1834 
‘‘(A) IN GENERAL.—In any case in which 
an Indian Tribe or Tribal Organization that is 
authorized or required under a compact or con-
tract issued pursuant to the Indian Self-Deter-
mination and Education Assistance Act (25 
U.S.C. 450 et seq.) to furnish or pay for health 
services to a person who is injured or suffers a 
disease on or after the date of enactment of the 
Indian Health Care Improvement Act Amend-
ments of 2009 under circumstances that estab-
lish grounds for a claim of liability against the 
tortfeasor with respect to the injury or disease, 
the Indian Tribe or Tribal Organization shall 
have a right to recover from the tortfeasor (or 
an insurer of the tortfeasor) the reasonable 
value of the health services so furnished, paid 
for, or to be paid for, in accordance with the 
Federal Medical Care Recovery Act (42 U.S.C. 
2651 et seq.), to the same extent and under the 
same circumstances as the United States may 
recover under that Act. 
‘‘(B) TREATMENT.—The right of an In-
dian Tribe or Tribal Organization to recover 
under subparagraph (A) shall be independent of 
the rights of the injured or diseased person 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01834
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1835 
served by the Indian Tribe or Tribal Organiza-
tion. 
‘‘(f) LIMITATION.—Absent specific written authoriza-
tion by the governing body of an Indian Tribe for the pe-
riod of such authorization (which may not be for a period 
of more than 1 year and which may be revoked at any 
time upon written notice by the governing body to the 
Service), the United States shall not have a right of recov-
ery under this section if the injury, illness, or disability 
for which health services were provided is covered under 
a self-insurance plan funded by an Indian Tribe, Tribal 
Organization, or urban Indian organization. Where such 
authorization is provided, the Service may receive and ex-
pend such amounts for the provision of additional health 
services consistent with such authorization. 
‘‘(g) COSTS AND ATTORNEYS’ FEES.—In any action 
brought to enforce the provisions of this section, a pre-
vailing plaintiff shall be awarded its reasonable attorneys’ 
fees and costs of litigation. 
‘‘(h) NONAPPLICATION OF CLAIMS FILING REQUIRE-
MENTS.—An insurance company, health maintenance or-
ganization, self-insurance plan, managed care plan, or 
other health care plan or program (under the Social Secu-
rity Act or otherwise) may not deny a claim for benefits 
submitted by the Service or by an Indian Tribe or Tribal 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01835
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1836 
Organization based on the format in which the claim is 
submitted if such format complies with the format re-
quired for submission of claims under title XVIII of the 
Social Security Act or recognized under section 1175 of 
such Act. 
‘‘(i) APPLICATION
TO URBAN INDIAN ORGANIZA-
TIONS.—The previous provisions of this section shall apply 
to urban Indian organizations with respect to populations 
served by such Organizations in the same manner they 
apply to Indian Tribes and Tribal Organizations with re-
spect to populations served by such Indian Tribes and 
Tribal Organizations. 
‘‘(j) STATUTE OF LIMITATIONS.—The provisions of 
section 2415 of title 28, United States Code, shall apply 
to all actions commenced under this section, and the ref-
erences therein to the United States are deemed to include 
Indian Tribes, Tribal Organizations, and urban Indian or-
ganizations. 
‘‘(k) SAVINGS.—Nothing in this section shall be con-
strued to limit any right of recovery available to the 
United States, an Indian Tribe, or Tribal Organization 
under the provisions of any applicable, Federal, State, or 
Tribal law, including medical lien laws. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01836
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1837 
‘‘SEC. 404. CREDITING OF REIMBURSEMENTS. 
‘‘(a) RETENTION OF AMOUNTS FOR USE BY PRO-
GRAM.—Except as provided in section 202(f) (relating to 
the Catastrophic Health Emergency Fund) and section 
806 (relating to health services for ineligible persons), all 
reimbursements received or recovered, including under 
section 806, by reason of the provision of health services 
by the Service, by an Indian Tribe or Tribal Organization, 
or by an urban Indian organization, shall be credited to 
the Service, such Indian Tribe or Tribal Organization, or 
such urban Indian organization, respectively, and may be 
used as provided in section 401. In the case of such a 
service provided by or through a Service Unit, such 
amounts shall be credited to such unit and used for such 
purposes. 
‘‘(b) NO OFFSET OF AMOUNTS.—The Service may 
not offset or limit any amount obligated to any Service 
Unit or entity receiving funding from the Service because 
of the receipt of reimbursements under subsection (a). 
‘‘SEC. 405. PURCHASING HEALTH CARE COVERAGE. 
‘‘(a) PURCHASING COVERAGE.— 
‘‘(1) IN
GENERAL.—Insofar as amounts are 
made available under law (including a provision of 
the Social Security Act, the Indian Self-Determina-
tion and Education Assistance Act (25 U.S.C. 450 
et seq.), or other law, other than under section 402) 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01837
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1838 
to Indian Tribes, Tribal Organizations, and urban 
Indian organizations for health benefits for Service 
beneficiaries, Indian Tribes, Tribal Organizations, 
and urban Indian organizations may use such 
amounts to purchase health benefits coverage that 
qualifies as creditable coverage under section 
2701(c)(1) of the Public Health Service Act for such 
beneficiaries, including, subject to paragraph (2), 
through— 
‘‘(A) a tribally owned and operated health 
care plan; 
‘‘(B) a State or locally authorized or li-
censed health care plan; 
‘‘(C) a health insurance provider or man-
aged care organization; or 
‘‘(D) a self-insured plan. 
‘‘(2) 
EXCEPTION.—The 
coverage 
provided 
under paragraph (1) may not include coverage con-
sisting of— 
‘‘(A) benefits provided under a health flexi-
ble spending arrangement (as defined in section 
106(c)(2) of the Internal Revenue Code of 
1986); or 
‘‘(B) a high deductible health plan (as de-
fined in section 223(c)(2) of such Code), with-
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01838
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1839 
out regard to whether the plan is purchased in 
conjunction with a health savings account (as 
defined under section 223(d) of such Code). 
‘‘(3) PERMITTING
PURCHASE
OF
COVERAGE 
BASED ON FINANCIAL NEED.—The purchase of cov-
erage by an Indian Tribe, Tribal Organization, or 
urban Indian organization under this subsection may 
be based on the financial needs of beneficiaries (as 
determined by the Indian Tribe or Tribes being 
served based on a schedule of income levels devel-
oped or implemented by such Indian Tribe or 
Tribes). 
‘‘(b) EXPENSES FOR SELF-INSURED PLAN.—In the 
case of a self-insured plan under subsection (a)(4), the 
amounts may be used for expenses of operating the plan, 
including administration and insurance to limit the finan-
cial risks to the entity offering the plan. 
‘‘(c) CONSTRUCTION.—Nothing in this section shall 
be construed as affecting the use of any amounts not re-
ferred to in subsection (a). 
‘‘SEC. 406. SHARING ARRANGEMENTS WITH FEDERAL AGEN-
CIES. 
‘‘(a) AUTHORITY.— 
‘‘(1) IN GENERAL.—The Secretary may enter 
into (or expand) arrangements for the sharing of 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01839
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1842 
‘‘(B) increased enrollment for services of 
the Department of Veterans Affairs by veterans 
who are members of Indian tribes should be en-
couraged to the maximum extent practicable. 
‘‘(2) PURPOSE.—The purpose of this section is 
to reaffirm the goals stated in the document entitled 
‘Memorandum of Understanding Between the VA/ 
Veterans Health Administration And HHS/Indian 
Health Service’ and dated February 25, 2003 (relat-
ing to cooperation and resource sharing between the 
Veterans Health Administration and Service). 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE
INDIAN
VETERAN.—The term 
‘eligible Indian veteran’ means an Indian or Alaska 
Native veteran who receives any medical service that 
is— 
‘‘(A) authorized under the laws adminis-
tered by the Secretary of Veterans Affairs; and 
‘‘(B) administered at a facility of the Serv-
ice (including a facility operated by an Indian 
tribe or tribal organization through a contract 
or compact with the Service under the Indian 
Self-Determination and Education Assistance 
Act (25 U.S.C. 450 et seq.)) pursuant to a local 
memorandum of understanding. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01842
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1843 
‘‘(2) 
LOCAL
MEMORANDUM
OF
UNDER-
STANDING.—The term ‘local memorandum of under-
standing’ means a memorandum of understanding 
between the Secretary (or a designee, including the 
director of any Area Office of the Service) and the 
Secretary of Veterans Affairs (or a designee) to im-
plement the document entitled ‘Memorandum of Un-
derstanding Between the VA/Veterans Health Ad-
ministration And HHS/Indian Health Service’ and 
dated February 25, 2003 (relating to cooperation 
and resource sharing between the Veterans Health 
Administration and Indian Health Service). 
‘‘(c) ELIGIBLE INDIAN VETERANS’ EXPENSES.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of law, the Secretary shall provide for vet-
eran-related expenses incurred by eligible Indian vet-
erans as described in subsection (b)(1)(B). 
‘‘(2) METHOD
OF
PAYMENT.—The Secretary 
shall establish such guidelines as the Secretary de-
termines to be appropriate regarding the method of 
payments to the Secretary of Veterans Affairs under 
paragraph (1). 
‘‘(d) TRIBAL APPROVAL OF MEMORANDA.—In nego-
tiating a local memorandum of understanding with the 
Secretary of Veterans Affairs regarding the provision of 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01843
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1844 
services to eligible Indian veterans, the Secretary shall 
consult with each Indian tribe that would be affected by 
the local memorandum of understanding. 
‘‘(e) FUNDING.— 
‘‘(1) TREATMENT.—Expenses incurred by the 
Secretary in carrying out subsection (c)(1) shall not 
be considered to be Contract Health Service ex-
penses. 
‘‘(2) USE OF FUNDS.—Of funds made available 
to the Secretary in appropriations Acts for the Serv-
ice (excluding funds made available for facilities, 
Contract Health Services, or contract support costs), 
the Secretary shall use such sums as are necessary 
to carry out this section. 
‘‘SEC. 408. PAYOR OF LAST RESORT. 
‘‘Indian Health Programs and health care programs 
operated by Urban Indian Organizations shall be the 
payor of last resort for services provided to persons eligible 
for services from Indian Health Programs and Urban In-
dian Organizations, notwithstanding any Federal, State, 
or local law to the contrary. 
‘‘SEC. 409. CONSULTATION. 
‘‘For provisions related to consultation with rep-
resentatives of Indian Health Programs and urban Indian 
organizations with respect to the health care programs es-
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01844
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1845 
tablished under titles XVIII, XIX, and XXI of the Social 
Security Act, see section 1139(d) of the Social Security 
Act (42 U.S.C. 1320b–9(d)). 
‘‘SEC. 410. STATE CHILDREN’S HEALTH INSURANCE PRO-
GRAM (SCHIP). 
‘‘For provisions relating to— 
‘‘(1) outreach to families of Indian children 
likely to be eligible for child health assistance under 
the State children’s health insurance program estab-
lished under title XXI of the Social Security Act, see 
sections 2105(c)(2)(C) and 1139(a) of such Act (42 
U.S.C. 1397ee(c)(2), 1320b–9); and 
‘‘(2) ensuring that child health assistance is 
provided under such program to targeted low-income 
children who are Indians and that payments are 
made under such program to Indian Health Pro-
grams and urban Indian organizations operating in 
the State that provide such assistance, see sections 
2102(b)(3)(D) and 2105(c)(6)(B) of such Act (42 
U.S.C. 1397bb(b)(3)(D), 1397ee(c)(6)(B)). 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01845
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1846 
‘‘SEC. 411. PREMIUM AND COST SHARING PROTECTIONS 
AND ELIGIBILITY DETERMINATIONS UNDER 
MEDICAID AND SCHIP AND PROTECTION OF 
CERTAIN INDIAN PROPERTY FROM MEDICAID 
ESTATE RECOVERY. 
‘‘For provisions relating to— 
‘‘(1) premiums or cost sharing protections for 
Indians furnished items or services directly by In-
dian Health Programs or through referral under the 
contract health service under the Medicaid program 
established under title XIX of the Social Security 
Act, see sections 1916(j) and 1916A(a)(1) of the So-
cial Security Act (42 U.S.C. 1396o(j), 1396o– 
1(a)(1)); 
‘‘(2) rules regarding the treatment of certain 
property for purposes of determining eligibility 
under such programs, see sections 1902(e)(13) and 
2107(e)(1)(B) of such Act (42 U.S.C. 1396a(e)(13), 
1397gg(e)(1)(B)); and 
‘‘(3) the protection of certain property from es-
tate recovery provisions under the Medicaid pro-
gram, see section 1917(b)(3)(B) of such Act (42 
U.S.C. 1396p(b)(3)(B)). 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01846
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1847 
‘‘SEC. 412. TREATMENT UNDER MEDICAID AND SCHIP MAN-
AGED CARE. 
‘‘For provisions relating to the treatment of Indians 
enrolled in a managed care entity under the Medicaid pro-
gram under title XIX of the Social Security Act and In-
dian Health Programs and urban Indian organizations 
that are providers of items or services to such Indian en-
rollees, see sections 1932(h) and 2107(e)(1)(H) of the So-
cial 
Security 
Act 
(42 
U.S.C. 
1396u–2(h), 
1397gg(e)(1)(H)). 
‘‘SEC. 413. NAVAJO NATION MEDICAID AGENCY FEASI-
BILITY STUDY. 
‘‘(a) STUDY.—The Secretary shall conduct a study 
to determine the feasibility of treating the Navajo Nation 
as a State for the purposes of title XIX of the Social Secu-
rity Act, to provide services to Indians living within the 
boundaries of the Navajo Nation through an entity estab-
lished having the same authority and performing the same 
functions as single-State Medicaid agencies responsible for 
the administration of the State plan under title XIX of 
the Social Security Act. 
‘‘(b) CONSIDERATIONS.—In conducting the study, 
the Secretary shall consider the feasibility of— 
‘‘(1) assigning and paying all expenditures for 
the provision of services and related administration 
funds, under title XIX of the Social Security Act, to 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01847
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1848 
Indians living within the boundaries of the Navajo 
Nation that are currently paid to or would otherwise 
be paid to the State of Arizona, New Mexico, or 
Utah; 
‘‘(2) providing assistance to the Navajo Nation 
in the development and implementation of such enti-
ty for the administration, eligibility, payment, and 
delivery of medical assistance under title XIX of the 
Social Security Act; 
‘‘(3) providing an appropriate level of matching 
funds for Federal medical assistance with respect to 
amounts such entity expends for medical assistance 
for services and related administrative costs; and 
‘‘(4) authorizing the Secretary, at the option of 
the Navajo Nation, to treat the Navajo Nation as a 
State for the purposes of title XIX of the Social Se-
curity Act (relating to the State children’s health in-
surance program) under terms equivalent to those 
described in paragraphs (2) through (4). 
‘‘(c) REPORT.—Not later than 3 years after the date 
of enactment of the Indian Health Care Improvement Act 
Amendments of 2009, the Secretary shall submit to the 
Committee on Indian Affairs and Committee on Finance 
of the Senate and the Committee on Natural Resources 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01848
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1849 
and Committee on Energy and Commerce of the House 
of Representatives a report that includes— 
‘‘(1) the results of the study under this section; 
‘‘(2) a summary of any consultation that oc-
curred between the Secretary and the Navajo Na-
tion, other Indian Tribes, the States of Arizona, 
New Mexico, and Utah, counties which include Nav-
ajo Lands, and other interested parties, in con-
ducting this study; 
‘‘(3) projected costs or savings associated with 
establishment of such entity, and any estimated im-
pact on services provided as described in this section 
in relation to probable costs or savings; and 
‘‘(4) legislative actions that would be required 
to authorize the establishment of such entity if such 
entity is determined by the Secretary to be feasible. 
‘‘SEC. 414. EXCEPTION FOR EXCEPTED BENEFITS. 
‘‘The previous provisions of this title shall not apply 
to the provision of excepted benefits described in para-
graph (1)(A) or (3) of section 2791(c) of the Public 
Health Service Act (42 U.S.C. 300gg–91(c)). 
‘‘SEC. 415. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There are authorized to be appropriated such sums 
as may be necessary to carry out this title. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01849
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1850 
‘‘TITLE V—HEALTH SERVICES 
FOR URBAN INDIANS 
‘‘SEC. 501. PURPOSE. 
‘‘The purpose of this title is to establish and maintain 
programs in Urban Centers to make health services more 
accessible and available to Urban Indians. 
‘‘SEC. 502. CONTRACTS WITH, AND GRANTS TO, URBAN IN-
DIAN ORGANIZATIONS. 
‘‘Under authority of the Act of November 2, 1921 
(25 U.S.C. 13) (commonly known as the ‘Snyder Act’), 
the Secretary, acting through the Service, shall enter into 
contracts with, or make grants to, urban Indian organiza-
tions to assist such organizations in the establishment and 
administration, within Urban Centers, of programs which 
meet the requirements set forth in this title. Subject to 
section 506, the Secretary, acting through the Service, 
shall include such conditions as the Secretary considers 
necessary to effect the purpose of this title in any contract 
into which the Secretary enters with, or in any grant the 
Secretary makes to, any urban Indian organization pursu-
ant to this title. 
‘‘SEC. 503. CONTRACTS AND GRANTS FOR THE PROVISION 
OF HEALTH CARE AND REFERRAL SERVICES. 
‘‘(a) REQUIREMENTS
FOR
GRANTS
AND
CON-
TRACTS.—Under authority of the Act of November 2, 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01850
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1851 
1921 (25 U.S.C. 13) (commonly known as the ‘Snyder 
Act’), the Secretary, acting through the Service, shall 
enter into contracts with, and make grants to, urban In-
dian organizations for the provision of health care and re-
ferral services for Urban Indians. Any such contract or 
grant shall include requirements that the urban Indian or-
ganization successfully undertake to— 
‘‘(1) estimate the population of Urban Indians 
residing in the Urban Center or centers that the or-
ganization proposes to serve who are or could be re-
cipients of health care or referral services; 
‘‘(2) estimate the current health status of 
Urban Indians residing in such Urban Center or 
centers; 
‘‘(3) estimate the current health care needs of 
Urban Indians residing in such Urban Center or 
centers; 
‘‘(4) provide basic health education, including 
health promotion and disease prevention education, 
to Urban Indians; 
‘‘(5) make recommendations to the Secretary 
and Federal, State, local, and other resource agen-
cies on methods of improving health service pro-
grams to meet the needs of Urban Indians; and 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01851
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1852 
‘‘(6) where necessary, provide, or enter into 
contracts for the provision of, health care services 
for Urban Indians. 
‘‘(b) CRITERIA.—The Secretary, acting through the 
Service, shall, by regulation, prescribe the criteria for se-
lecting 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 or centers in-
volved; 
‘‘(2) the size of the urban Indian population in 
the Urban Center or centers involved; 
‘‘(3) the extent, if any, to which the activities 
set forth in subsection (a) would duplicate any 
project funded under this title, or under any current 
public health service project funded in a manner 
other than pursuant to this title; 
‘‘(4) the capability of an urban Indian organiza-
tion to perform the activities set forth in subsection 
(a) and to enter into a contract with the Secretary 
or to meet the requirements for receiving a grant 
under this section; 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01852
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1853 
‘‘(5) the satisfactory performance and success-
ful completion by an urban Indian organization of 
other contracts with the Secretary under this title; 
‘‘(6) the appropriateness and likely effectiveness 
of conducting the activities set forth in subsection 
(a) in an Urban Center or centers; and 
‘‘(7) the extent of existing or likely future par-
ticipation in the activities set forth in subsection (a) 
by appropriate health and health-related Federal, 
State, local, and other agencies. 
‘‘(c) ACCESS TO HEALTH PROMOTION AND DISEASE 
PREVENTION PROGRAMS.—The Secretary, acting through 
the Service, shall facilitate access to or provide health pro-
motion and disease prevention services for Urban Indians 
through grants made to urban Indian organizations ad-
ministering contracts entered into or receiving grants 
under subsection (a). 
‘‘(d) IMMUNIZATION SERVICES.— 
‘‘(1) ACCESS
OR
SERVICES
PROVIDED.—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 or 
receiving grants under this section. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01853
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1854 
‘‘(2) DEFINITION.—For purposes of this sub-
section, the term ‘immunization services’ means 
services to provide without charge immunizations 
against vaccine-preventable diseases. 
‘‘(e) BEHAVIORAL HEALTH SERVICES.— 
‘‘(1) ACCESS
OR
SERVICES
PROVIDED.—The 
Secretary, acting through the Service, shall facilitate 
access to, or provide, behavioral health services for 
Urban Indians through grants made to urban Indian 
organizations administering contracts entered into or 
receiving grants under subsection (a). 
‘‘(2) ASSESSMENT REQUIRED.—Except as pro-
vided by paragraph (3)(A), a grant may not be made 
under this subsection to an urban Indian organiza-
tion until that organization has prepared, and the 
Service has approved, an assessment of the fol-
lowing: 
‘‘(A) The behavioral health needs of the 
urban Indian population concerned. 
‘‘(B) The behavioral health services and 
other related resources available to that popu-
lation. 
‘‘(C) The barriers to obtaining those serv-
ices and resources. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01854
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1855 
‘‘(D) The needs that are unmet by such 
services and resources. 
‘‘(3) PURPOSES OF GRANTS.—Grants may be 
made under this subsection for the following: 
‘‘(A) To prepare assessments required 
under paragraph (2). 
‘‘(B) To provide outreach, educational, and 
referral services to Urban Indians regarding the 
availability of direct behavioral health services, 
to educate Urban Indians about behavioral 
health issues and services, and effect coordina-
tion with existing behavioral health providers in 
order to improve services to Urban Indians. 
‘‘(C) To provide outpatient behavioral 
health services to Urban Indians, including the 
identification and assessment of illness, thera-
peutic treatments, case management, support 
groups, family treatment, and other treatment. 
‘‘(D) To develop innovative behavioral 
health service delivery models which incorporate 
Indian cultural support systems and resources. 
‘‘(f) PREVENTION OF CHILD ABUSE.— 
‘‘(1) ACCESS
OR
SERVICES
PROVIDED.—The 
Secretary, acting through the Service, shall facilitate 
access to or provide services for Urban Indians 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01855
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1856 
through grants to urban Indian organizations ad-
ministering contracts entered into or receiving 
grants under subsection (a) to prevent and treat 
child abuse (including sexual abuse) among Urban 
Indians. 
‘‘(2) EVALUATION REQUIRED.—Except as pro-
vided by paragraph (3)(A), a grant may not be made 
under this subsection to an urban Indian organiza-
tion 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) PURPOSES OF GRANTS.—Grants may be 
made under this subsection for the following: 
‘‘(A) To prepare assessments required 
under paragraph (2). 
‘‘(B) For the development of prevention, 
training, and education programs for Urban In-
dians, including child education, parent edu-
cation, provider training on identification and 
intervention, education on reporting require-
ments, prevention campaigns, and establishing 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01856
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1857 
service networks of all those involved in Indian 
child protection. 
‘‘(C) To provide direct outpatient treat-
ment 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 sur-
vivors of child sexual abuse, to the families of 
such child victims, and to urban Indian per-
petrators of child abuse (including sexual 
abuse). 
‘‘(4) 
CONSIDERATIONS
WHEN
MAKING 
GRANTS.—In making grants to carry out this sub-
section, the Secretary shall take into consideration— 
‘‘(A) the support for the urban Indian or-
ganization 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 dem-
onstrated by the urban Indian organization to 
address the complex problem of child sexual 
abuse in the community; and 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01857
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1858 
‘‘(C) the assessment required under para-
graph (2). 
‘‘(g) 
OTHER
GRANTS.—The 
Secretary, 
acting 
through the Service, may enter into a contract with or 
make grants to an urban Indian organization that pro-
vides or arranges for the provision of health care services 
(through satellite facilities, provider networks, or other-
wise) to Urban Indians in more than 1 Urban Center. 
‘‘SEC. 504. USE OF FEDERAL GOVERNMENT FACILITIES AND 
SOURCES OF SUPPLY. 
‘‘(a) IN GENERAL.—The Secretary may permit an 
urban Indian organization that has entered into a contract 
or received a grant pursuant to this title, in carrying out 
such contract or grant, to use existing facilities and all 
equipment therein or pertaining thereto and other per-
sonal property owned by the Federal Government within 
the Secretary’s jurisdiction under such terms and condi-
tions as may be agreed upon for their use and mainte-
nance. 
‘‘(b) DONATIONS.—Subject to subsection (d), the 
Secretary may donate to an urban Indian organization 
that has entered into a contract or received a grant pursu-
ant to this title any personal or real property determined 
to be excess to the needs of the Indian Health Service or 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01858
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS