I 
116TH CONGRESS 
1ST SESSION H. R. 4533 
To amend the Public Health Service Act to improve behavioral health 
outcomes for American Indians and Alaskan Natives, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 26, 2019 
Mr. PALLONE (for himself and Mr. RUIZ) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committees on Ways and Means, and Natural Resources, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend the Public Health Service Act to improve behav-
ioral health outcomes for American Indians and Alaskan 
Natives, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Native Health Access 
Improvement Act of 2019’’. 
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SEC. 2. SPECIAL BEHAVIORAL HEALTH PROGRAM FOR IN-
DIANS. 
Part A of title V of the Public Health Service Act 
(42 U.S.C. 290aa et seq.) is amended by adding at the 
end the following new section: 
‘‘SEC. 506B. SPECIAL BEHAVIORAL HEALTH PROGRAM FOR 
INDIANS. 
‘‘(a) IN GENERAL.—The Director of the Indian 
Health Service, in coordination with the Assistant Sec-
retary for Mental Health and Substance Use, shall award 
grants for providing services in accordance with subsection 
(b) for the prevention and treatment of mental health and 
substance use disorders. 
‘‘(b) SERVICES THROUGH INDIAN HEALTH FACILI-
TIES.—For purposes of subsection (a), services are pro-
vided in accordance with this subsection if the services are 
provided through any of the following entities: 
‘‘(1) The Indian Health Service. 
‘‘(2) An Indian health program operated by an 
Indian tribe or tribal organization pursuant to a 
contract, grant, cooperative agreement, or compact 
with the Indian Health Service pursuant to the In-
dian Self-Determination and Education Assistance 
Act (25 U.S.C. 5301 et seq.). 
‘‘(3) An urban Indian health program operated 
by an urban Indian organization pursuant to a grant 
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or contract with the Indian Health Service pursuant 
to title V of the Indian Health Care Improvement 
Act (25 U.S.C. 1651 et seq.). 
‘‘(c) REPORTS.—Each grantee under this section 
shall submit reports at such time, in such manner, and 
containing such information as the Director of the Indian 
Health Service may require. 
‘‘(d) TECHNICAL ASSISTANCE CENTER.— 
‘‘(1) ESTABLISHMENT.—The Director of the 
Indian Health Service, in coordination with the As-
sistant Secretary for Mental Health and Substance 
Use, shall establish a technical assistance center (di-
rectly or by contract or cooperative agreement)— 
‘‘(A) to provide technical assistance to 
grantees under this section; and 
‘‘(B) to collect and evaluate information on 
the program carried out under this section. 
‘‘(2) CONSULTATION.—The technical assistance 
center shall consult with grantees under this section 
for purposes of developing evaluation measures and 
data submission requirements for purposes of the 
collection and evaluation of information under para-
graph (1)(B). 
‘‘(3) DATA SUBMISSION.—As a condition on re-
ceipt of a grant under this section, an applicant 
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shall agree to submit data consistent with the data 
submission requirements developed pursuant to 
paragraph (2). 
‘‘(e) FUNDING.— 
‘‘(1) IN GENERAL.—For the purpose of making 
grants under this section, there is authorized to be 
appropriated, and there is appropriated, out of any 
money in the Treasury not otherwise appropriated, 
$150,000,000 for each of fiscal years 2020 through 
2024. 
‘‘(2) TECHNICAL ASSISTANCE CENTER.—Of the 
amount made available to carry out this section for 
each of fiscal years 2020 through 2024, the Director 
of the Indian Health Service shall allocate a percent-
age of such amount, to be determined by the Direc-
tor in consultation with Indian tribes, for the tech-
nical assistance center under subsection (d). 
‘‘(f) DEFINITIONS.—In this section, the terms ‘In-
dian health program’, ‘Indian tribe’, ‘tribal organization’, 
and ‘urban Indian organization’ have the meanings given 
those terms in section 4 of the Indian Health Care Im-
provement Act (25 U.S.C. 1603).’’. 
SEC. 3. INDIAN DEFINED IN PPACA. 
(a) INDIAN DEFINED IN PPACA.— 
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