1703 
after in this section referred to as ‘INMED’) as a means 
of encouraging Indians to enter the health professions. 
‘‘(b) QUENTIN N. BURDICK GRANT.—The Secretary 
shall provide 1 of the grants authorized under subsection 
(a) to maintain the INMED program at the University 
of North Dakota, to be known as the ‘Quentin N. Burdick 
Indian Health Programs’, unless the Secretary makes a 
determination, based upon program reviews, that the pro-
gram is not meeting the purposes of this section. Such 
program shall, to the maximum extent feasible, coordinate 
with the Quentin N. Burdick American Indians Into Psy-
chology Program established under section 105(b) and the 
Quentin N. Burdick American Indians Into Nursing Pro-
gram established under section 115. 
‘‘(c) REGULATIONS.—The Secretary, pursuant to this 
Act, shall develop regulations to govern grants pursuant 
to this section. 
‘‘(d) REQUIREMENTS.—Applicants for grants pro-
vided under this section shall agree to provide a program 
which— 
‘‘(1) provides outreach and recruitment for 
health professions to Indian communities including 
elementary and secondary schools and community 
colleges located on reservations which will be served 
by the program; 
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‘‘(2) incorporates a program advisory board 
comprised of representatives from the Indian Tribes 
and Indian communities which will be served by the 
program; 
‘‘(3) provides summer preparatory programs for 
Indian students who need enrichment in the subjects 
of math and science in order to pursue training in 
the health professions; 
‘‘(4) provides tutoring, counseling, and support 
to students who are enrolled in a health career pro-
gram of study at the respective college or university; 
and 
‘‘(5) to the maximum extent feasible, employs 
qualified Indians in the program. 
‘‘SEC. 118. HEALTH TRAINING PROGRAMS OF COMMUNITY 
COLLEGES. 
‘‘(a) GRANTS TO ESTABLISH PROGRAMS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Service, shall award grants to accredited 
and accessible community colleges for the purpose of 
assisting such community colleges in the establish-
ment of programs which provide education in a 
health profession leading to a degree or diploma in 
a health profession for individuals who desire to 
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practice such profession on or near a reservation or 
in an Indian Health Program. 
‘‘(2) AMOUNT OF GRANTS.—The amount of any 
grant awarded to a community college under para-
graph (1) for the first year in which such a grant 
is provided to the community college shall not exceed 
$250,000. 
‘‘(b) GRANTS
FOR MAINTENANCE
AND RECRUIT-
ING.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Service, shall award grants to accredited 
and accessible community colleges that have estab-
lished a program described in subsection (a)(1) for 
the purpose of maintaining the program and recruit-
ing students for the program. 
‘‘(2) REQUIREMENTS.—Grants may only be 
made under this section to a community college 
which— 
‘‘(A) is accredited; 
‘‘(B) has a relationship with a hospital fa-
cility, Service facility, or hospital that could 
provide training of nurses or health profes-
sionals; 
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‘‘(C) has entered into an agreement with 
an accredited college or university medical 
school, the terms of which— 
‘‘(i) provide a program that enhances 
the transition and recruitment of students 
into advanced baccalaureate or graduate 
programs that train health professionals; 
and 
‘‘(ii) stipulate certifications necessary 
to approve internship and field placement 
opportunities at Indian Health Programs; 
‘‘(D) has a qualified staff which has the 
appropriate certifications; 
‘‘(E) is capable of obtaining State or re-
gional accreditation of the program described in 
subsection (a)(1); and 
‘‘(F) agrees to provide for Indian pref-
erence for applicants for programs under this 
section. 
‘‘(c) TECHNICAL ASSISTANCE.—The Secretary shall 
encourage community colleges described in subsection 
(b)(2) to establish and maintain programs described in 
subsection (a)(1) by— 
‘‘(1) entering into agreements with such col-
leges for the provision of qualified personnel of the 
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Service to teach courses of study in such programs; 
and 
‘‘(2) providing technical assistance and support 
to such colleges. 
‘‘(d) ADVANCED TRAINING.— 
‘‘(1) REQUIRED.—Any program receiving as-
sistance under this section that is conducted with re-
spect to a health profession shall also offer courses 
of study which provide advanced training for any 
health professional who— 
‘‘(A) has already received a degree or di-
ploma in such health profession; and 
‘‘(B) provides clinical services on or near a 
reservation or for an Indian Health Program. 
‘‘(2) MAY BE OFFERED AT ALTERNATE SITE.— 
Such courses of study may be offered in conjunction 
with the college or university with which the commu-
nity college has entered into the agreement required 
under subsection (b)(2)(C). 
‘‘(e) PRIORITY.—Where the requirements of sub-
section (b) are met, grant award priority shall be provided 
to tribal colleges and universities in Service Areas where 
they exist. 
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‘‘SEC. 119. RETENTION BONUS. 
‘‘(a) BONUS AUTHORIZED.—The Secretary may pay 
a retention bonus to any health professional employed by, 
or assigned to, and serving in, an Indian Health Program 
or urban Indian organization either as a civilian employee 
or as a commissioned officer in the Regular or Reserve 
Corps of the Public Health Service who— 
‘‘(1) is assigned to, and serving in, a position 
for which recruitment or retention of personnel is 
difficult; 
‘‘(2) the Secretary determines is needed by In-
dian Health Programs and urban Indian organiza-
tions; 
‘‘(3) has— 
‘‘(A) completed 2 years of employment 
with an Indian Health Program or urban In-
dian organization; or 
‘‘(B) completed any service obligations in-
curred as a requirement of— 
‘‘(i) any Federal scholarship program; 
or 
‘‘(ii) any Federal education loan re-
payment program; and 
‘‘(4) enters into an agreement with an Indian 
Health Program or urban Indian organization for 
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continued employment for a period of not less than 
1 year. 
‘‘(b) RATES.—The Secretary may establish rates for 
the retention bonus which shall provide for a higher an-
nual rate for multiyear agreements than for single year 
agreements referred to in subsection (a)(4), but in no 
event shall the annual rate be more than $25,000 per 
annum. 
‘‘(c) DEFAULT OF RETENTION AGREEMENT.—Any 
health professional failing to complete the agreed upon 
term of service, except where such failure is through no 
fault of the individual, shall be obligated to refund to the 
Government the full amount of the retention bonus for the 
period covered by the agreement, plus interest as deter-
mined by the Secretary in accordance with section 
110(l)(2)(B). 
‘‘(d) OTHER RETENTION BONUS.—The Secretary 
may pay a retention bonus to any health professional em-
ployed by a Tribal Health Program if such health profes-
sional is serving in a position which the Secretary deter-
mines is— 
‘‘(1) a position for which recruitment or reten-
tion is difficult; and 
‘‘(2) necessary for providing health care services 
to Indians. 
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‘‘SEC. 120. NURSING RESIDENCY PROGRAM. 
‘‘(a) ESTABLISHMENT
OF
PROGRAM.—The Sec-
retary, acting through the Service, shall establish a pro-
gram to enable Indians who are licensed practical nurses, 
licensed vocational nurses, and registered nurses who are 
working in an Indian Health Program or urban Indian 
organization, and have done so for a period of not less 
than 1 year, to pursue advanced training. Such program 
shall include a combination of education and work study 
in an Indian Health Program or urban Indian organiza-
tion leading to an associate or bachelor’s degree (in the 
case of a licensed practical nurse or licensed vocational 
nurse), a bachelor’s degree (in the case of a registered 
nurse), or advanced degrees or certifications in nursing 
and public health. 
‘‘(b) SERVICE OBLIGATION.—An individual who par-
ticipates in a program under subsection (a), where the 
educational costs are paid by the Service, shall incur an 
obligation to serve in an Indian Health Program or urban 
Indian organization for a period of obligated service equal 
to 1 year for every year that nonprofessional employee (li-
censed practical nurses, licensed vocational nurses, nurs-
ing assistants, and various health care technicians), or 2 
years for every year that professional nurse (associate de-
gree and bachelor-prepared registered nurses), partici-
pates in such program. In the event that the individual 
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fails to complete such obligated service, the United States 
shall be entitled to recover from such individual an amount 
determined in accordance with the formula specified sub-
section (d)(1) of Section 104 for individuals failing to 
graduate from their degree program and subsection (l) of 
Section 110 for individuals failing to start or complete the 
obligated service. 
‘‘SEC. 121. COMMUNITY HEALTH AIDE PROGRAM. 
‘‘(a) GENERAL PURPOSES OF PROGRAM.—Under the 
authority of the Act of November 2, 1921 (25 U.S.C. 13) 
(commonly known as the ‘Snyder Act’), the Secretary, act-
ing through the Service, shall develop and operate a Com-
munity Health Aide Program in Alaska under which the 
Service— 
‘‘(1) provides for the training of Alaska Natives 
as health aides or community health practitioners; 
‘‘(2) uses such aides or practitioners in the pro-
vision of health care, health promotion, and disease 
prevention services to Alaska Natives living in vil-
lages in rural Alaska; and 
‘‘(3) provides for the establishment of tele-
conferencing capacity in health clinics located in or 
near such villages for use by community health aides 
or community health practitioners. 
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‘‘(b) SPECIFIC PROGRAM REQUIREMENTS.—The Sec-
retary, acting through the Community Health Aide Pro-
gram of the Service, shall— 
‘‘(1) using trainers accredited by the Program, 
provide a high standard of training to community 
health aides and community health practitioners to 
ensure that such aides and practitioners provide 
quality health care, health promotion, and disease 
prevention services to the villages served by the Pro-
gram; 
‘‘(2) in order to provide such training, develop 
a curriculum that— 
‘‘(A) combines education in the theory of 
health care with supervised practical experience 
in the provision of health care; 
‘‘(B) provides instruction and practical ex-
perience in the provision of acute care, emer-
gency care, health promotion, disease preven-
tion, and the efficient and effective manage-
ment of clinic pharmacies, supplies, equipment, 
and facilities; and 
‘‘(C) promotes the achievement of the 
health status objectives specified in section 
3(2); 
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‘‘(3) establish and maintain a Community 
Health Aide Certification Board to certify as com-
munity health aides or community health practi-
tioners individuals who have successfully completed 
the training described in paragraph (1) or can dem-
onstrate equivalent experience; 
‘‘(4) develop and maintain a system which iden-
tifies the needs of community health aides and com-
munity health practitioners for continuing education 
in the provision of health care, including the areas 
described in paragraph (2)(B), and develop pro-
grams that meet the needs for such continuing edu-
cation; 
‘‘(5) develop and maintain a system that pro-
vides close supervision of community health aides 
and community health practitioners; 
‘‘(6) develop a system under which the work of 
community health aides and community health prac-
titioners is reviewed and evaluated to assure the pro-
vision of quality health care, health promotion, and 
disease prevention services; and 
‘‘(7) ensure that pulpal therapy (not including 
pulpotomies on deciduous teeth) or extraction of 
adult teeth can be performed by a dental health aide 
therapist only after consultation with a licensed den-
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tist who determines that the procedure is a medical 
emergency that cannot be resolved with palliative 
treatment, and further that dental health aide thera-
pists are strictly prohibited from performing all 
other oral or jaw surgeries, provided that uncompli-
cated extractions shall not be considered oral sur-
gery under this section. 
‘‘(c) PROGRAM REVIEW.— 
‘‘(1) NEUTRAL PANEL.— 
‘‘(A) ESTABLISHMENT.—The Secretary, 
acting through the Service, shall establish a 
neutral panel to carry out the study under 
paragraph (2). 
‘‘(B) MEMBERSHIP.—Members of the neu-
tral panel shall be appointed by the Secretary 
from among clinicians, economists, community 
practitioners, oral epidemiologists, and Alaska 
Natives. 
‘‘(2) STUDY.— 
‘‘(A) IN GENERAL.—The neutral panel es-
tablished under paragraph (1) shall conduct a 
study of the dental health aide therapist serv-
ices provided by the Community Health Aide 
Program under this section to ensure that the 
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quality of care provided through those services 
is adequate and appropriate. 
‘‘(B) PARAMETERS OF STUDY.—The Sec-
retary, in consultation with interested parties, 
including professional dental organizations, 
shall develop the parameters of the study. 
‘‘(C) INCLUSIONS.—The study shall in-
clude a determination by the neutral panel with 
respect to— 
‘‘(i) the ability of the dental health 
aide therapist services under this section to 
address the dental care needs of Alaska 
Natives; 
‘‘(ii) the quality of care provided 
through those services, including any train-
ing, improvement, or additional oversight 
required to improve the quality of care; 
and 
‘‘(iii) whether safer and less costly al-
ternatives to the dental health aide thera-
pist services exist. 
‘‘(D) CONSULTATION.—In carrying out the 
study under this paragraph, the neutral panel 
shall consult with Alaska Tribal Organizations 
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with respect to the adequacy and accuracy of 
the study. 
‘‘(3) REPORT.—The neutral panel shall submit 
to the Secretary, the Committee on Indian Affairs of 
the Senate, and the Committee on Natural Re-
sources of the House of Representatives a report de-
scribing the results of the study under paragraph 
(2), including a description of— 
‘‘(A) any determination of the neutral 
panel under paragraph (2)(C); and 
‘‘(B) any comments received from an Alas-
ka 
Tribal 
Organization 
under 
paragraph 
(2)(D). 
‘‘(d) NATIONALIZATION OF PROGRAM.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the Secretary, acting through the Service, 
may establish a national Community Health Aide 
Program in accordance with the program under this 
section, as the Secretary determines to be appro-
priate. 
‘‘(2) EXCEPTION.—The national Community 
Health Aide Program under paragraph (1) shall not 
include dental health aide therapist services. 
‘‘(3) REQUIREMENT.—In establishing a na-
tional program under paragraph (1), the Secretary 
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shall not reduce the amount of funds provided for 
the Community Health Aide Program described in 
subsections (a) and (b). 
‘‘SEC. 122. TRIBAL HEALTH PROGRAM ADMINISTRATION. 
‘‘The Secretary shall, by contract or otherwise, pro-
vide training for individuals in the administration and 
planning of Tribal Health Programs, with priority to Indi-
ans. 
‘‘SEC. 123. HEALTH PROFESSIONAL CHRONIC SHORTAGE 
DEMONSTRATION PROGRAMS. 
‘‘(a) DEMONSTRATION PROGRAMS AUTHORIZED.— 
The Secretary, acting through the Service, may fund dem-
onstration programs for Tribal Health Programs to ad-
dress the chronic shortages of health professionals. 
‘‘(b) PURPOSES OF PROGRAMS.—The purposes of 
demonstration programs funded under subsection (a) shall 
be— 
‘‘(1) to provide direct clinical and practical ex-
perience at a Service Unit to health profession stu-
dents and residents from medical schools; 
‘‘(2) to improve the quality of health care for 
Indians by assuring access to qualified health care 
professionals; and 
‘‘(3) to provide academic and scholarly opportu-
nities for health professionals serving Indians by 
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identifying all academic and scholarly resources of 
the region. 
‘‘(c) ADVISORY BOARD.—The demonstration pro-
grams established pursuant to subsection (a) shall incor-
porate a program advisory board composed of representa-
tives from the Indian Tribes and Indian communities in 
the area which will be served by the program. 
‘‘SEC. 124. NATIONAL HEALTH SERVICE CORPS. 
‘‘(a) NO REDUCTION IN SERVICES.—The Secretary 
shall not— 
‘‘(1) remove a member of the National Health 
Service Corps from an Indian Health Program or 
urban Indian organization; or 
‘‘(2) withdraw funding used to support such 
member, unless the Secretary, acting through the 
Service, has ensured that the Indians receiving serv-
ices from such member will experience no reduction 
in services. 
‘‘(b) TREATMENT OF INDIAN HEALTH PROGRAMS.— 
At the request of an Indian Health Program, the services 
of a member of the National Health Service Corps as-
signed to an Indian Health Program may be limited to 
the persons who are eligible for services from such Pro-
gram. 
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‘‘SEC. 125. SUBSTANCE ABUSE COUNSELOR EDUCATIONAL 
CURRICULA DEMONSTRATION PROGRAMS. 
‘‘(a) CONTRACTS AND GRANTS.—The Secretary, act-
ing through the Service, may enter into contracts with, 
or make grants to, accredited tribal colleges and univer-
sities and eligible accredited and accessible community col-
leges to establish demonstration programs to develop edu-
cational curricula for substance abuse counseling. 
‘‘(b) USE OF FUNDS.—Funds provided under this 
section shall be used only for developing and providing 
educational curriculum for substance abuse counseling (in-
cluding paying salaries for instructors). Such curricula 
may be provided through satellite campus programs. 
‘‘(c) TIME PERIOD OF ASSISTANCE; RENEWAL.—A 
contract entered into or a grant provided under this sec-
tion shall be for a period of 3 years. Such contract or 
grant may be renewed for an additional 2-year period 
upon the approval of the Secretary. 
‘‘(d) CRITERIA FOR REVIEW AND APPROVAL OF AP-
PLICATIONS.—Not later than 180 days after the date of 
enactment of the Indian Health Care Improvement Act 
Amendments of 2009, the Secretary, after consultation 
with Indian Tribes and administrators of tribal colleges 
and universities and eligible accredited and accessible com-
munity colleges, shall develop and issue criteria for the 
review and approval of applications for funding (including 
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