198 
‘‘(h) NONAPPLICATION OF CLAIMS FILING REQUIRE-
MENTS.—An insurance company, health maintenance orga-
nization, self-insurance plan, managed care plan, or other 
health care plan or program (under the Social Security Act 
or otherwise) may not deny a claim for benefits submitted 
by the Service or by an Indian Tribe or Tribal Organiza-
tion based on the format in which the claim is submitted 
if such format complies with the format required for sub-
mission 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 Trib-
al Organizations. 
‘‘(j) STATUTE OF LIMITATIONS.—The provisions of sec-
tion 2415 of title 28, United States Code, shall apply to 
all actions commenced under this section, and the references 
therein to the United States are deemed to include Indian 
Tribes, Tribal Organizations, and Urban Indian Organiza-
tions. 
‘‘(k) SAVINGS.—Nothing in this section shall be con-
strued to limit any right of recovery available to the United 
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States, an Indian Tribe, or Tribal Organization under the 
provisions of any applicable, Federal, State, or Tribal law, 
including medical lien laws. 
‘‘SEC. 404. CREDITING OF REIMBURSEMENTS. 
‘‘(a) USE OF AMOUNTS.— 
‘‘(1) RETENTION BY PROGRAM.—Except as pro-
vided in section 202(f) (relating to the Catastrophic 
Health Emergency Fund) and section 807 (relating to 
health services for ineligible persons), all reimburse-
ments received or recovered under any of the pro-
grams described in paragraph (2), including under 
section 807, by reason of the provision of health serv-
ices by the Service, by an Indian Tribe or Tribal Or-
ganization, or by an Urban Indian Organization, 
shall be credited to the Service, such Indian Tribe or 
Tribal Organization, or such Urban Indian Organi-
zation, 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. 
‘‘(2) PROGRAMS
COVERED.—The programs re-
ferred to in paragraph (1) are the following: 
‘‘(A) Titles XVIII, XIX, and XXI of the So-
cial Security Act. 
‘‘(B) This Act, including section 807. 
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‘‘(C) Public Law 87–693. 
‘‘(D) Any other provision of law. 
‘‘(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) IN GENERAL.—Insofar as amounts are made 
available under law (including a provision of the Social 
Security Act, the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 450 et seq.), or other law, other 
than under section 402) to Indian Tribes, Tribal Organiza-
tions, and Urban Indian Organizations for health benefits 
for Service beneficiaries, Indian Tribes, Tribal Organiza-
tions, and Urban Indian Organizations may use such 
amounts to purchase health benefits coverage for such bene-
ficiaries in any manner, including through— 
‘‘(1) a tribally owned and operated health care 
plan; 
‘‘(2) a State or locally authorized or licensed 
health care plan; 
‘‘(3) a health insurance provider or managed 
care organization; or 
‘‘(4) a self-insured plan. 
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The purchase of such coverage by an Indian Tribe, Tribal 
Organization, or Urban Indian Organization may be based 
on the financial needs of such beneficiaries (as determined 
by the Indian Tribe or Tribes being served based on a sched-
ule of income levels developed or implemented by such In-
dian 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 referred 
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 
medical facilities and services between the Service, In-
dian Tribes, and Tribal Organizations and the De-
partment of Veterans Affairs and the Department of 
Defense. 
‘‘(2) 
CONSULTATION
BY
SECRETARY
RE-
QUIRED.—The Secretary may not finalize any ar-
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202 
rangement between the Service and a Department de-
scribed in paragraph (1) without first consulting with 
the Indian Tribes which will be significantly affected 
by the arrangement. 
‘‘(b) LIMITATIONS.—The Secretary shall not take any 
action under this section or under subchapter IV of chapter 
81 of title 38, United States Code, which would impair— 
‘‘(1) the priority access of any Indian to health 
care services provided through the Service and the eli-
gibility of any Indian to receive health services 
through the Service; 
‘‘(2) the quality of health care services provided 
to any Indian through the Service; 
‘‘(3) the priority access of any veteran to health 
care services provided by the Department of Veterans 
Affairs; 
‘‘(4) the quality of health care services provided 
by the Department of Veterans Affairs or the Depart-
ment of Defense; or 
‘‘(5) the eligibility of any Indian who is a vet-
eran to receive health services through the Department 
of Veterans Affairs. 
‘‘(c) REIMBURSEMENT.—The Service, Indian Tribe, or 
Tribal Organization shall be reimbursed by the Department 
of Veterans Affairs or the Department of Defense (as the 
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203 
case may be) where services are provided through the Serv-
ice, an Indian Tribe, or a Tribal Organization to bene-
ficiaries eligible for services from either such Department, 
notwithstanding any other provision of law. 
‘‘(d) CONSTRUCTION.—Nothing in this section may be 
construed as creating any right of a non-Indian veteran 
to obtain health services from the Service. 
‘‘SEC. 407. 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 Indian 
Organizations, notwithstanding any Federal, State, or local 
law to the contrary. 
‘‘SEC. 408. NONDISCRIMINATION UNDER FEDERAL HEALTH 
CARE PROGRAMS IN QUALIFICATIONS FOR 
REIMBURSEMENT FOR SERVICES. 
‘‘(a) REQUIREMENT TO SATISFY GENERALLY APPLI-
CABLE PARTICIPATION REQUIREMENTS.— 
‘‘(1) IN GENERAL.—A Federal health care pro-
gram must accept an entity that is operated by the 
Service, an Indian Tribe, Tribal Organization, or 
Urban Indian Organization as a provider eligible to 
receive payment under the program for health care 
services furnished to an Indian on the same basis as 
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204 
any other provider qualified to participate as a pro-
vider of health care services under the program if the 
entity meets generally applicable State or other re-
quirements for participation as a provider of health 
care services under the program. 
‘‘(2) SATISFACTION OF STATE OR LOCAL LICEN-
SURE
OR
RECOGNITION
REQUIREMENTS.—Any re-
quirement for participation as a provider of health 
care services under a Federal health care program 
that an entity be licensed or recognized under the 
State or local law where the entity is located to fur-
nish health care services shall be deemed to have been 
met in the case of an entity operated by the Service, 
an Indian Tribe, Tribal Organization, or Urban In-
dian Organization if the entity meets all the applica-
ble standards for such licensure or recognition, re-
gardless of whether the entity obtains a license or 
other documentation under such State or local law. In 
accordance with section 221, the absence of the licen-
sure of a health care professional employed by such 
an entity under the State or local law where the enti-
ty is located shall not be taken into account for pur-
poses of determining whether the entity meets such 
standards, if the professional is licensed in another 
State. 
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‘‘(b) APPLICATION OF EXCLUSION FROM PARTICIPA-
TION IN FEDERAL HEALTH CARE PROGRAMS.— 
‘‘(1) EXCLUDED ENTITIES.—No entity operated 
by the Service, an Indian Tribe, Tribal Organization, 
or Urban Indian Organization that has been excluded 
from participation in any Federal health care pro-
gram or for which a license is under suspension or 
has been revoked by the State where the entity is lo-
cated shall be eligible to receive payment or reim-
bursement under any such program for health care 
services furnished to an Indian. 
‘‘(2) EXCLUDED
INDIVIDUALS.—No individual 
who has been excluded from participation in any 
Federal health care program or whose State license is 
under suspension shall be eligible to receive payment 
or reimbursement under any such program for health 
care services furnished by that individual, directly or 
through an entity that is otherwise eligible to receive 
payment for health care services, to an Indian. 
‘‘(3) FEDERAL
HEALTH
CARE
PROGRAM
DE-
FINED.—In this subsection, the term, ‘Federal health 
care program’ has the meaning given that term in 
section 1128B(f) of the Social Security Act (42 U.S.C. 
1320a–7b(f)), except that, for purposes of this sub-
section, such term shall include the health insurance 
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program under chapter 89 of title 5, United States 
Code. 
‘‘(c) RELATED PROVISIONS.—For provisions related to 
nondiscrimination against providers operated by the Serv-
ice, an Indian Tribe, Tribal Organization, or Urban In-
dian Organization, see section 1139(c) of the Social Secu-
rity Act (42 U.S.C. 1320b–9(c)). 
‘‘SEC. 409. CONSULTATION. 
‘‘For provisions related to consultation with represent-
atives of Indian Health Programs and Urban Indian Orga-
nizations with respect to the health care programs estab-
lished under titles XVIII, XIX, and XXI of the Social Secu-
rity 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 like-
ly to be eligible for child health assistance under the 
State children’s health insurance program established 
under title XXI of the Social Security Act, see sec-
tions 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 pro-
vided under such program to targeted low-income 
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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)). 
‘‘SEC. 411. EXCLUSION WAIVER AUTHORITY FOR AFFECTED 
INDIAN HEALTH PROGRAMS AND SAFE HAR-
BOR TRANSACTIONS UNDER THE SOCIAL SE-
CURITY ACT. 
‘‘For provisions relating to— 
‘‘(1) exclusion waiver authority for affected In-
dian Health Programs under the Social Security Act, 
see section 1128(k) of the Social Security Act (42 
U.S.C. 1320a–7(k)); and 
‘‘(2) certain transactions involving Indian 
Health Programs deemed to be in safe harbors under 
that Act, see section 1128B(b)(4) of the Social Secu-
rity Act (42 U.S.C. 1320a–7b(b)(4)). 
‘‘SEC. 412. 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— 
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‘‘(1) premiums or cost sharing protections for 
Indians furnished items or services directly by Indian 
Health Programs or through referral under the con-
tract health service under the Medicaid program es-
tablished under title XIX of the Social Security Act, 
see sections 1916(j) and 1916A(a)(1) of the Social Se-
curity 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 program, 
see section 1917(b)(3)(B) of such Act (42 U.S.C. 
1396p(b)(3)(B)). 
‘‘SEC. 413. 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 Indian 
Health Programs and Urban Indian Organizations that 
are providers of items or services to such Indian enrollees, 
see sections 1932(h) and 2107(e)(1)(H) of the Social Secu-
rity Act (42 U.S.C. 1396u–2(h), 1397gg(e)(1)(H)). 
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‘‘SEC. 414. NAVAJO NATION MEDICAID AGENCY FEASIBILITY 
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 Security 
Act, to provide services to Indians living within the bound-
aries of the Navajo Nation through an entity established 
having the same authority and performing the same func-
tions as single-State medicaid agencies responsible for the 
administration of the State plan under title XIX of the So-
cial 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 
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 entity 
for the administration, eligibility, payment, and de-
livery of medical assistance under title XIX of the So-
cial Security Act; 
‘‘(3) providing an appropriate level of matching 
funds for Federal medical assistance with respect to 
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210 
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 Secu-
rity Act (relating to the State children’s health insur-
ance program) under terms equivalent to those de-
scribed in paragraphs (2) through (4). 
‘‘(c) REPORT.—Not later then 3 years after the date 
of enactment of the Indian Health Care Improvement Act 
Amendments of 2007, the Secretary shall submit to the 
Committee on Indian Affairs and Committee on Finance 
of the Senate and the Committee on Natural Resources and 
Committee on Energy and Commerce of the House of Rep-
resentatives 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 Nation, 
other Indian Tribes, the States of Arizona, New Mex-
ico, and Utah, counties which include Navajo Lands, 
and other interested parties, in conducting this study; 
‘‘(3) projected costs or savings associated with es-
tablishment of such entity, and any estimated impact 
on services provided as described in this section in re-
lation to probable costs or savings; and 
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211 
‘‘(4) legislative actions that would be required to 
authorize the establishment of such entity if such enti-
ty is determined by the Secretary to be feasible. 
‘‘SEC. 415. GENERAL EXCEPTIONS. 
‘‘The requirements of this title shall not apply to any 
excepted benefits described in paragraph (1)(A) or (3) of 
section 2791(c) of the Public Health Service Act (42 U.S.C. 
300gg–91). 
‘‘SEC. 416. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There are authorized to be appropriated such sums 
as may be necessary for each fiscal year through fiscal year 
2017 to carry out this title. 
‘‘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 Sec-
retary, acting through the Service, shall enter into contracts 
with, or make grants to, Urban Indian Organizations to 
assist such organizations in the establishment and adminis-
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tration, 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 Sec-
retary enters with, or in any grant the Secretary makes 
to, any Urban Indian Organization pursuant to this title. 
‘‘SEC. 503. CONTRACTS AND GRANTS FOR THE PROVISION 
OF HEALTH CARE AND REFERRAL SERVICES. 
‘‘(a) REQUIREMENTS FOR GRANTS AND CONTRACTS.— 
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, 
and make grants to, Urban Indian Organizations for the 
provision of health care and referral services for Urban In-
dians. Any such contract or grant shall include require-
ments that the Urban Indian Organization successfully un-
dertake to— 
‘‘(1) estimate the population of Urban Indians 
residing in the Urban Center or centers that the orga-
nization proposes to serve who are or could be recipi-
ents of health care or referral services; 
‘‘(2) estimate the current health status of Urban 
Indians residing in such Urban Center or centers; 
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‘‘(3) estimate the current health care needs of 
Urban Indians residing in such Urban Center or cen-
ters; 
‘‘(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 agencies on 
methods of improving health service programs to meet 
the needs of Urban Indians; and 
‘‘(6) where necessary, provide, or enter into con-
tracts 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 select-
ing 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 
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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 Organi-
zation 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; 
‘‘(5) the satisfactory performance and successful 
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). 
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‘‘(d) IMMUNIZATION SERVICES.— 
‘‘(1) ACCESS OR SERVICES PROVIDED.—The Sec-
retary, acting through the Service, shall facilitate ac-
cess to, or provide, immunization services for Urban 
Indians through grants made to Urban Indian Orga-
nizations administering contracts entered into or re-
ceiving grants under this section. 
‘‘(2) DEFINITION.—For purposes of this sub-
section, the term ‘immunization services’ means serv-
ices to provide without charge immunizations against 
vaccine-preventable diseases. 
‘‘(e) BEHAVIORAL HEALTH SERVICES.— 
‘‘(1) ACCESS OR SERVICES PROVIDED.—The Sec-
retary, acting through the Service, shall facilitate ac-
cess 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 following: 
‘‘(A) The behavioral health needs of the 
Urban Indian population concerned. 
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‘‘(B) The behavioral health services and 
other related resources available to that popu-
lation. 
‘‘(C) The barriers to obtaining those services 
and resources. 
‘‘(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. 
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‘‘(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 Sec-
retary, acting through the Service, shall facilitate ac-
cess to or provide services for Urban Indians through 
grants to Urban Indian Organizations administering 
contracts entered into or receiving grants under sub-
section (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). 
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‘‘(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 
service networks of all those involved in Indian 
child protection. 
‘‘(C) To provide direct outpatient treatment 
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 survivors of 
child sexual abuse, to the families of such child 
victims, and to Urban Indian perpetrators of 
child abuse (including sexual abuse). 
‘‘(4) CONSIDERATIONS WHEN MAKING GRANTS.— 
In making grants to carry out this subsection, 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; 
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‘‘(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 
‘‘(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 provides or arranges 
for the provision of health care services (through satellite 
facilities, provider networks, or otherwise) to Urban Indi-
ans in more than 1 Urban Center. 
‘‘SEC. 504. CONTRACTS AND GRANTS FOR THE DETERMINA-
TION OF UNMET HEALTH CARE NEEDS. 
‘‘(a) GRANTS AND CONTRACTS AUTHORIZED.—Under 
authority of the Act of November 2, 1921 (25 U.S.C. 13) 
(commonly known as the ‘Snyder Act’), the Secretary, act-
ing through the Service, may enter into contracts with or 
make grants to Urban Indian Organizations situated in 
Urban Centers for which contracts have not been entered 
into or grants have not been made under section 503. 
‘‘(b) PURPOSE.—The purpose of a contract or grant 
made under this section shall be the determination of the 
matters described in subsection (c)(1) in order to assist the 
Secretary in assessing the health status and health care 
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220 
needs of Urban Indians in the Urban Center involved and 
determining whether the Secretary should enter into a con-
tract or make a grant under section 503 with respect to 
the Urban Indian Organization which the Secretary has en-
tered into a contract with, or made a grant to, under this 
section. 
‘‘(c) GRANT
AND CONTRACT REQUIREMENTS.—Any 
contract entered into, or grant made, by the Secretary 
under this section shall include requirements that— 
‘‘(1) the Urban Indian Organization successfully 
undertakes to— 
‘‘(A) document the health care status and 
unmet health care needs of Urban Indians in the 
Urban Center involved; and 
‘‘(B) with respect to Urban Indians in the 
Urban Center involved, determine the matters 
described in paragraphs (2), (3), (4), and (7) of 
section 503(b); and 
‘‘(2) the Urban Indian Organization complete 
performance of the contract, or carry out the require-
ments of the grant, within 1 year after the date on 
which the Secretary and such organization enter into 
such contract, or within 1 year after such organiza-
tion receives such grant, whichever is applicable. 
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‘‘(d) NO RENEWALS.—The Secretary may not renew 
any contract entered into or grant made under this section. 
‘‘SEC. 505. EVALUATIONS; RENEWALS. 
‘‘(a) PROCEDURES
FOR
EVALUATIONS.—The Sec-
retary, acting through the Service, shall develop procedures 
to evaluate compliance with grant requirements and com-
pliance with and performance of contracts entered into by 
Urban Indian Organizations under this title. Such proce-
dures shall include provisions for carrying out the require-
ments of this section. 
‘‘(b) EVALUATIONS.—The Secretary, acting through 
the Service, shall evaluate the compliance of each Urban 
Indian Organization which has entered into a contract or 
received a grant under section 503 with the terms of such 
contract or grant. For purposes of this evaluation, the Sec-
retary shall— 
‘‘(1) acting through the Service, conduct an an-
nual onsite evaluation of the organization; or 
‘‘(2) accept in lieu of such onsite evaluation evi-
dence of the organization’s provisional or full accredi-
tation by a private independent entity recognized by 
the Secretary for purposes of conducting quality re-
views of providers participating in the Medicare pro-
gram under title XVIII of the Social Security Act. 
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222 
‘‘(c) NONCOMPLIANCE; UNSATISFACTORY PERFORM-
ANCE.—If, as a result of the evaluations conducted under 
this section, the Secretary determines that an Urban Indian 
Organization has not complied with the requirements of a 
grant or complied with or satisfactorily performed a con-
tract under section 503, the Secretary shall, prior to renew-
ing such contract or grant, attempt to resolve with the orga-
nization the areas of noncompliance or unsatisfactory per-
formance and modify the contract or grant to prevent future 
occurrences of noncompliance or unsatisfactory perform-
ance. If the Secretary determines that the noncompliance 
or unsatisfactory performance cannot be resolved and pre-
vented in the future, the Secretary shall not renew the con-
tract or grant with the organization and is authorized to 
enter into a contract or make a grant under section 503 
with another Urban Indian Organization which is situated 
in the same Urban Center as the Urban Indian Organiza-
tion whose contract or grant is not renewed under this sec-
tion. 
‘‘(d) CONSIDERATIONS
FOR RENEWALS.—In deter-
mining whether to renew a contract or grant with an Urban 
Indian Organization under section 503 which has com-
pleted performance of a contract or grant under section 504, 
the Secretary shall review the records of the Urban Indian 
Organization, the reports submitted under section 507, and 
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shall consider the results of the onsite evaluations or accred-
itations under subsection (b). 
‘‘SEC. 506. OTHER CONTRACT AND GRANT REQUIREMENTS. 
‘‘(a) PROCUREMENT.—Contracts with Urban Indian 
Organizations entered into pursuant to this title shall be 
in accordance with all Federal contracting laws and regula-
tions relating to procurement except that in the discretion 
of the Secretary, such contracts may be negotiated without 
advertising and need not conform to the provisions of sec-
tions 1304 and 3131 through 3133 of title 40, United States 
Code. 
‘‘(b) PAYMENTS UNDER CONTRACTS OR GRANTS.— 
‘‘(1) IN GENERAL.—Payments under any con-
tracts or grants pursuant to this title, notwith-
standing any term or condition of such contract or 
grant— 
‘‘(A) may be made in a single advance pay-
ment by the Secretary to the Urban Indian Or-
ganization by no later than the end of the first 
30 days of the funding period with respect to 
which the payments apply, unless the Secretary 
determines through an evaluation under section 
505 that the organization is not capable of ad-
ministering such a single advance payment; and 
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‘‘(B) if any portion thereof is unexpended 
by the Urban Indian Organization during the 
funding period with respect to which the pay-
ments initially apply, shall be carried forward 
for expenditure with respect to allowable or re-
imbursable costs incurred by the organization 
during 1 or more subsequent funding periods 
without additional justification or documenta-
tion by the organization as a condition of car-
rying forward the availability for expenditure of 
such funds. 
‘‘(2) SEMIANNUAL
AND
QUARTERLY
PAYMENTS 
AND REIMBURSEMENTS.—If the Secretary determines 
under paragraph (1)(A) that an Urban Indian Orga-
nization is not capable of administering an entire 
single advance payment, on request of the Urban In-
dian Organization, the payments may be made— 
‘‘(A) in semiannual or quarterly payments 
by not later than 30 days after the date on which 
the funding period with respect to which the 
payments apply begins; or 
‘‘(B) by way of reimbursement. 
‘‘(c) REVISION OR AMENDMENT OF CONTRACTS.—Not-
withstanding any provision of law to the contrary, the Sec-
retary may, at the request and consent of an Urban Indian 
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225 
Organization, revise or amend any contract entered into 
by the Secretary with such organization under this title as 
necessary to carry out the purposes of this title. 
‘‘(d) FAIR
AND UNIFORM SERVICES
AND ASSIST-
ANCE.—Contracts with or grants to Urban Indian Organi-
zations and regulations adopted pursuant to this title shall 
include provisions to assure the fair and uniform provision 
to Urban Indians of services and assistance under such con-
tracts or grants by such organizations. 
‘‘SEC. 507. REPORTS AND RECORDS. 
‘‘(a) REPORTS.— 
‘‘(1) IN GENERAL.—For each fiscal year during 
which an Urban Indian Organization receives or ex-
pends funds pursuant to a contract entered into or a 
grant received pursuant to this title, such Urban In-
dian Organization shall submit to the Secretary not 
more frequently than every 6 months, a report that 
includes the following: 
‘‘(A) In the case of a contract or grant 
under section 503, recommendations pursuant to 
section 503(a)(5). 
‘‘(B) Information on activities conducted by 
the organization pursuant to the contract or 
grant. 
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‘‘(C) An accounting of the amounts and 
purpose for which Federal funds were expended. 
‘‘(D) A minimum set of data, using uni-
formly defined elements, as specified by the Sec-
retary after consultation with Urban Indian Or-
ganizations. 
‘‘(2) HEALTH STATUS AND SERVICES.— 
‘‘(A) IN
GENERAL.—Not later than 18 
months after the date of enactment of the Indian 
Health Care Improvement Act Amendments of 
2007, the Secretary, acting through the Service, 
shall submit to Congress a report evaluating— 
‘‘(i) the health status of Urban Indi-
ans; 
‘‘(ii) the services provided to Indians 
pursuant to this title; and 
‘‘(iii) areas of unmet needs in the de-
livery of health services to Urban Indians. 
‘‘(B) CONSULTATION AND CONTRACTS.—In 
preparing the report under paragraph (1), the 
Secretary— 
‘‘(i) shall consult with Urban Indian 
Organizations; and 
‘‘(ii) may enter into a contract with a 
national organization representing Urban 
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227 
Indian Organizations to conduct any aspect 
of the report. 
‘‘(b) AUDIT.—The reports and records of the Urban In-
dian Organization with respect to a contract or grant under 
this title shall be subject to audit by the Secretary and the 
Comptroller General of the United States. 
‘‘(c) COSTS OF AUDITS.—The Secretary shall allow as 
a cost of any contract or grant entered into or awarded 
under section 502 or 503 the cost of an annual independent 
financial audit conducted by— 
‘‘(1) a certified public accountant; or 
‘‘(2) a certified public accounting firm qualified 
to conduct Federal compliance audits. 
‘‘SEC. 508. LIMITATION ON CONTRACT AUTHORITY. 
‘‘The authority of the Secretary to enter into contracts 
or to award grants under this title shall be to the extent, 
and in an amount, provided for in appropriation Acts. 
‘‘SEC. 509. FACILITIES. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Service, may make grants to contractors or grant recipients 
under this title for the lease, purchase, renovation, construc-
tion, or expansion of facilities, including leased facilities, 
in order to assist such contractors or grant recipients in 
complying with applicable licensure or certification re-
quirements. 
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‘‘(b) LOAN FUND STUDY.—The Secretary, acting 
through the Service, may carry out a study to determine 
the feasibility of establishing a loan fund to provide to 
Urban Indian Organizations direct loans or guarantees for 
loans for the construction of health care facilities in a man-
ner consistent with section 309, including by submitting a 
report in accordance with subsection (c) of that section. 
‘‘SEC. 510. DIVISION OF URBAN INDIAN HEALTH. 
‘‘There is established within the Service a Division of 
Urban Indian Health, which shall be responsible for— 
‘‘(1) carrying out the provisions of this title; 
‘‘(2) providing central oversight of the programs 
and services authorized under this title; and 
‘‘(3) providing technical assistance to Urban In-
dian Organizations. 
‘‘SEC. 511. GRANTS FOR ALCOHOL AND SUBSTANCE ABUSE- 
RELATED SERVICES. 
‘‘(a) GRANTS AUTHORIZED.—The Secretary, acting 
through the Service, may make grants for the provision of 
health-related services in prevention of, treatment of, reha-
bilitation of, or school- and community-based education re-
garding, alcohol and substance abuse in Urban Centers to 
those Urban Indian Organizations with which the Sec-
retary has entered into a contract under this title or under 
section 201. 
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229 
‘‘(b) GOALS.—Each grant made pursuant to subsection 
(a) shall set forth the goals to be accomplished pursuant 
to the grant. The goals shall be specific to each grant as 
agreed to between the Secretary and the grantee. 
‘‘(c) CRITERIA.—The Secretary shall establish criteria 
for the grants made under subsection (a), including criteria 
relating to the following: 
‘‘(1) The size of the Urban Indian population. 
‘‘(2) Capability of the organization to adequately 
perform the activities required under the grant. 
‘‘(3) Satisfactory performance standards for the 
organization in meeting the goals set forth in such 
grant. The standards shall be negotiated and agreed 
to between the Secretary and the grantee on a grant- 
by-grant basis. 
‘‘(4) Identification of the need for services. 
‘‘(d) ALLOCATION OF GRANTS.—The Secretary shall 
develop a methodology for allocating grants made pursuant 
to this section based on the criteria established pursuant 
to subsection (c). 
‘‘(e) GRANTS SUBJECT TO CRITERIA.—Any grant re-
ceived by an Urban Indian Organization under this Act 
for substance abuse prevention, treatment, and rehabilita-
tion shall be subject to the criteria set forth in subsection 
(c). 
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‘‘SEC. 512. TREATMENT OF CERTAIN DEMONSTRATION 
PROJECTS. 
‘‘Notwithstanding any other provision of law, the 
Tulsa Clinic and Oklahoma City Clinic demonstration 
projects shall— 
‘‘(1) be permanent programs within the Service’s 
direct care program; 
‘‘(2) continue to be treated as Service Units and 
Operating Units in the allocation of resources and co-
ordination of care; and 
‘‘(3) continue to meet the requirements and defi-
nitions of an Urban Indian Organization in this Act, 
and shall not be subject to the provisions of the In-
dian Self-Determination and Education Assistance 
Act (25 U.S.C. 450 et seq.). 
‘‘SEC. 513. URBAN NIAAA TRANSFERRED PROGRAMS. 
‘‘(a) GRANTS
AND
CONTRACTS.—The Secretary, 
through the Division of Urban Indian Health, shall make 
grants or enter into contracts with Urban Indian Organiza-
tions, to take effect not later than September 30, 2010, for 
the administration of Urban Indian alcohol programs that 
were originally established under the National Institute on 
Alcoholism and Alcohol Abuse (hereafter in this section re-
ferred to as ‘NIAAA’) and transferred to the Service. 
‘‘(b) USE OF FUNDS.—Grants provided or contracts 
entered into under this section shall be used to provide sup-
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231 
port for the continuation of alcohol prevention and treat-
ment services for Urban Indian populations and such other 
objectives as are agreed upon between the Service and a re-
cipient of a grant or contract under this section. 
‘‘(c) ELIGIBILITY.—Urban Indian Organizations that 
operate Indian alcohol programs originally funded under 
the NIAAA and subsequently transferred to the Service are 
eligible for grants or contracts under this section. 
‘‘(d) REPORT.—The Secretary shall evaluate and re-
port to Congress on the activities of programs funded under 
this section not less than every 5 years. 
‘‘SEC. 514. CONSULTATION WITH URBAN INDIAN ORGANIZA-
TIONS. 
‘‘(a) IN GENERAL.—The Secretary shall ensure that 
the Service consults, to the greatest extent practicable, with 
Urban Indian Organizations. 
‘‘(b) DEFINITION OF CONSULTATION.—For purposes of 
subsection (a), consultation is the open and free exchange 
of information and opinions which leads to mutual under-
standing and comprehension and which emphasizes trust, 
respect, and shared responsibility. 
‘‘SEC. 515. URBAN YOUTH TREATMENT CENTER DEM-
ONSTRATION. 
‘‘(a) CONSTRUCTION AND OPERATION.—The Secretary, 
acting through the Service, through grant or contract, is 
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authorized to fund the construction and operation of at least 
2 residential treatment centers in each State described in 
subsection (b) to demonstrate the provision of alcohol and 
substance abuse treatment services to Urban Indian youth 
in a culturally competent residential setting. 
‘‘(b) DEFINITION OF STATE.—A State described in this 
subsection is a State in which— 
‘‘(1) there resides Urban Indian youth with need 
for alcohol and substance abuse treatment services in 
a residential setting; and 
‘‘(2) there is a significant shortage of culturally 
competent residential treatment services for Urban 
Indian youth. 
‘‘SEC. 516. GRANTS FOR DIABETES PREVENTION, TREAT-
MENT, AND CONTROL. 
‘‘(a) GRANTS
AUTHORIZED.—The Secretary may 
make grants to those Urban Indian Organizations that have 
entered into a contract or have received a grant under this 
title for the provision of services for the prevention and 
treatment of, and control of the complications resulting 
from, diabetes among Urban Indians. 
‘‘(b) GOALS.—Each grant made pursuant to subsection 
(a) shall set forth the goals to be accomplished under the 
grant. The goals shall be specific to each grant as agreed 
to between the Secretary and the grantee. 
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‘‘(c) ESTABLISHMENT OF CRITERIA.—The Secretary 
shall establish criteria for the grants made under subsection 
(a) relating to— 
‘‘(1) the size and location of the Urban Indian 
population to be served; 
‘‘(2) the need for prevention of and treatment of, 
and control of the complications resulting from, dia-
betes among the Urban Indian population to be 
served; 
‘‘(3) performance standards for the organization 
in meeting the goals set forth in such grant that are 
negotiated and agreed to by the Secretary and the 
grantee; 
‘‘(4) the capability of the organization to ade-
quately perform the activities required under the 
grant; and 
‘‘(5) the willingness of the organization to col-
laborate with the registry, if any, established by the 
Secretary under section 204(e) in the Area Office of 
the Service in which the organization is located. 
‘‘(d) FUNDS SUBJECT TO CRITERIA.—Any funds re-
ceived by an Urban Indian Organization under this Act 
for the prevention, treatment, and control of diabetes among 
Urban Indians shall be subject to the criteria developed by 
the Secretary under subsection (c). 
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‘‘SEC. 517. COMMUNITY HEALTH REPRESENTATIVES. 
‘‘The Secretary, acting through the Service, may enter 
into contracts with, and make grants to, Urban Indian Or-
ganizations for the employment of Indians trained as health 
service providers through the Community Health Represent-
atives Program under section 109 in the provision of health 
care, health promotion, and disease prevention services to 
Urban Indians. 
‘‘SEC. 518. EFFECTIVE DATE. 
‘‘The amendments made by the Indian Health Care 
Improvement Act Amendments of 2007 to this title shall 
take effect beginning on the date of enactment of that Act, 
regardless of whether the Secretary has promulgated regula-
tions implementing such amendments. 
‘‘SEC. 519. ELIGIBILITY FOR SERVICES. 
‘‘Urban Indians shall be eligible for, and the ultimate 
beneficiaries of, health care or referral services provided 
pursuant to this title. 
‘‘SEC. 520. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There are authorized to be appropriated such sums 
as may be necessary for each fiscal year through fiscal year 
2017 to carry out this title. 
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235 
‘‘TITLE VI—ORGANIZATIONAL 
IMPROVEMENTS 
‘‘SEC. 601. ESTABLISHMENT OF THE INDIAN HEALTH SERV-
ICE AS AN AGENCY OF THE PUBLIC HEALTH 
SERVICE. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN GENERAL.—In order to more effectively 
and efficiently carry out the responsibilities, authori-
ties, and functions of the United States to provide 
health care services to Indians and Indian Tribes, as 
are or may be hereafter provided by Federal statute 
or treaties, there is established within the Public 
Health Service of the Department the Indian Health 
Service. 
‘‘(2) 
ASSISTANT
SECRETARY
OF
INDIAN 
HEALTH.—The Service shall be administered by an 
Assistant Secretary of Indian Health, who shall be 
appointed by the President, by and with the advice 
and consent of the Senate. The Assistant Secretary 
shall report to the Secretary. Effective with respect to 
an individual appointed by the President, by and 
with the advice and consent of the Senate, after Janu-
ary 1, 2007, the term of service of the Assistant Sec-
retary shall be 4 years. An Assistant Secretary may 
serve more than 1 term. 
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‘‘(3) INCUMBENT.—The individual serving in the 
position of Director of the Service on the day before 
the date of enactment of the Indian Health Care Im-
provement Act Amendments of 2007 shall serve as As-
sistant Secretary. 
‘‘(4) ADVOCACY AND CONSULTATION.—The posi-
tion of Assistant Secretary is established to, in a 
manner consistent with the government-to-government 
relationship between the United States and Indian 
Tribes— 
‘‘(A) facilitate advocacy for the development 
of appropriate Indian health policy; and 
‘‘(B) promote consultation on matters relat-
ing to Indian health. 
‘‘(b) AGENCY.—The Service shall be an agency within 
the Public Health Service of the Department, and shall not 
be an office, component, or unit of any other agency of the 
Department. 
‘‘(c) DUTIES.—The Assistant Secretary shall— 
‘‘(1) perform all functions that were, on the day 
before the date of enactment of the Indian Health 
Care Improvement Act Amendments of 2007, carried 
out by or under the direction of the individual serv-
ing as Director of the Service on that day; 
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‘‘(2) perform all functions of the Secretary relat-
ing to the maintenance and operation of hospital and 
health facilities for Indians and the planning for, and 
provision and utilization of, health services for Indi-
ans; 
‘‘(3) administer all health programs under which 
health care is provided to Indians based upon their 
status as Indians which are administered by the Sec-
retary, including programs under— 
‘‘(A) this Act; 
‘‘(B) the Act of November 2, 1921 (25 
U.S.C. 13); 
‘‘(C) the Act of August 5, 1954 (42 U.S.C. 
2001 et seq.); 
‘‘(D) the Act of August 16, 1957 (42 U.S.C. 
2005 et seq.); and 
‘‘(E) the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 450 et 
seq.); 
‘‘(4) administer all scholarship and loan func-
tions carried out under title I; 
‘‘(5) report directly to the Secretary concerning 
all policy- and budget-related matters affecting In-
dian health; 
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‘‘(6) collaborate with the Assistant Secretary for 
Health concerning appropriate matters of Indian 
health that affect the agencies of the Public Health 
Service; 
‘‘(7) advise each Assistant Secretary of the De-
partment concerning matters of Indian health with 
respect to which that Assistant Secretary has author-
ity and responsibility; 
‘‘(8) advise the heads of other agencies and pro-
grams of the Department concerning matters of In-
dian health with respect to which those heads have 
authority and responsibility; 
‘‘(9) coordinate the activities of the Department 
concerning matters of Indian health; and 
‘‘(10) perform such other functions as the Sec-
retary may designate. 
‘‘(d) AUTHORITY.— 
‘‘(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Assistant Secretary, shall have the au-
thority— 
‘‘(A) except to the extent provided for in 
paragraph (2), to appoint and compensate em-
ployees for the Service in accordance with title 
5, United States Code; 
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‘‘(B) to enter into contracts for the procure-
ment of goods and services to carry out the func-
tions of the Service; and 
‘‘(C) to manage, expend, and obligate all 
funds appropriated for the Service. 
‘‘(2) 
PERSONNEL
ACTIONS.—Notwithstanding 
any other provision of law, the provisions of section 
12 of the Act of June 18, 1934 (48 Stat. 986; 25 
U.S.C. 472), shall apply to all personnel actions 
taken with respect to new positions created within the 
Service as a result of its establishment under sub-
section (a). 
‘‘(e) REFERENCES.—Any reference to the Director of 
the Indian Health Service in any other Federal law, Execu-
tive order, rule, regulation, or delegation of authority, or 
in any document of or relating to the Director of the Indian 
Health Service, shall be deemed to refer to the Assistant Sec-
retary. 
‘‘SEC. 602. AUTOMATED MANAGEMENT INFORMATION SYS-
TEM. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN GENERAL.—The Secretary shall establish 
an automated management information system for 
the Service. 
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‘‘(2) REQUIREMENTS OF SYSTEM.—The informa-
tion system established under paragraph (1) shall in-
clude— 
‘‘(A) a financial management system; 
‘‘(B) a patient care information system for 
each area served by the Service; 
‘‘(C) a privacy component that protects the 
privacy of patient information held by, or on be-
half of, the Service; 
‘‘(D) a services-based cost accounting com-
ponent that provides estimates of the costs associ-
ated with the provision of specific medical treat-
ments or services in each Area office of the Serv-
ice; 
‘‘(E) an interface mechanism for patient 
billing and accounts receivable system; and 
‘‘(F) a training component. 
‘‘(b) PROVISION OF SYSTEMS TO TRIBES AND ORGANI-
ZATIONS.—The Secretary shall provide each Tribal Health 
Program automated management information systems 
which— 
‘‘(1) meet the management information needs of 
such Tribal Health Program with respect to the treat-
ment by the Tribal Health Program of patients of the 
Service; and 
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‘‘(2) meet the management information needs of 
the Service. 
‘‘(c) ACCESS
TO RECORDS.—Notwithstanding any 
other provision of law, each patient shall have reasonable 
access to the medical or health records of such patient which 
are held by, or on behalf of, the Service. 
‘‘(d) AUTHORITY TO ENHANCE INFORMATION TECH-
NOLOGY.—The Secretary, acting through the Assistant Sec-
retary, shall have the authority to enter into contracts, 
agreements, or joint ventures with other Federal agencies, 
States, private and nonprofit organizations, for the purpose 
of enhancing information technology in Indian Health Pro-
grams and facilities. 
‘‘SEC. 603. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There is authorized to be appropriated such sums as 
may be necessary for each fiscal year through fiscal year 
2017 to carry out this title. 
‘‘TITLE VII—BEHAVIORAL 
HEALTH PROGRAMS 
‘‘SEC. 701. BEHAVIORAL HEALTH PREVENTION AND TREAT-
MENT SERVICES. 
‘‘(a) PURPOSES.—The purposes of this section are as 
follows: 
‘‘(1) To authorize and direct the Secretary, act-
ing through the Service, Indian Tribes, Tribal Orga-
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nizations, and Urban Indian Organizations, to de-
velop a comprehensive behavioral health prevention 
and treatment program which emphasizes collabora-
tion among alcohol and substance abuse, social serv-
ices, and mental health programs. 
‘‘(2) To provide information, direction, and 
guidance relating to mental illness and dysfunction 
and self-destructive behavior, including child abuse 
and family violence, to those Federal, tribal, State, 
and local agencies responsible for programs in Indian 
communities in areas of health care, education, social 
services, child and family welfare, alcohol and sub-
stance abuse, law enforcement, and judicial services. 
‘‘(3) To assist Indian Tribes to identify services 
and resources available to address mental illness and 
dysfunctional and self-destructive behavior. 
‘‘(4) To provide authority and opportunities for 
Indian Tribes and Tribal Organizations to develop, 
implement, and coordinate with community-based 
programs which include identification, prevention, 
education, referral, and treatment services, including 
through multidisciplinary resource teams. 
‘‘(5) To ensure that Indians, as citizens of the 
United States and of the States in which they reside, 
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have the same access to behavioral health services to 
which all citizens have access. 
‘‘(6) To modify or supplement existing programs 
and authorities in the areas identified in paragraph 
(2). 
‘‘(b) PLANS.— 
‘‘(1) DEVELOPMENT.—The Secretary, acting 
through the Service, Indian Tribes, Tribal Organiza-
tions, and Urban Indian Organizations, shall encour-
age Indian Tribes and Tribal Organizations to de-
velop tribal plans, and Urban Indian Organizations 
to develop local plans, and for all such groups to par-
ticipate in developing areawide plans for Indian Be-
havioral Health Services. The plans shall include, to 
the extent feasible, the following components: 
‘‘(A) An assessment of the scope of alcohol 
or other substance abuse, mental illness, and dys-
functional and self-destructive behavior, includ-
ing suicide, child abuse, and family violence, 
among Indians, including— 
‘‘(i) the number of Indians served who 
are directly or indirectly affected by such 
illness or behavior; or 
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‘‘(ii) an estimate of the financial and 
human cost attributable to such illness or 
behavior. 
‘‘(B) An assessment of the existing and ad-
ditional resources necessary for the prevention 
and treatment of such illness and behavior, in-
cluding an assessment of the progress toward 
achieving the availability of the full continuum 
of care described in subsection (c). 
‘‘(C) An estimate of the additional funding 
needed by the Service, Indian Tribes, Tribal Or-
ganizations, and Urban Indian Organizations to 
meet their responsibilities under the plans. 
‘‘(2) 
NATIONAL
CLEARINGHOUSE.—The 
Sec-
retary, acting through the Service, shall coordinate 
with existing national clearinghouses and informa-
tion centers to include at the clearinghouses and cen-
ters plans and reports on the outcomes of such plans 
developed by Indian Tribes, Tribal Organizations, 
Urban Indian Organizations, and Service Areas re-
lating to behavioral health. The Secretary shall ensure 
access to these plans and outcomes by any Indian 
Tribe, Tribal Organization, Urban Indian Organiza-
tion, or the Service. 
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‘‘(3) TECHNICAL
ASSISTANCE.—The Secretary 
shall provide technical assistance to Indian Tribes, 
Tribal Organizations, and Urban Indian Organiza-
tions in preparation of plans under this section and 
in developing standards of care that may be used and 
adopted locally. 
‘‘(c) PROGRAMS.—The Secretary, acting through the 
Service, Indian Tribes, and Tribal Organizations, shall 
provide, to the extent feasible and if funding is available, 
programs including the following: 
‘‘(1) COMPREHENSIVE CARE.—A comprehensive 
continuum of behavioral health care which provides— 
‘‘(A) community-based prevention, interven-
tion, outpatient, and behavioral health aftercare; 
‘‘(B) detoxification (social and medical); 
‘‘(C) acute hospitalization; 
‘‘(D) intensive outpatient/day treatment; 
‘‘(E) residential treatment; 
‘‘(F) transitional living for those needing a 
temporary, stable living environment that is 
supportive of treatment and recovery goals; 
‘‘(G) emergency shelter; 
‘‘(H) intensive case management; and 
‘‘(I) diagnostic services. 
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‘‘(2) CHILD
CARE.—Behavioral health services 
for Indians from birth through age 17, including— 
‘‘(A) preschool and school age fetal alcohol 
disorder services, including assessment and be-
havioral intervention; 
‘‘(B) mental health and substance abuse 
services (emotional, organic, alcohol, drug, inhal-
ant, and tobacco); 
‘‘(C) identification and treatment of co-oc-
curring disorders and comorbidity; 
‘‘(D) prevention of alcohol, drug, inhalant, 
and tobacco use; 
‘‘(E) early intervention, treatment, and 
aftercare; 
‘‘(F) promotion of healthy approaches to 
risk and safety issues; and 
‘‘(G) identification and treatment of neglect 
and physical, mental, and sexual abuse. 
‘‘(3) ADULT CARE.—Behavioral health services 
for Indians from age 18 through 55, including— 
‘‘(A) early intervention, treatment, and 
aftercare; 
‘‘(B) mental health and substance abuse 
services (emotional, alcohol, drug, inhalant, and 
tobacco), including sex specific services; 
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‘‘(C) identification and treatment of co-oc-
curring disorders (dual diagnosis) and comor-
bidity; 
‘‘(D) promotion of healthy approaches for 
risk-related behavior; 
‘‘(E) treatment services for women at risk of 
giving birth to a child with a fetal alcohol dis-
order; and 
‘‘(F) sex specific treatment for sexual as-
sault and domestic violence. 
‘‘(4) FAMILY CARE.—Behavioral health services 
for families, including— 
‘‘(A) early intervention, treatment, and 
aftercare for affected families; 
‘‘(B) treatment for sexual assault and do-
mestic violence; and 
‘‘(C) promotion of healthy approaches relat-
ing to parenting, domestic violence, and other 
abuse issues. 
‘‘(5) ELDER CARE.—Behavioral health services 
for Indians 56 years of age and older, including— 
‘‘(A) early intervention, treatment, and 
aftercare; 
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