164 
‘‘(iii) provide ambulatory care in a 
Service Area (specified in the contract or 
compact under the Indian Self-Determina-
tion and Education Assistance Act (25 
U.S.C. 450 et seq.)) with a population of 
no fewer than 1,500 eligible Indians and 
other users who are eligible for services in 
such facility in accordance with section 
807(c)(2). 
‘‘(2) ADDITIONAL ALLOWABLE USE.—The Sec-
retary may also reserve a portion of the funding pro-
vided under this section and use those reserved 
funds to reduce an outstanding debt incurred by In-
dian Tribes or Tribal Organizations for the con-
struction, expansion, or modernization of an ambula-
tory care facility that meets the requirements under 
paragraph (1). The provisions of this section shall 
apply, except that such applications for funding 
under this paragraph shall be considered separately 
from applications for funding under paragraph (1). 
‘‘(3) USE
ONLY
FOR
CERTAIN
PORTION
OF 
COSTS.—A grant provided under this section may be 
used only for the cost of that portion of a construc-
tion, expansion, or modernization project that bene-
fits the Service population identified above in sub-
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165 
section (b)(1)(C) (ii) and (iii). The requirements of 
clauses (ii) and (iii) of paragraph (1)(C) shall not 
apply to an Indian Tribe or Tribal Organization ap-
plying for a grant under this section for a health 
care facility located or to be constructed on an is-
land or when such facility is not located on a road 
system providing direct access to an inpatient hos-
pital where care is available to the Service popu-
lation. 
‘‘(c) GRANTS.— 
‘‘(1) APPLICATION.—No grant may be made 
under this section unless an application or proposal 
for the grant has been approved by the Secretary in 
accordance with applicable regulations and has set 
forth reasonable assurance by the applicant that, at 
all times after the construction, expansion, or mod-
ernization of a facility carried out using a grant re-
ceived under this section— 
‘‘(A) adequate financial support will be 
available for the provision of services at such 
facility; 
‘‘(B) such facility will be available to eligi-
ble Indians without regard to ability to pay or 
source of payment; and 
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166 
‘‘(C) such facility will, as feasible without 
diminishing the quality or quantity of services 
provided to eligible Indians, serve noneligible 
persons on a cost basis. 
‘‘(2) PRIORITY.—In awarding grants under this 
section, the Secretary shall give priority to Indian 
Tribes and Tribal Organizations that demonstrate— 
‘‘(A) a need for increased ambulatory care 
services; and 
‘‘(B) insufficient capacity to deliver such 
services. 
‘‘(3) PEER
REVIEW
PANELS.—The Secretary 
may provide for the establishment of peer review 
panels, as necessary, to review and evaluate applica-
tions and proposals and to advise the Secretary re-
garding such applications using the criteria devel-
oped pursuant to subsection (a)(1). 
‘‘(d) REVERSION OF FACILITIES.—If any facility (or 
portion thereof) with respect to which funds have been 
paid under this section, ceases, at any time after comple-
tion of the construction, expansion, or modernization car-
ried out with such funds, to be used for the purposes of 
providing health care services to eligible Indians, all of the 
right, title, and interest in and to such facility (or portion 
thereof) shall transfer to the United States unless other-
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