tribal Organizations, shall— 
‘‘(1) develop and provide services for the pre-
vention, intervention, treatment, and aftercare for 
those affected by fetal alcohol spectrum disorders in 
Indian communities; and 
‘‘(2) provide supportive services, including serv-
ices to meet the special educational, vocational, 
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school-to-work transition, and independent living 
needs of adolescent and adult Indians with fetal al-
cohol spectrum disorders. 
‘‘(c) APPLIED
RESEARCH
PROJECTS.—The Sec-
retary, acting through the Substance Abuse and Mental 
Health Services Administration, shall make grants to In-
dian Tribes, Tribal Organizations, and urban Indian Or-
ganizations for applied research projects which propose to 
elevate the understanding of methods to prevent, inter-
vene, treat, or provide rehabilitation and behavioral health 
aftercare for Indians and urban Indians affected by fetal 
alcohol spectrum disorders. 
‘‘(d) FUNDING
FOR
URBAN
INDIAN
ORGANIZA-
TIONS.—Ten percent of the funds appropriated pursuant 
to this section shall be used to make grants to urban In-
dian Organizations funded under title V. 
‘‘SEC. 713. CHILD SEXUAL ABUSE PREVENTION AND TREAT-
MENT PROGRAMS. 
‘‘(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Service, shall establish, consistent with section 
702, in every Service area, programs involving treatment 
for— 
‘‘(1) victims of sexual abuse who are Indian 
children or children in an Indian household; and 
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‘‘(2) other members of the household or family 
of the victims described in paragraph (1). 
‘‘(b) USE OF FUNDS.—Funding provided pursuant to 
this section shall be used for the following: 
‘‘(1) To develop and provide community edu-
cation and prevention programs related to sexual 
abuse of Indian children or children in an Indian 
household. 
‘‘(2) To identify and provide behavioral health 
treatment to victims of sexual abuse who are Indian 
children or children in an Indian household, and to 
their family members who are affected by sexual 
abuse. 
‘‘(3) To develop prevention and intervention 
models which incorporate traditional health care 
practices, cultural values, and community involve-
ment. 
‘‘(4) To develop and implement culturally sen-
sitive assessment and diagnostic tools for use in In-
dian communities and urban centers. 
‘‘(c) COORDINATION.—The programs established 
under subsection (a) shall be carried out in coordination 
with programs and services authorized under the Indian 
Child Protection and Family Violence Prevention Act (25 
U.S.C. 3201 et seq.). 
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182 
‘‘SEC. 714. DOMESTIC AND SEXUAL VIOLENCE PREVENTION 
AND TREATMENT. 
‘‘(a) IN GENERAL.—The Secretary, in accordance 
with section 702, is authorized to establish in each Service 
area programs involving the prevention and treatment 
of— 
‘‘(1) Indian victims of domestic violence or sex-
ual abuse; and 
‘‘(2) other members of the household or family 
of the victims described in paragraph (1). 
‘‘(b) USE OF FUNDS.—Funds made available to carry 
out this section shall be used— 
‘‘(1) to develop and implement prevention pro-
grams and community education programs relating 
to domestic violence and sexual abuse; 
‘‘(2) to provide behavioral health services, in-
cluding victim support services, and medical treat-
ment (including examinations performed by sexual 
assault nurse examiners) to Indian victims of domes-
tic violence or sexual abuse; 
‘‘(3) to purchase rape kits; and 
‘‘(4) to develop prevention and intervention 
models, which may incorporate traditional health 
care practices. 
‘‘(c) TRAINING AND CERTIFICATION.— 
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183 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of the Indian Healthcare Im-
provement Act of 2011, the Secretary shall establish 
appropriate protocols, policies, procedures, standards 
of practice, and, if not available elsewhere, training 
curricula and training and certification requirements 
for services for victims of domestic violence and sex-
ual abuse. 
‘‘(2) REPORT.—Not later than 18 months after 
the date of enactment of the Indian Healthcare Im-
provement Act of 2011, the Secretary shall submit 
to the Committee on Indian Affairs of the Senate 
and the Committee on Natural Resources of the 
House of Representatives a report that describes the 
means and extent to which the Secretary has carried 
out paragraph (1). 
‘‘(d) COORDINATION.— 
‘‘(1) IN GENERAL.—The Secretary, in coordina-
tion with the Attorney General, Federal and tribal 
law enforcement agencies, Indian health programs, 
and domestic violence or sexual assault victim orga-
nizations, shall develop appropriate victim services 
and victim advocate training programs— 
‘‘(A) to improve domestic violence or sex-
ual abuse responses; 
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190 
health services in suicide prevention, intervention, 
and treatment of Indian youth, including through— 
‘‘(A) the use of psychotherapy, psychiatric 
assessments, diagnostic interviews, therapies for 
mental health conditions predisposing to sui-
cide, and alcohol and substance abuse treat-
ment; 
‘‘(B) the provision of clinical expertise to, 
consultation services with, and medical advice 
and training for frontline health care providers 
working with Indian youth; 
‘‘(C) training and related support for com-
munity leaders, family members, and health 
and education workers who work with Indian 
youth; 
‘‘(D) the development of culturally relevant 
educational materials on suicide; and 
‘‘(E) data collection and reporting; 
‘‘(2) to encourage Indian tribes, tribal organiza-
tions, and other mental health care providers serving 
residents of Indian country to obtain the services of 
predoctoral psychology and psychiatry interns; and 
‘‘(3) to enhance the provision of mental health 
care services to Indian youth through existing grant 
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221 
pension, or limitation of clinical privileges of 
such health care provider. 
‘‘(C) To a governmental board or agency 
or to a professional health care society or orga-
nization, if such medical quality assurance 
record or testimony is needed by such board, 
agency, society, or organization to perform li-
censing, credentialing, or the monitoring of pro-
fessional standards with respect to any health 
care provider who is or was an employee of any 
Indian health program or urban Indian organi-
zation. 
‘‘(D) To a hospital, medical center, or 
other institution that provides health care serv-
ices, if such medical quality assurance record or 
testimony is needed by such institution to as-
sess the professional qualifications of any health 
care provider who is or was an employee of any 
Indian health program or urban Indian organi-
zation and who has applied for or been granted 
authority or employment to provide health care 
services in or on behalf of such program or or-
ganization. 
‘‘(E) To an officer, employee, or contractor 
of the Indian health program or urban Indian 
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