142 
‘‘(7) all Federal agencies are authorized to 
transfer to the Secretary funds identified, granted, 
loaned, or appropriated whereby the Department’s 
applicable policies, rules, and regulations shall apply 
in the implementation of such projects; 
‘‘(8) the Secretary of Health and Human Serv-
ices shall enter into interagency agreements with 
Federal and State agencies for the purpose of pro-
viding financial assistance for sanitation facilities 
and services under this Act; and 
‘‘(9) the Secretary of Health and Human Serv-
ices shall, by regulation developed through rule-
making under section 802, establish standards appli-
cable to the planning, design, and construction of 
sanitation facilities funded under this Act. 
‘‘(d) CERTAIN CAPABILITIES NOT PREREQUISITE.— 
The financial and technical capability of an Indian Tribe, 
Tribal Organization, or Indian community to safely oper-
ate, manage, and maintain a sanitation facility shall not 
be a prerequisite to the provision or construction of sanita-
tion facilities by the Secretary. 
‘‘(e) FINANCIAL ASSISTANCE.—The Secretary is au-
thorized to provide financial assistance to Indian Tribes, 
Tribal Organizations, and Indian communities for oper-
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CCOLEMAN on PROD1PC71 with BILLS
143 
ation, management, and maintenance of their sanitation 
facilities. 
‘‘(f) OPERATION, MANAGEMENT, AND MAINTENANCE 
OF FACILITIES.—The Indian Tribe has the primary re-
sponsibility to establish, collect, and use reasonable user 
fees, or otherwise set aside funding, for the purpose of 
operating, managing, and maintaining sanitation facilities. 
If a sanitation facility serving a community that is oper-
ated by an Indian Tribe or Tribal Organization is threat-
ened with imminent failure and such operator lacks capac-
ity to maintain the integrity or the health benefits of the 
sanitation facility, then the Secretary is authorized to as-
sist the Indian Tribe, Tribal Organization, or Indian com-
munity in the resolution of the problem on a short-term 
basis through cooperation with the emergency coordinator 
or by providing operation, management, and maintenance 
service. 
‘‘(g) ISDEAA PROGRAM
FUNDED
ON
EQUAL 
BASIS.—Tribal Health Programs shall be eligible (on an 
equal basis with programs that are administered directly 
by the Service) for— 
‘‘(1) any funds appropriated pursuant to this 
section; and 
‘‘(2) any funds appropriated for the purpose of 
providing sanitation facilities. 
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CCOLEMAN on PROD1PC71 with BILLS
144 
‘‘(h) REPORT.— 
‘‘(1) REQUIRED; CONTENTS.—The Secretary, in 
consultation with the Secretary of Housing and 
Urban Development, Indian Tribes, Tribal Organiza-
tions, and tribally designated housing entities (as de-
fined in section 4 of the Native American Housing 
Assistance and Self-Determination Act of 1996 (25 
U.S.C. 4103)) shall submit to the President, for in-
clusion in the report required to be transmitted to 
Congress under section 801, a report which sets 
forth— 
‘‘(A) the current Indian sanitation facility 
priority system of the Service; 
‘‘(B) the methodology for determining 
sanitation deficiencies and needs; 
‘‘(C) the level of initial and final sanitation 
deficiency for each type of sanitation facility for 
each project of each Indian Tribe or Indian 
community; 
‘‘(D) the amount and most effective use of 
funds, derived from whatever source, necessary 
to accommodate the sanitation facilities needs 
of new homes assisted with funds under the 
Native American Housing Assistance and Self- 
Determination Act, and to reduce the identified 
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CCOLEMAN on PROD1PC71 with BILLS
145 
sanitation deficiency levels of all Indian Tribes 
and Indian communities to level I sanitation de-
ficiency as defined in paragraph (4)(A); and 
‘‘(E) a 10-year plan to provide sanitation 
facilities to serve existing Indian homes and In-
dian communities and new and renovated In-
dian homes. 
‘‘(2) CRITERIA.—The criteria on which the defi-
ciencies and needs will be evaluated shall be devel-
oped through negotiated rulemaking pursuant to 
section 802. 
‘‘(3) UNIFORM METHODOLOGY.—The method-
ology used by the Secretary in determining, pre-
paring cost estimates for, and reporting sanitation 
deficiencies for purposes of paragraph (1) shall be 
applied uniformly to all Indian Tribes and Indian 
communities. 
‘‘(4) SANITATION
DEFICIENCY
LEVELS.—For 
purposes of this subsection, the sanitation deficiency 
levels for an individual, Indian Tribe, or Indian com-
munity sanitation facility to serve Indian homes are 
determined as follows: 
‘‘(A) A level I deficiency exists if a sanita-
tion facility serving an individual, Indian Tribe, 
or Indian community— 
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CCOLEMAN on PROD1PC71 with BILLS
146 
‘‘(i) complies with all applicable water 
supply, pollution control, and solid waste 
disposal laws; and 
‘‘(ii) deficiencies relate to routine re-
placement, repair, or maintenance needs. 
‘‘(B) A level II deficiency exists if a sanita-
tion facility serving an individual, Indian Tribe, 
or Indian community substantially or recently 
complied with all applicable water supply, pollu-
tion control, and solid waste laws and any defi-
ciencies relate to— 
‘‘(i) small or minor capital improve-
ments needed to bring the facility back 
into compliance; 
‘‘(ii) capital improvements that are 
necessary to enlarge or improve the facili-
ties in order to meet the current needs for 
domestic sanitation facilities; or 
‘‘(iii) the lack of equipment or train-
ing by an Indian Tribe, Tribal Organiza-
tion, or an Indian community to properly 
operate and maintain the sanitation facili-
ties. 
‘‘(C) A level III deficiency exists if a sani-
tation facility serving an individual, Indian 
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CCOLEMAN on PROD1PC71 with BILLS
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Tribe or Indian community meets 1 or more of 
the following conditions— 
‘‘(i) water or sewer service in the 
home is provided by a haul system with 
holding tanks and interior plumbing; 
‘‘(ii) major significant interruptions to 
water supply or sewage disposal occur fre-
quently, requiring major capital improve-
ments to correct the deficiencies; or 
‘‘(iii) there is no access to or no ap-
proved or permitted solid waste facility 
available. 
‘‘(D) A level IV deficiency exists— 
‘‘(i) if a sanitation facility for an indi-
vidual home, an Indian Tribe, or an Indian 
community exists but— 
‘‘(I) lacks— 
‘‘(aa) a safe water supply 
system; or 
‘‘(bb) a waste disposal sys-
tem; 
‘‘(II) contains no piped water or 
sewer facilities; or 
‘‘(III) has become inoperable due 
to a major component failure; or 
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