152 
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-
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 
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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. 
‘‘(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 criteria on which the deficiencies 
and needs will be evaluated; 
‘‘(D) the level of initial and final sanitation 
deficiency for each type of sanitation facility for 
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each project of each Indian Tribe or Indian 
community; 
‘‘(E) 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 (25 U.S.C. 4101 et seq.), 
and to reduce the identified sanitation defi-
ciency levels of all Indian Tribes and Indian 
communities to level I sanitation deficiency as 
defined in paragraph (3)(A); and 
‘‘(F) 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) 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. 
‘‘(3) SANITATION
DEFICIENCY
LEVELS.—For 
purposes of this subsection, the sanitation deficiency 
levels for an individual, Indian Tribe, or Indian com-
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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— 
‘‘(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-
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