154 
‘‘(B) mental health and substance abuse 
services (emotional, alcohol, drug, inhalant, and 
tobacco), including sex specific services; 
‘‘(C) identification and treatment of co-oc-
curring disorders (dual diagnosis) and comor-
bidity; 
‘‘(D) promotion of healthy approaches to 
managing conditions related to aging; 
‘‘(E) sex specific treatment for sexual as-
sault, domestic violence, neglect, physical and 
mental abuse and exploitation; and 
‘‘(F) identification and treatment of de-
mentias regardless of cause. 
‘‘(d) COMMUNITY BEHAVIORAL HEALTH PLAN.— 
‘‘(1) ESTABLISHMENT.—The governing body of 
any Indian tribe, tribal organization, or urban In-
dian organization may adopt a resolution for the es-
tablishment of a community behavioral health plan 
providing for the identification and coordination of 
available resources and programs to identify, pre-
vent, or treat substance abuse, mental illness, or 
dysfunctional and self-destructive behavior, including 
child abuse and family violence, among its members 
or its service population. This plan should include 
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behavioral health services, social services, intensive 
outpatient services, and continuing aftercare. 
‘‘(2) TECHNICAL ASSISTANCE.—At the request 
of an Indian tribe, tribal organization, or urban In-
dian organization, the Bureau of Indian Affairs and 
the Service shall cooperate with and provide tech-
nical assistance to the Indian tribe, tribal organiza-
tion, or urban Indian organization in the develop-
ment and implementation of such plan. 
‘‘(3) FUNDING.—The Secretary, acting through 
the Service, Indian tribes, and tribal organizations, 
may make funding available to Indian tribes and 
tribal organizations which adopt a resolution pursu-
ant to paragraph (1) to obtain technical assistance 
for the development of a community behavioral 
health plan and to provide administrative support in 
the implementation of such plan. 
‘‘(e) COORDINATION FOR AVAILABILITY OF SERV-
ICES.—The Secretary, acting through the Service, shall 
coordinate behavioral health planning, to the extent fea-
sible, with other Federal agencies and with State agencies, 
to encourage comprehensive behavioral health services for 
Indians regardless of their place of residence. 
‘‘(f) MENTAL HEALTH CARE NEED ASSESSMENT.— 
Not later than 1 year after the date of enactment of the 
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Indian Healthcare Improvement Act of 2017, the Sec-
retary, acting through the Service, shall make an assess-
ment of the need for inpatient mental health care among 
Indians and the availability and cost of inpatient mental 
health facilities which can meet such need. In making such 
assessment, the Secretary shall consider the possible con-
version of existing, underused Service hospital beds into 
psychiatric units to meet such need. 
‘‘SEC. 703. MEMORANDA OF AGREEMENT WITH THE DE-
PARTMENT OF INTERIOR. 
‘‘(a) CONTENTS.—Not later than 1 year after the 
date of enactment of the Indian Healthcare Improvement 
Act of 2017, the Secretary, acting through the Service, 
and the Secretary of the Interior shall develop and enter 
into a memoranda of agreement, or review and update any 
existing memoranda of agreement, as required by section 
4205 of the Indian Alcohol and Substance Abuse Preven-
tion and Treatment Act of 1986 (25 U.S.C. 2411) under 
which the Secretaries address the following: 
‘‘(1) The scope and nature of mental illness and 
dysfunctional and self-destructive behavior, including 
child abuse and family violence, among Indians. 
‘‘(2) The existing Federal, tribal, State, local, 
and private services, resources, and programs avail-
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able to provide behavioral health services for Indi-
ans. 
‘‘(3) The unmet need for additional services, re-
sources, and programs necessary to meet the needs 
identified pursuant to paragraph (1). 
‘‘(4)(A) The right of Indians, as citizens of the 
United States and of the States in which they re-
side, to have access to behavioral health services to 
which all citizens have access. 
‘‘(B) The right of Indians to participate in, and 
receive the benefit of, such services. 
‘‘(C) The actions necessary to protect the exer-
cise of such right. 
‘‘(5) The responsibilities of the Bureau of In-
dian Affairs and the Service, including mental illness 
identification, prevention, education, referral, and 
treatment services (including services through multi-
disciplinary resource teams), at the central, area, 
and agency and Service unit, Service area, and head-
quarters levels to address the problems identified in 
paragraph (1). 
‘‘(6) A strategy for the comprehensive coordina-
tion of the behavioral health services provided by the 
Bureau of Indian Affairs and the Service to meet 
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the problems identified pursuant to paragraph (1), 
including— 
‘‘(A) the coordination of alcohol and sub-
stance abuse programs of the Service, the Bu-
reau of Indian Affairs, and Indian tribes and 
tribal organizations (developed under the Indian 
Alcohol and Substance Abuse Prevention and 
Treatment Act of 1986 (25 U.S.C. 2401 et 
seq.)) with behavioral health initiatives pursu-
ant to this Act, particularly with respect to the 
referral and treatment of dually diagnosed indi-
viduals requiring behavioral health and sub-
stance abuse treatment; and 
‘‘(B) ensuring that the Bureau of Indian 
Affairs and Service programs and services (in-
cluding multidisciplinary resource teams) ad-
dressing child abuse and family violence are co-
ordinated with such non-Federal programs and 
services. 
‘‘(7) Directing appropriate officials of the Bu-
reau of Indian Affairs and the Service, particularly 
at the agency and Service unit levels, to cooperate 
fully with tribal requests made pursuant to commu-
nity behavioral health plans adopted under section 
702(c) and section 4206 of the Indian Alcohol and 
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Substance Abuse Prevention and Treatment Act of 
1986 (25 U.S.C. 2412). 
‘‘(8) Providing for an annual review of such 
agreement by the Secretaries which shall be provided 
to Congress and Indian tribes and tribal organiza-
tions. 
‘‘(b) SPECIFIC PROVISIONS REQUIRED.—The memo-
randa of agreement updated or entered into pursuant to 
subsection (a) shall include specific provisions pursuant to 
which the Service shall assume responsibility for— 
‘‘(1) the determination of the scope of the prob-
lem of alcohol and substance abuse among Indians, 
including the number of Indians within the jurisdic-
tion of the Service who are directly or indirectly af-
fected by alcohol and substance abuse and the finan-
cial and human cost; 
‘‘(2) an assessment of the existing and needed 
resources necessary for the prevention of alcohol and 
substance abuse and the treatment of Indians af-
fected by alcohol and substance abuse; and 
‘‘(3) an estimate of the funding necessary to 
adequately support a program of prevention of alco-
hol and substance abuse and treatment of Indians 
affected by alcohol and substance abuse. 
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‘‘(c) PUBLICATION.—Each memorandum of agree-
ment entered into or renewed (and amendments or modi-
fications thereto) under subsection (a) shall be published 
in the Federal Register. At the same time as publication 
in the Federal Register, the Secretary shall provide a copy 
of such memoranda, amendment, or modification to each 
Indian tribe, tribal organization, and urban Indian organi-
zation. 
‘‘SEC. 704. COMPREHENSIVE BEHAVIORAL HEALTH PRE-
VENTION AND TREATMENT PROGRAM. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Service, shall provide a program of com-
prehensive behavioral health, prevention, treatment, 
and aftercare, which may include, if feasible and ap-
propriate, systems of care, and shall include— 
‘‘(A) prevention, through educational inter-
vention, in Indian communities; 
‘‘(B) acute detoxification, psychiatric hos-
pitalization, residential, and intensive outpatient 
treatment; 
‘‘(C) community-based rehabilitation and 
aftercare; 
‘‘(D) community education and involve-
ment, including extensive training of health 
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care, educational, and community-based per-
sonnel; 
‘‘(E) specialized residential treatment pro-
grams for high-risk populations, including preg-
nant and postpartum women and their children; 
and 
‘‘(F) diagnostic services. 
‘‘(2) TARGET POPULATIONS.—The target popu-
lation of such programs shall be members of Indian 
tribes. Efforts to train and educate key members of 
the Indian community shall also target employees of 
health, education, judicial, law enforcement, legal, 
and social service programs. 
‘‘(b) CONTRACT HEALTH SERVICES.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Service, may enter into contracts with 
public or private providers of behavioral health treat-
ment services for the purpose of carrying out the 
program required under subsection (a). 
‘‘(2) PROVISION OF ASSISTANCE.—In carrying 
out this subsection, the Secretary shall provide as-
sistance to Indian tribes and tribal organizations to 
develop criteria for the certification of behavioral 
health service providers and accreditation of service 
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facilities which meet minimum standards for such 
services and facilities. 
‘‘SEC. 705. MENTAL HEALTH TECHNICIAN PROGRAM. 
‘‘(a) IN GENERAL.—Pursuant to the Act of Novem-
ber 2, 1921 (25 U.S.C. 13) (commonly known as the ‘Sny-
der Act’), the Secretary shall establish and maintain a 
mental health technician program within the Service 
which— 
‘‘(1) provides for the training of Indians as 
mental health technicians; and 
‘‘(2) employs such technicians in the provision 
of community-based mental health care that includes 
identification, prevention, education, referral, and 
treatment services. 
‘‘(b) PARAPROFESSIONAL TRAINING.—In carrying 
out subsection (a), the Secretary, acting through the Serv-
ice, shall provide high-standard paraprofessional training 
in mental health care necessary to provide quality care to 
the Indian communities to be served. Such training shall 
be based upon a curriculum developed or approved by the 
Secretary which combines education in the theory of men-
tal health care with supervised practical experience in the 
provision of such care. 
‘‘(c) SUPERVISION AND EVALUATION OF TECHNI-
CIANS.—The Secretary, acting through the Service, shall 
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supervise and evaluate the mental health technicians in 
the training program. 
‘‘(d) TRADITIONAL HEALTH CARE PRACTICES.—The 
Secretary, acting through the Service, shall ensure that 
the program established pursuant to this section involves 
the use and promotion of the traditional health care prac-
tices of the Indian tribes to be served. 
‘‘SEC. 
706. 
LICENSING 
REQUIREMENT 
FOR 
MENTAL 
HEALTH CARE WORKERS. 
‘‘(a) IN GENERAL.—Subject to section 221, and ex-
cept as provided in subsection (b), any individual employed 
as a psychologist, social worker, or marriage and family 
therapist for the purpose of providing mental health care 
services to Indians in a clinical setting under this Act is 
required to be licensed as a psychologist, social worker, 
or marriage and family therapist, respectively. 
‘‘(b) TRAINEES.—An individual may be employed as 
a trainee in psychology, social work, or marriage and fam-
ily therapy to provide mental health care services de-
scribed in subsection (a) if such individual— 
‘‘(1) works under the direct supervision of a li-
censed psychologist, social worker, or marriage and 
family therapist, respectively; 
‘‘(2) is enrolled in or has completed at least 2 
years of course work at a post-secondary, accredited 
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education program for psychology, social work, mar-
riage and family therapy, or counseling; and 
‘‘(3) meets such other training, supervision, and 
quality review requirements as the Secretary may es-
tablish. 
‘‘SEC. 707. INDIAN WOMEN TREATMENT PROGRAMS. 
‘‘(a) GRANTS.—The Secretary, consistent with sec-
tion 702, may make grants to Indian tribes, tribal organi-
zations, and urban Indian organizations to develop and 
implement a comprehensive behavioral health program of 
prevention, intervention, treatment, and relapse preven-
tion services that specifically addresses the cultural, his-
torical, social, and child care needs of Indian women, re-
gardless of age. 
‘‘(b) USE OF GRANT FUNDS.—A grant made pursu-
ant to this section may be used— 
‘‘(1) to develop and provide community train-
ing, education, and prevention programs for Indian 
women relating to behavioral health issues, including 
fetal alcohol spectrum disorders; 
‘‘(2) to identify and provide psychological serv-
ices, counseling, advocacy, support, and relapse pre-
vention to Indian women and their families; and 
‘‘(3) to develop prevention and intervention 
models for Indian women which incorporate tradi-
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