‘‘(B) Preventive health, including mammog-
raphy and other cancer screening in accordance 
with section 207. 
‘‘(C) Dental care. 
‘‘(D) Mental health, including community 
mental health services, inpatient mental health 
services, dormitory mental health services, thera-
peutic and residential treatment centers, and 
training of traditional health care practitioners. 
‘‘(E) Emergency medical services. 
‘‘(F) Treatment and control of, and reha-
bilitative care related to, alcoholism and drug 
abuse (including fetal alcohol syndrome) among 
Indians. 
‘‘(G) Injury prevention programs, including 
data collection and evaluation, demonstration 
projects, training, and capacity building. 
‘‘(H) Home health care. 
‘‘(I) Community health representatives. 
‘‘(J) Maintenance and improvement. 
‘‘(b) NO OFFSET OR LIMITATION.—Any funds appro-
priated under the authority of this section shall not be used 
to offset or limit any other appropriations made to the 
Service under this Act or the Act of November 2, 1921 (25 
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U.S.C. 13) (commonly known as the ‘Snyder Act’), or any 
other provision of law. 
‘‘(c) ALLOCATION; USE.— 
‘‘(1) IN GENERAL.—Funds appropriated under 
the authority of this section shall be allocated to Serv-
ice Units, Indian Tribes, or Tribal Organizations. 
The funds allocated to each Indian Tribe, Tribal Or-
ganization, or Service Unit under this paragraph 
shall be used by the Indian Tribe, Tribal Organiza-
tion, or Service Unit under this paragraph to im-
prove the health status and reduce the resource defi-
ciency of each Indian Tribe served by such Service 
Unit, Indian Tribe, or Tribal Organization. 
‘‘(2) APPORTIONMENT OF ALLOCATED FUNDS.— 
The apportionment of funds allocated to a Service 
Unit, Indian Tribe, or Tribal Organization under 
paragraph (1) among the health service responsibil-
ities described in subsection (a)(5) shall be determined 
by the Service in consultation with, and with the ac-
tive participation of, the affected Indian Tribes and 
Tribal Organizations. 
‘‘(d) PROVISIONS RELATING TO HEALTH STATUS AND 
RESOURCE DEFICIENCIES.—For the purposes of this sec-
tion, the following definitions apply: 
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‘‘(1) DEFINITION.—The term ‘health status and 
resource deficiency’ means the extent to which— 
‘‘(A) the health status objectives set forth in 
section 3(2) are not being achieved; and 
‘‘(B) the Indian Tribe or Tribal Organiza-
tion does not have available to it the health re-
sources it needs, taking into account the actual 
cost of providing health care services given local 
geographic, 
climatic, 
rural, 
or 
other 
cir-
cumstances. 
‘‘(2) AVAILABLE
RESOURCES.—The health re-
sources available to an Indian Tribe or Tribal Orga-
nization include health resources provided by the 
Service as well as health resources used by the Indian 
Tribe or Tribal Organization, including services and 
financing systems provided by any Federal programs, 
private insurance, and programs of State or local 
governments. 
‘‘(3) PROCESS
FOR
REVIEW
OF
DETERMINA-
TIONS.—The Secretary shall establish procedures 
which allow any Indian Tribe or Tribal Organization 
to petition the Secretary for a review of any deter-
mination of the extent of the health status and re-
source deficiency of such Indian Tribe or Tribal Or-
ganization. 
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‘‘(e) ELIGIBILITY FOR FUNDS.—Tribal Health Pro-
grams shall be eligible for funds appropriated under the au-
thority of this section on an equal basis with programs that 
are administered directly by the Service. 
‘‘(f) REPORT.—By no later than the date that is 3 
years after the date of enactment of the Indian Health Care 
Improvement Act Amendments of 2007, the Secretary shall 
submit to Congress the current health status and resource 
deficiency report of the Service for each Service Unit, in-
cluding newly recognized or acknowledged Indian Tribes. 
Such report shall set out— 
‘‘(1) the methodology then in use by the Service 
for determining Tribal health status and resource de-
ficiencies, as well as the most recent application of 
that methodology; 
‘‘(2) the extent of the health status and resource 
deficiency of each Indian Tribe served by the Service 
or a Tribal Health Program; 
‘‘(3) the amount of funds necessary to eliminate 
the health status and resource deficiencies of all In-
dian Tribes served by the Service or a Tribal Health 
Program; and 
‘‘(4) an estimate of— 
‘‘(A) the amount of health service funds ap-
propriated under the authority of this Act, or 
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any other Act, including the amount of any 
funds transferred to the Service for the preceding 
fiscal year which is allocated to each Service 
Unit, Indian Tribe, or Tribal Organization; 
‘‘(B) the number of Indians eligible for 
health services in each Service Unit or Indian 
Tribe or Tribal Organization; and 
‘‘(C) the number of Indians using the Serv-
ice resources made available to each Service 
Unit, Indian Tribe or Tribal Organization, and, 
to the extent available, information on the wait-
ing lists and number of Indians turned away for 
services due to lack of resources. 
‘‘(g) INCLUSION
IN BASE BUDGET.—Funds appro-
priated under this section for any fiscal year shall be in-
cluded in the base budget of the Service for the purpose of 
determining appropriations under this section in subse-
quent fiscal years. 
‘‘(h) CLARIFICATION.—Nothing in this section is in-
tended to diminish the primary responsibility of the Service 
to eliminate existing backlogs in unmet health care needs, 
nor are the provisions of this section intended to discourage 
the Service from undertaking additional efforts to achieve 
equity among Indian Tribes and Tribal Organizations. 
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‘‘(i) FUNDING
DESIGNATION.—Any funds appro-
priated under the authority of this section shall be des-
ignated as the ‘Indian Health Care Improvement Fund’. 
‘‘SEC. 202. CATASTROPHIC HEALTH EMERGENCY FUND. 
‘‘(a) ESTABLISHMENT.—There is established an In-
dian Catastrophic Health Emergency Fund (hereafter in 
this section referred to as the ‘CHEF’) consisting of— 
‘‘(1) the amounts deposited under subsection (f); 
and 
‘‘(2) the amounts appropriated to CHEF under 
this section. 
‘‘(b) ADMINISTRATION.—CHEF shall be administered 
by the Secretary, acting through the headquarters of the 
Service, solely for the purpose of meeting the extraordinary 
medical costs associated with the treatment of victims of 
disasters or catastrophic illnesses who are within the re-
sponsibility of the Service. 
‘‘(c) CONDITIONS
ON USE
OF FUND.—No part of 
CHEF or its administration shall be subject to contract or 
grant under any law, including the Indian Self-Determina-
tion and Education Assistance Act (25 U.S.C. 450 et seq.), 
nor shall CHEF funds be allocated, apportioned, or dele-
gated on an Area Office, Service Unit, or other similar 
basis. 
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