320 
based on prevailing professional standards at the time the 
medical quality assurance program activity took place. 
‘‘(h) APPLICATION
TO
INFORMATION
IN
CERTAIN 
OTHER RECORDS.—Nothing in this section shall be con-
strued as limiting access to the information in a record cre-
ated and maintained outside a medical quality assurance 
program, including a patient’s medical records, on the 
grounds that the information was presented during meet-
ings of a review body that are part of a medical quality 
assurance program. 
‘‘(i) REGULATIONS.—The Secretary, acting through 
the Service, shall promulgate regulations pursuant to sec-
tion 802. 
‘‘(j) DEFINITIONS.—In this section: 
‘‘(1) The term ‘health care provider’ means any 
health care professional, including community health 
aides and practitioners certified under section 121, 
who are granted clinical practice privileges or em-
ployed to provide health care services in an Indian 
Health Program or health program of an Urban In-
dian Organization, who is licensed or certified to per-
form health care services by a governmental board or 
agency or professional health care society or organiza-
tion. 
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321 
‘‘(2) The term ‘medical quality assurance pro-
gram’ means any activity carried out before, on, or 
after the date of enactment of this Act by or for any 
Indian Health Program or Urban Indian Organiza-
tion to assess the quality of medical care, including 
activities conducted by or on behalf of individuals, 
Indian Health Program or Urban Indian Organiza-
tion medical or dental treatment review committees, 
or other review bodies responsible for quality assur-
ance, credentials, infection control, patient safety, pa-
tient care assessment (including treatment procedures, 
blood, drugs, and therapeutics), medical records, 
health resources management review and identifica-
tion and prevention of medical or dental incidents 
and risks. 
‘‘(3) The term ‘medical quality assurance record’ 
means the proceedings, records, minutes, and reports 
that emanate from quality assurance program activi-
ties described in paragraph (2) and are produced or 
compiled by or for an Indian Health Program or 
Urban Indian Organization as part of a medical 
quality assurance program. 
‘‘SEC. 815. APPROPRIATIONS; AVAILABILITY. 
‘‘Any new spending authority (described in subpara-
graph (A) or (B) of section 401(c)(2) of the Congressional 
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322 
Budget Act of 1974 (Public Law 93–344; 88 Stat. 317)) 
which is provided under this Act shall be effective for any 
fiscal year only to such extent or in such amounts as are 
provided in appropriation Acts. 
‘‘SEC. 816. 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.’’. 
(b) RATE OF PAY.— 
(1) POSITIONS AT LEVEL IV.—Section 5315 of 
title 5, United States Code, is amended by striking 
‘‘Assistant Secretaries of Health and Human Services 
(6)’’ and inserting ‘‘Assistant Secretaries of Health 
and Human Services (7)’’. 
(2) POSITIONS AT LEVEL V.—Section 5316 of 
title 5, United States Code, is amended by striking 
‘‘Director, Indian Health Service, Department of 
Health and Human Services’’. 
(c) AMENDMENTS TO OTHER PROVISIONS OF LAW.— 
(1) Section 3307(b)(1)(C) of the Children’s 
Health Act of 2000 (25 U.S.C. 1671 note; Public Law 
106–310) is amended by striking ‘‘Director of the In-
dian Health Service’’ and inserting ‘‘Assistant Sec-
retary for Indian Health’’. 
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323 
(2) The Indian Lands Open Dump Cleanup Act 
of 1994 is amended— 
(A) in section 3 (25 U.S.C. 3902)— 
(i) by striking paragraph (2); 
(ii) by redesignating paragraphs (1), 
(3), (4), (5), and (6) as paragraphs (4), (5), 
(2), (6), and (1), respectively, and moving 
those paragraphs so as to appear in numer-
ical order; and 
(iii) by inserting before paragraph (4) 
(as redesignated by clause (ii)) the fol-
lowing: 
‘‘(3) ASSISTANT SECRETARY.—The term ‘Assist-
ant Secretary’ means the Assistant Secretary for In-
dian Health.’’; 
(B) in section 5 (25 U.S.C. 3904), by strik-
ing the section designation and heading and in-
serting the following: 
‘‘SEC. 5. AUTHORITY OF ASSISTANT SECRETARY FOR IN-
DIAN HEALTH.’’; 
(C) in section 6(a) (25 U.S.C. 3905(a)), in 
the subsection heading, by striking ‘‘DIRECTOR’’ 
and inserting ‘‘ASSISTANT SECRETARY’’; 
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324 
(D) in section 9(a) (25 U.S.C. 3908(a)), in 
the subsection heading, by striking ‘‘DIRECTOR’’ 
and inserting ‘‘ASSISTANT SECRETARY’’; and 
(E) by striking ‘‘Director’’ each place it ap-
pears and inserting ‘‘Assistant Secretary’’. 
(3) Section 5504(d)(2) of the Augustus F. Haw-
kins-Robert T. Stafford Elementary and Secondary 
School Improvement Amendments of 1988 (25 U.S.C. 
2001 note; Public Law 100–297) is amended by strik-
ing ‘‘Director of the Indian Health Service’’ and in-
serting ‘‘Assistant Secretary for Indian Health’’. 
(4) Section 203(a)(1) of the Rehabilitation Act of 
1973 (29 U.S.C. 763(a)(1)) is amended by striking 
‘‘Director of the Indian Health Service’’ and inserting 
‘‘Assistant Secretary for Indian Health’’. 
(5) Subsections (b) and (e) of section 518 of the 
Federal Water Pollution Control Act (33 U.S.C. 1377) 
are amended by striking ‘‘Director of the Indian 
Health Service’’ each place it appears and inserting 
‘‘Assistant Secretary for Indian Health’’. 
(6) Section 317M(b) of the Public Health Service 
Act (42 U.S.C. 247b–14(b)) is amended— 
(A) by striking ‘‘Director of the Indian 
Health Service’’ each place it appears and in-
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325 
serting ‘‘Assistant Secretary for Indian Health’’; 
and 
(B) in paragraph (2)(A), by striking ‘‘the 
Directors referred to in such paragraph’’ and in-
serting ‘‘the Director of the Centers for Disease 
Control and Prevention and the Assistant Sec-
retary for Indian Health’’. 
(7) Section 417C(b) of the Public Health Service 
Act (42 U.S.C. 285–9(b)) is amended by striking ‘‘Di-
rector of the Indian Health Service’’ and inserting 
‘‘Assistant Secretary for Indian Health’’. 
(8) Section 1452(i) of the Safe Drinking Water 
Act (42 U.S.C. 300j–12(i)) is amended by striking 
‘‘Director of the Indian Health Service’’ each place it 
appears and inserting ‘‘Assistant Secretary for In-
dian Health’’. 
(9) Section 803B(d)(1) of the Native American 
Programs Act of 1974 (42 U.S.C. 2991b–2(d)(1)) is 
amended in the last sentence by striking ‘‘Director of 
the Indian Health Service’’ and inserting ‘‘Assistant 
Secretary for Indian Health’’. 
(10) Section 203(b) of the Michigan Indian 
Land Claims Settlement Act (Public Law 105–143; 
111 Stat. 2666) is amended by striking ‘‘Director of 
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326 
the Indian Health Service’’ and inserting ‘‘Assistant 
Secretary for Indian Health’’. 
SEC. 102. SOBOBA SANITATION FACILITIES. 
The Act of December 17, 1970 (84 Stat. 1465), is 
amended by adding at the end the following: 
‘‘SEC. 9. Nothing in this Act shall preclude the Soboba 
Band of Mission Indians and the Soboba Indian Reserva-
tion from being provided with sanitation facilities and serv-
ices under the authority of section 7 of the Act of August 
5, 1954 (68 Stat. 674), as amended by the Act of July 31, 
1959 (73 Stat. 267).’’. 
SEC. 103. NATIVE AMERICAN HEALTH AND WELLNESS 
FOUNDATION. 
(a) IN GENERAL.—The Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 450 et seq.) is 
amended by adding at the end the following: 
‘‘TITLE VIII—NATIVE AMERICAN 
HEALTH 
AND 
WELLNESS 
FOUNDATION 
‘‘SEC. 801. DEFINITIONS. 
‘‘In this title: 
‘‘(1) BOARD.—The term ‘Board’ means the 
Board of Directors of the Foundation. 
‘‘(2) COMMITTEE.—The term ‘Committee’ means 
the Committee for the Establishment of Native Amer-
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327 
ican Health and Wellness Foundation established 
under section 802(f). 
‘‘(3) 
FOUNDATION.—The 
term 
‘Foundation’ 
means the Native American Health and Wellness 
Foundation established under section 802. 
‘‘(4) SECRETARY.—The term ‘Secretary’ means 
the Secretary of Health and Human Services. 
‘‘(5) SERVICE.—The term ‘Service’ means the In-
dian Health Service of the Department of Health and 
Human Services. 
‘‘SEC. 802. NATIVE AMERICAN HEALTH AND WELLNESS 
FOUNDATION. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN GENERAL.—As soon as practicable after 
the date of enactment of this title, the Secretary shall 
establish, under the laws of the District of Columbia 
and in accordance with this title, the Native Amer-
ican Health and Wellness Foundation. 
‘‘(2) FUNDING
DETERMINATIONS.—No funds, 
gift, property, or other item of value (including any 
interest accrued on such an item) acquired by the 
Foundation shall— 
‘‘(A) be taken into consideration for pur-
poses of determining Federal appropriations re-
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lating to the provision of health care and services 
to Indians; or 
‘‘(B) otherwise limit, diminish, or affect the 
Federal responsibility for the provision of health 
care and services to Indians. 
‘‘(b) PERPETUAL EXISTENCE.—The Foundation shall 
have perpetual existence. 
‘‘(c) NATURE OF CORPORATION.—The Foundation— 
‘‘(1) shall be a charitable and nonprofit federally 
chartered corporation; and 
‘‘(2) shall not be an agency or instrumentality of 
the United States. 
‘‘(d) PLACE OF INCORPORATION AND DOMICILE.—The 
Foundation shall be incorporated and domiciled in the Dis-
trict of Columbia. 
‘‘(e) DUTIES.—The Foundation shall— 
‘‘(1) encourage, accept, and administer private 
gifts of real and personal property, and any income 
from or interest in such gifts, for the benefit of, or in 
support of, the mission of the Service; 
‘‘(2) undertake and conduct such other activities 
as will further the health and wellness activities and 
opportunities of Native Americans; and 
‘‘(3) participate with and assist Federal, State, 
and tribal governments, agencies, entities, and indi-
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329 
viduals in undertaking and conducting activities that 
will further the health and wellness activities and op-
portunities of Native Americans. 
‘‘(f) COMMITTEE FOR THE ESTABLISHMENT OF NATIVE 
AMERICAN HEALTH AND WELLNESS FOUNDATION.— 
‘‘(1) IN GENERAL.—The Secretary shall establish 
the Committee for the Establishment of Native Amer-
ican Health and Wellness Foundation to assist the 
Secretary in establishing the Foundation. 
‘‘(2) DUTIES.—Not later than 180 days after the 
date of enactment of this section, the Committee 
shall— 
‘‘(A) carry out such activities as are nec-
essary to incorporate the Foundation under the 
laws of the District of Columbia, including act-
ing as incorporators of the Foundation; 
‘‘(B) ensure that the Foundation qualifies 
for and maintains the status required to carry 
out this section, until the Board is established; 
‘‘(C) establish the constitution and initial 
bylaws of the Foundation; 
‘‘(D) provide for the initial operation of the 
Foundation, including providing for temporary 
or interim quarters, equipment, and staff; and 
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330 
‘‘(E) appoint the initial members of the 
Board in accordance with the constitution and 
initial bylaws of the Foundation. 
‘‘(g) BOARD OF DIRECTORS.— 
‘‘(1) IN GENERAL.—The Board of Directors shall 
be the governing body of the Foundation. 
‘‘(2) POWERS.—The Board may exercise, or pro-
vide for the exercise of, the powers of the Foundation. 
‘‘(3) SELECTION.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the number of members of the Board, 
the manner of selection of the members (includ-
ing the filling of vacancies), and the terms of of-
fice of the members shall be as provided in the 
constitution and bylaws of the Foundation. 
‘‘(B) REQUIREMENTS.— 
‘‘(i) 
NUMBER
OF
MEMBERS.—The 
Board shall have at least 11 members, who 
shall have staggered terms. 
‘‘(ii) INITIAL VOTING MEMBERS.—The 
initial voting members of the Board— 
‘‘(I) shall be appointed by the 
Committee not later than 180 days 
after the date on which the Foundation 
is established; and 
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331 
‘‘(II) shall have staggered terms. 
‘‘(iii) QUALIFICATION.—The members 
of the Board shall be United States citizens 
who are knowledgeable or experienced in 
Native American health care and related 
matters. 
‘‘(C) COMPENSATION.—A member of the 
Board shall not receive compensation for service 
as a member, but shall be reimbursed for actual 
and necessary travel and subsistence expenses in-
curred in the performance of the duties of the 
Foundation. 
‘‘(h) OFFICERS.— 
‘‘(1) IN GENERAL.—The officers of the Founda-
tion shall be— 
‘‘(A) a secretary, elected from among the 
members of the Board; and 
‘‘(B) any other officers provided for in the 
constitution and bylaws of the Foundation. 
‘‘(2) CHIEF OPERATING OFFICER.—The secretary 
of the Foundation may serve, at the direction of the 
Board, as the chief operating officer of the Founda-
tion, or the Board may appoint a chief operating offi-
cer, who shall serve at the direction of the Board. 
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332 
‘‘(3) ELECTION.—The manner of election, term 
of office, and duties of the officers of the Foundation 
shall be as provided in the constitution and bylaws 
of the Foundation. 
‘‘(i) POWERS.—The Foundation— 
‘‘(1) shall adopt a constitution and bylaws for 
the management of the property of the Foundation 
and the regulation of the affairs of the Foundation; 
‘‘(2) may adopt and alter a corporate seal; 
‘‘(3) may enter into contracts; 
‘‘(4) may acquire (through a gift or otherwise), 
own, lease, encumber, and transfer real or personal 
property as necessary or convenient to carry out the 
purposes of the Foundation; 
‘‘(5) may sue and be sued; and 
‘‘(6) may perform any other act necessary and 
proper to carry out the purposes of the Foundation. 
‘‘(j) PRINCIPAL OFFICE.— 
‘‘(1) IN GENERAL.—The principal office of the 
Foundation shall be in the District of Columbia. 
‘‘(2) ACTIVITIES; OFFICES.—The activities of the 
Foundation may be conducted, and offices may be 
maintained, throughout the United States in accord-
ance with the constitution and bylaws of the Founda-
tion. 
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333 
‘‘(k) SERVICE OF PROCESS.—The Foundation shall 
comply with the law on service of process of each State in 
which the Foundation is incorporated and of each State in 
which the Foundation carries on activities. 
‘‘(l) LIABILITY
OF
OFFICERS, EMPLOYEES, 
AND 
AGENTS.— 
‘‘(1) IN GENERAL.—The Foundation shall be lia-
ble for the acts of the officers, employees, and agents 
of the Foundation acting within the scope of their au-
thority. 
‘‘(2) PERSONAL
LIABILITY.—A member of the 
Board shall be personally liable only for gross neg-
ligence in the performance of the duties of the mem-
ber. 
‘‘(m) RESTRICTIONS.— 
‘‘(1) LIMITATION
ON
SPENDING.—Beginning 
with the fiscal year following the first full fiscal year 
during which the Foundation is in operation, the ad-
ministrative costs of the Foundation shall not exceed 
the percentage described in paragraph (2) of the sum 
of— 
‘‘(A) the amounts transferred to the Foun-
dation under subsection (o) during the preceding 
fiscal year; and 
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334 
‘‘(B) 
donations 
received 
from 
private 
sources during the preceding fiscal year. 
‘‘(2) PERCENTAGES.—The percentages referred to 
in paragraph (1) are— 
‘‘(A) for the first fiscal year described in 
that paragraph, 20 percent; 
‘‘(B) for the following fiscal year, 15 per-
cent; and 
‘‘(C) for each fiscal year thereafter, 10 per-
cent. 
‘‘(3) APPOINTMENT AND HIRING.—The appoint-
ment of officers and employees of the Foundation 
shall be subject to the availability of funds. 
‘‘(4) STATUS.—A member of the Board or officer, 
employee, or agent of the Foundation shall not by 
reason of association with the Foundation be consid-
ered to be an officer, employee, or agent of the United 
States. 
‘‘(n) AUDITS.—The Foundation shall comply with sec-
tion 10101 of title 36, United States Code, as if the Founda-
tion were a corporation under part B of subtitle II of that 
title. 
‘‘(o) FUNDING.— 
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
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