1670 
with health problems by increasing their knowl-
edge and providing them with valid information; 
‘‘(B) encouraging adequate and appro-
priate diet, exercise, and sleep; 
‘‘(C) promoting education and work in con-
formity with physical and mental capacity; 
‘‘(D) making available safe water and sani-
tary facilities; 
‘‘(E) improving the physical, economic, cul-
tural, psychological, and social environment; 
‘‘(F) promoting culturally competent care; 
and 
‘‘(G) providing adequate and appropriate 
programs, which may include— 
‘‘(i) abuse prevention (mental and 
physical); 
‘‘(ii) community health; 
‘‘(iii) community safety; 
‘‘(iv) consumer health education; 
‘‘(v) diet and nutrition; 
‘‘(vi) immunization and other preven-
tion of communicable diseases, including 
HIV/AIDS; 
‘‘(vii) environmental health; 
‘‘(viii) exercise and physical fitness;
1671 
‘‘(ix) avoidance of fetal alcohol dis-
orders; 
‘‘(x) first aid and CPR education; 
‘‘(xi) human growth and development; 
‘‘(xii) injury prevention and personal 
safety; 
‘‘(xiii) behavioral health; 
‘‘(xiv) monitoring of disease indicators 
between 
health 
care 
provider 
visits, 
through 
appropriate 
means, 
including 
Internet-based health care management 
systems; 
‘‘(xv) personal health and wellness 
practices; 
‘‘(xvi) personal capacity building; 
‘‘(xvii) prenatal, pregnancy, and in-
fant care; 
‘‘(xviii) psychological well-being; 
‘‘(xix) reproductive health and family 
planning; 
‘‘(xx) safe and adequate water; 
‘‘(xxi) healthy work environments; 
‘‘(xxii) elimination, reduction, and 
prevention of contaminants that create
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the formula specified in subsection (l) of section 110 
in the manner provided for in such subsection. 
‘‘(3) CANCELLATION UPON DEATH OF RECIPI-
ENT.—Upon the death of an individual who receives 
an Indian Health Scholarship, any outstanding obli-
gation of that individual for service or payment that 
relates to that scholarship shall be canceled. 
‘‘(4) WAIVERS
AND
SUSPENSIONS.—The Sec-
retary shall provide for the partial or total waiver or 
suspension of any obligation of service or payment of 
a recipient of an Indian Health Scholarship if the 
Secretary determines that— 
‘‘(A) it is not possible for the recipient to 
meet that obligation or make that payment; 
‘‘(B) requiring that recipient to meet that 
obligation or make that payment would result 
in extreme hardship to the recipient; or 
‘‘(C) the enforcement of the requirement to 
meet the obligation or make the payment would 
be unconscionable. 
‘‘(5) EXTREME
HARDSHIP.—Notwithstanding 
any other provision of law, in any case of extreme 
hardship or for other good cause shown, the Sec-
retary may waive, in whole or in part, the right of
1908 
sociated with the provision of specific medical 
treatments or services in each Area office of the 
Service; 
‘‘(E) an interface mechanism for patient 
billing and accounts receivable system; and 
‘‘(F) a training component. 
‘‘(b) PROVISION OF SYSTEMS TO TRIBES AND ORGA-
NIZATIONS.—The Secretary shall provide each Tribal 
Health Program automated management information sys-
tems which— 
‘‘(1) meet the management information needs 
of such Tribal Health Program with respect to the 
treatment by the Tribal Health Program of patients 
of the Service; and 
‘‘(2) meet the management information needs 
of the Service. 
‘‘(c) ACCESS TO RECORDS.—The Service shall pro-
vide access of patients to their medical or health records 
which are held by, or on behalf of, the Service in accord-
ance with the regulations promulgated under section 
264(c) of the Health Insurance Portability and Account-
ability Act of 1996 or, to the extent consistent with such 
regulations, other Federal rules applicable to access to 
health care records.
1915 
‘‘(A) early intervention, treatment, and 
aftercare for affected families; 
‘‘(B) treatment for sexual assault and do-
mestic violence; and 
‘‘(C) promotion of healthy approaches re-
lating 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; 
‘‘(B) mental health and substance abuse 
services (emotional, alcohol, drug, inhalant, and 
tobacco), including sex specific services; 
‘‘(C) identification and treatment of co-oc-
curring disorders (dual diagnosis) and comor-
bidity; 
‘‘(D) promotion of healthy approaches to 
managing conditions related to aging; 
‘‘(E) sex specific treatment for sexual as-
sault, domestic violence, neglect, physical and 
mental abuse and exploitation; and 
‘‘(F) identification and treatment of de-
mentias regardless of cause. 
‘‘(d) COMMUNITY BEHAVIORAL HEALTH PLAN.—