ignated Indian Health Scholarships and shall be 
made in accordance with section 338A of the Public 
Health Services Act (42 U.S.C. 254l), except as pro-
vided in subsection (b) of this section. 
‘‘(2) DETERMINATIONS
BY
SECRETARY.—The 
Secretary, acting through the Service, shall deter-
mine— 
‘‘(A) who shall receive scholarship grants 
under subsection (a); and 
‘‘(B) the distribution of the scholarships 
among health professions on the basis of the 
relative needs of Indians for additional service 
in the health professions. 
‘‘(3) CERTAIN DELEGATION NOT ALLOWED.— 
The administration of this section shall be a respon-
sibility of the Assistant Secretary and shall not be 
delegated in a contract or compact under the Indian 
Self-Determination and Education Assistance Act 
(25 U.S.C. 450 et seq.). 
‘‘(b) ACTIVE DUTY SERVICE OBLIGATION.— 
‘‘(1) OBLIGATION MET.—The active duty serv-
ice obligation under a written contract with the Sec-
retary under this section that an Indian has entered 
into shall, if that individual is a recipient of an In-
dian Health Scholarship, be met in full-time practice 
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equal to 1 year for each school year for which the 
participant receives a scholarship award under this 
part, or 2 years, whichever is greater, by service in 
1 or more of the following: 
‘‘(A) In an Indian Health Program. 
‘‘(B) In a program assisted under title V 
of this Act. 
‘‘(C) In the private practice of the applica-
ble profession if, as determined by the Sec-
retary, in accordance with guidelines promul-
gated by the Secretary, such practice is situated 
in a physician or other health professional 
shortage area and addresses the health care 
needs of a substantial number of Indians. 
‘‘(D) In a teaching capacity in a tribal col-
lege or university nursing program (or a related 
health profession program) if, as determined by 
the Secretary, the health service provided to In-
dians would not decrease. 
‘‘(2) OBLIGATION DEFERRED.—At the request 
of any individual who has entered into a contract re-
ferred to in paragraph (1) and who receives a degree 
in medicine (including osteopathic or allopathic med-
icine), dentistry, optometry, podiatry, or pharmacy, 
the Secretary shall defer the active duty service obli-
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gation of that individual under that contract, in 
order that such individual may complete any intern-
ship, residency, or other advanced clinical training 
that is required for the practice of that health pro-
fession, for an appropriate period (in years, as deter-
mined by the Secretary), subject to the following 
conditions: 
‘‘(A) No period of internship, residency, or 
other advanced clinical training shall be counted 
as satisfying any period of obligated service 
under this subsection. 
‘‘(B) The active duty service obligation of 
that individual shall commence not later than 
90 days after the completion of that advanced 
clinical training (or by a date specified by the 
Secretary). 
‘‘(C) The active duty service obligation will 
be served in the health profession of that indi-
vidual in a manner consistent with paragraph 
(1). 
‘‘(D) A recipient of a scholarship under 
this section may, at the election of the recipient, 
meet the active duty service obligation described 
in paragraph (1) by service in a program speci-
fied under that paragraph that— 
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‘‘(i) is located on the reservation of 
the Indian Tribe in which the recipient is 
enrolled; or 
‘‘(ii) serves the Indian Tribe in which 
the recipient is enrolled. 
‘‘(3) PRIORITY WHEN MAKING ASSIGNMENTS.— 
Subject to paragraph (2), the Secretary, in making 
assignments of Indian Health Scholarship recipients 
required to meet the active duty service obligation 
described in paragraph (1), shall give priority to as-
signing individuals to service in those programs 
specified in paragraph (1) that have a need for 
health professionals to provide health care services 
as a result of individuals having breached contracts 
entered into under this section. 
‘‘(c) PART-TIME STUDENTS.—In the case of an indi-
vidual receiving a scholarship under this section who is 
enrolled part time in an approved course of study— 
‘‘(1) such scholarship shall be for a period of 
years not to exceed the part-time equivalent of 4 
years, as determined by the Secretary; 
‘‘(2) the period of obligated service described in 
subsection (b)(1) shall be equal to the greater of— 
‘‘(A) the part-time equivalent of 1 year for 
each year for which the individual was provided 
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a scholarship (as determined by the Secretary); 
or 
‘‘(B) 2 years; and 
‘‘(3) the amount of the monthly stipend speci-
fied in section 338A(g)(1)(B) of the Public Health 
Service Act (42 U.S.C. 254l(g)(1)(B)) shall be re-
duced pro rata (as determined by the Secretary) 
based on the number of hours such student is en-
rolled. 
‘‘(d) BREACH OF CONTRACT.— 
‘‘(1) SPECIFIED
BREACHES.—An individual 
shall be liable to the United States for the amount 
which has been paid to the individual, or on behalf 
of the individual, under a contract entered into with 
the Secretary under this section on or after the date 
of enactment of the Indian Health Care Improve-
ment Act Amendments of 2009 if that individual— 
‘‘(A) fails to maintain an acceptable level 
of academic standing in the educational institu-
tion in which he or she is enrolled (such level 
determined by the educational institution under 
regulations of the Secretary); 
‘‘(B) is dismissed from such educational 
institution for disciplinary reasons; 
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‘‘(C) voluntarily terminates the training in 
such an educational institution for which he or 
she is provided a scholarship under such con-
tract before the completion of such training; or 
‘‘(D) fails to accept payment, or instructs 
the educational institution in which he or she is 
enrolled not to accept payment, in whole or in 
part, of a scholarship under such contract, in 
lieu of any service obligation arising under such 
contract. 
‘‘(2) OTHER BREACHES.—If for any reason not 
specified in paragraph (1) an individual breaches a 
written contract by failing either to begin such indi-
vidual’s service obligation required under such con-
tract or to complete such service obligation, the 
United States shall be entitled to recover from the 
individual an amount determined in accordance with 
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.— 
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‘‘(A) IN
GENERAL.—The Secretary shall 
provide for the partial or total waiver or sus-
pension of any obligation of service or payment 
of a recipient of an Indian Health Scholarship 
if the Secretary determines that— 
‘‘(i) it is not possible for the recipient 
to meet that obligation or make that pay-
ment; 
‘‘(ii) requiring that recipient to meet 
that obligation or make that payment 
would result in extreme hardship to the re-
cipient; or 
‘‘(iii) the enforcement of the require-
ment to meet the obligation or make the 
payment would be unconscionable. 
‘‘(B) FACTORS
FOR
CONSIDERATION.— 
When waiving or suspending an obligation of 
service or payment under subparagraph (A), the 
Secretary shall consult with the Area Office, In-
dian Tribes, Tribal Organizations, or urban In-
dian organizations affected to consider whether 
the obligation may be satisfied in a teaching ca-
pacity at a tribal college or university nursing 
program under subsection (b)(1)(D). 
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‘‘(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 
the United States to recover funds made available 
under this section. 
‘‘(6) 
BANKRUPTCY.—Notwithstanding 
any 
other provision of law, with respect to a recipient of 
an Indian Health Scholarship, no obligation for pay-
ment may be released by a discharge in bankruptcy 
under title 11, United States Code, unless that dis-
charge is granted after the expiration of the 5-year 
period beginning on the initial date on which that 
payment is due, and only if the bankruptcy court 
finds that the nondischarge of the obligation would 
be unconscionable. 
‘‘SEC. 105. AMERICAN INDIANS INTO PSYCHOLOGY PRO-
GRAM. 
‘‘(a) GRANTS AUTHORIZED.—The Secretary, acting 
through the Service, shall make grants of not more than 
$300,000 to each of 9 colleges and universities for the pur-
pose of developing and maintaining Indian psychology ca-
reer recruitment programs as a means of encouraging In-
dians to enter the behavioral health field. These programs 
shall be located at various locations throughout the coun-
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try to maximize their availability to Indian students and 
new programs shall be established in different locations 
from time to time. 
‘‘(b) QUENTIN N. BURDICK PROGRAM GRANT.—The 
Secretary shall provide a grant authorized under sub-
section (a) to develop and maintain a program at the Uni-
versity of North Dakota to be known as the ‘Quentin N. 
Burdick American Indians Into Psychology Program’. 
Such program shall, to the maximum extent feasible, co-
ordinate with the Quentin N. Burdick Indian Health Pro-
grams authorized under section 117(b), the Quentin N. 
Burdick American Indians Into Nursing Program author-
ized under section 115(e), and existing university research 
and communications networks. 
‘‘(c) REGULATIONS.—The Secretary shall issue regu-
lations pursuant to this Act for the competitive awarding 
of grants provided under this section. 
‘‘(d) CONDITIONS OF GRANT.—Applicants under this 
section shall agree to provide a program which, at a min-
imum— 
‘‘(1) provides outreach and recruitment for 
health professions to Indian communities including 
elementary, secondary, and accredited and accessible 
community colleges that will be served by the pro-
gram; 
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‘‘(2) incorporates a program advisory board 
comprised of representatives from the tribes and 
communities that will be served by the program; 
‘‘(3) provides summer enrichment programs to 
expose Indian students to the various fields of psy-
chology through research, clinical, and experimental 
activities; 
‘‘(4) provides stipends to undergraduate and 
graduate students to pursue a career in psychology; 
‘‘(5) develops affiliation agreements with tribal 
colleges and universities, the Service, university af-
filiated programs, and other appropriate accredited 
and accessible entities to enhance the education of 
Indian students; 
‘‘(6) to the maximum extent feasible, uses exist-
ing university tutoring, counseling, and student sup-
port services; and 
‘‘(7) to the maximum extent feasible, employs 
qualified Indians in the program. 
‘‘(e) ACTIVE DUTY SERVICE REQUIREMENT.—The 
active duty service obligation prescribed under section 
338C of the Public Health Service Act (42 U.S.C. 254m) 
shall be met by each graduate who receives a stipend de-
scribed in subsection (d)(4) that is funded under this sec-
tion. Such obligation shall be met by service— 
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‘‘(1) in an Indian Health Program; 
‘‘(2) in a program assisted under title V of this 
Act; or 
‘‘(3) in the private practice of psychology if, as 
determined by the Secretary, in accordance with 
guidelines promulgated by the Secretary, such prac-
tice is situated in a physician or other health profes-
sional shortage area and addresses the health care 
needs of a substantial number of Indians. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$2,700,000 for each of fiscal years 2010 through 2025. 
‘‘SEC. 106. SCHOLARSHIP PROGRAMS FOR INDIAN TRIBES. 
‘‘(a) IN GENERAL.— 
‘‘(1) GRANTS
AUTHORIZED.—The Secretary, 
acting through the Service, shall make grants to 
Tribal Health Programs for the purpose of providing 
scholarships for Indians to serve as health profes-
sionals in Indian communities. 
‘‘(2) AMOUNT.—Amounts available under para-
graph (1) for any fiscal year shall not exceed 5 per-
cent of the amounts available for each fiscal year for 
Indian Health Scholarships under section 104. 
‘‘(3) APPLICATION.—An application for a grant 
under paragraph (1) shall be in such form and con-
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