hicle accidents (30 percent) and intentional self-
harm (39 percent). 
‘‘(4) DENTAL HEALTH.—With respect to dental 
health—
‘‘(A) Native Hawaiian children exhibit 
among the highest rates of dental caries in the 
United States, and the highest in the State as 
compared with the 5 other major ethnic groups 
in the State; 
‘‘(B) the average number of decayed or 
filled primary teeth for Native Hawaiian chil-
dren aged 5 through 9 years was 4.3, as com-
pared with 3.7 for all children in the State and 
1.9 for all children in the United States; and 
‘‘(C) the proportion of Native Hawaiian 
children aged 5 through 12 years with unmet 
dental treatment needs (defined as having ac-
tive dental caries requiring treatment) is 40 
percent, as compared with 33 percent for all 
other racial groups in the State. 
‘‘(5) LIFE EXPECTANCY.—With respect to life 
expectancy—
‘‘(A) Native Hawaiians have the lowest life 
expectancy of all population groups in the 
State;
‘‘(B) between 1910 and 1980, the life ex-
pectancy of Native Hawaiians from birth has 
ranged from 5 to 10 years less than that of the 
overall State population average; and 
‘‘(C) the most recent tables for 1990 show 
Native Hawaiian life expectancy at birth (74.27 
years) to be approximately 5 years less than 
that of the total State population (78.85 years). 
‘‘(6) MATERNAL AND CHILD HEALTH.—
‘‘(A) IN GENERAL.—With respect to ma-
ternal and child health, for 2000—
‘‘(i) 39 percent of all deaths of chil-
dren under the age of 18 years in the 
State were Native Hawaiian; and 
‘‘(ii) perinatal conditions accounted 
for 38 percent of all Native Hawaiian 
deaths in that age group. 
‘‘(B) PRENATAL
CARE.—With respect to 
prenatal care—
‘‘(i) as of 1998, Native Hawaiian 
women have the highest prevalence (24 
percent) of having had no prenatal care 
during the first trimester of pregnancy, as 
compared with the 5 largest ethnic groups 
in the State;
‘‘(ii) of the mothers in the State who 
received no prenatal care throughout their 
pregnancies in 1996, 44 percent were Na-
tive Hawaiian; 
‘‘(iii) more than 65 percent of the re-
ferrals to Healthy Start in fiscal years 
1996 and 1997 were Native Hawaiian 
newborns; and 
‘‘(iv) in every region of the State, 
many Native Hawaiian newborns begin life 
in a potentially hazardous circumstance, 
far higher than any other racial group. 
‘‘(C) BIRTHS.—With respect to births—
‘‘(i) in 1996, 45 percent of the live 
births to Native Hawaiian mothers were 
infants born to single mothers, a cir-
cumstance which statistics indicate puts in-
fants at higher risk of low birth weight and 
infant mortality; 
‘‘(ii) in 1996, of the births to Native 
Hawaiian single mothers, 8 percent were 
low birth weight (defined as a weight of 
less than 2,500 grams); and
‘‘(iii) of all low birth weight infants 
born to single mothers in the State, 44 
percent were Native Hawaiian. 
‘‘(D) TEEN PREGNANCIES.—With respect 
to births—
‘‘(i) in 1993 and 1994, Native Hawai-
ians had the highest percentage of teen 
(individuals who were less than 18 years of 
age) births (8.1 percent), as compared with 
the rate for all other racial groups in the 
State (3.6 percent); 
‘‘(ii) in 1998, nearly 49 percent of all 
mothers in the State under 19 years of age 
were Native Hawaiian; 
‘‘(iii) in 1998, Native Hawaiians com-
prised 31 percent (1,425) of all live births 
to mothers with medical risk factors in the 
State (4,559); and 
‘‘(iv) lower rates of abortion (approxi-
mately 33 percent lower than for the state-
wide population) among Hawaiian women 
may account, in part, for that higher per-
centage of live births. 
‘‘(E) FETAL MORTALITY.—With respect to 
fetal mortality—
‘‘(i) in 2000, Native Hawaiians had 
the highest number of fetal deaths in the 
State; and 
‘‘(ii)(I) 21 percent all fetal deaths in 
the State were associated with expectant 
Native Hawaiian mothers; and 
‘‘(II) 37 percent of those Native Ha-
waiian mothers were under the age of 25 
years. 
‘‘(7) MENTAL HEALTH.—
‘‘(A) ALCOHOL AND DRUG ABUSE.—With 
respect to alcohol and drug abuse—
‘‘(i) Native Hawaiians represent 38 
percent of the total admissions to sub-
stance abuse treatment programs funded 
by the Department of Health, Alcohol, 
Drugs and Other Drugs of the State; 
‘‘(ii) in 2000, the prevalence of ciga-
rette smoking by Native Hawaiians was 
31.0 percent, a rate that is 57 percent 
higher than that for the total population in 
the State, which is 19.7 percent; 
‘‘(iii) Native Hawaiians have the high-
est prevalence rate of acute alcohol drink-
ing (19.6 percent), a rate that is 40 per-
largest percentage of all juvenile arrests in 
that year; 
‘‘(iii) in the period of 1996 through 
1998, the overrepresentation of Native Ha-
waiian juvenile arrests for index crimes 
and Part II offenses increased by 6 per-
cent and 2 percent, respectively; 
‘‘(iv) in 1998, Native Hawaiians rep-
resented 22 percent of the 2,423 adults ar-
rested for drug-related offenses in the 
State; 
‘‘(v) Native Hawaiians are overrepre-
sented in the prison population in the 
State; 
‘‘(vi) of the 2,260 incarcerated Native 
Hawaiians, 70 percent are between 20 and 
40 years of age; 
‘‘(vii) in 1995 and 1996, Native Ha-
waiians comprised 36.5 percent of the sen-
tenced felon prison population in Hawaii, 
as compared with 20.5 percent for Cauca-
sian Americans, 3.7 percent for Japanese 
Americans, and 6 percent for Chinese 
Americans;
‘‘(viii) in 2002, Native Hawaiians 
comprised 40 percent of the total sen-
tenced felon population in the State, as 
compared with 25 percent for Caucasian 
Americans, 12 percent for Filipino Ameri-
cans, 6 percent for Japanese Americans, 
and 5 percent for Samoans; and 
‘‘(ix) based on anecdotal information 
from inmates at the Halawa Correction 
Facilities, Native Hawaiians are estimated 
to comprise between 60 and 70 percent of 
all inmates in the State. 
‘‘(8) OBESITY.—Native Hawaiians have the 
highest prevalence rate of overweightness and obe-
sity (69.4 percent), a rate that is 38 percent higher 
than that for the total State population (50.2 per-
cent). 
‘‘(9) HEALTH
PROFESSIONS
EDUCATION
AND 
TRAINING.—With respect to health professions edu-
cation and training—
‘‘(A)(i) Native Hawaiians who are at least 
25 years of age have a comparable rate of high 
school completion as compared with all people 
in the State who are at least 25 years of age; 
but
‘‘(ii) the rate of baccalaureate degree 
achievement among Native Hawaiians is 6.9 
percent, which is less than the average in the 
State (15.76 percent); 
‘‘(B) Native Hawaiian physicians make up 
4 percent of the total physician workforce in the 
State; and 
‘‘(C)(i) in fiscal year 1999, Native Hawai-
ians comprised—
‘‘(I) 9 percent of those individuals 
who earned Bachelor’s degrees; 
‘‘(II) 15 percent of those individuals 
who earned 2-year diplomas; and 
‘‘(III) 6 percent of those individuals 
who earned Master’s degrees; and 
‘‘(ii) in 1997, Native Hawaiians comprised 
less than 1 percent of individuals who earned 
doctoral degrees at the University of Hawaii. 
‘‘SEC. 3. DEFINITIONS. 
‘‘In this Act: 
‘‘(1) DEPARTMENT.—The term ‘Department’ 
means the Department of Health and Human Serv-
ices. 
‘‘(2) DISEASE PREVENTION.—The term ‘disease 
prevention’ includes—
‘‘(A) immunizations; 
‘‘(B) control of high blood pressure; 
‘‘(C) control of sexually transmittable dis-
eases; 
‘‘(D) prevention and control of chronic dis-
eases; 
‘‘(E) control of toxic agents; 
‘‘(F) occupational safety and health; 
‘‘(G) injury prevention; 
‘‘(H) fluoridation of water; 
‘‘(I) control of infectious agents; and 
‘‘(J) provision of mental health care. 
‘‘(3) HEALTH PROMOTION.—The term ‘health 
promotion’ includes—
‘‘(A) pregnancy and infant care, including 
prevention of fetal alcohol syndrome; 
‘‘(B) cessation of tobacco smoking; 
‘‘(C) reduction in the misuse of alcohol and 
harmful illicit drugs; 
‘‘(D) improvement of nutrition; 
‘‘(E) improvement in physical fitness; 
‘‘(F) family planning; 
‘‘(G) control of stress;
‘‘(H) reduction of major behavioral risk 
factors and promotion of healthy lifestyle prac-
tices; and 
‘‘(I) integration of cultural approaches to 
health and well-being (including traditional 
practices relating to the atmosphere (lewa lani), 
land (‘aina), water (wai), and ocean (kai)). 
‘‘(4) HEALTH SERVICE.—The term ‘health serv-
ice’ means—
‘‘(A) service provided by a physician, phy-
sician’s assistant, nurse practitioner, nurse, 
dentist, or other health professional; 
‘‘(B) a diagnostic laboratory or radiologic 
service; 
‘‘(C) a preventive health service (including 
a perinatal service, well child service, family 
planning service, nutrition service, home health 
service, sports medicine and athletic training 
service, and, generally, any service associated 
with enhanced health and wellness); 
‘‘(D) emergency medical service, including 
a service provided by a first responder, emer-
gency medical technician, or mobile intensive 
care technician;
‘‘(E) a transportation service required for 
adequate patient care; 
‘‘(F) a preventive dental service; 
‘‘(G) a pharmaceutical and medical service; 
‘‘(H) a mental health service, including a 
service provided by a psychologist or social 
worker; 
‘‘(I) a genetic counseling service; 
‘‘(J) a health administration service, in-
cluding a service provided by a health program 
administrator; 
‘‘(K) a health research service, including a 
service provided by an individual with an ad-
vanced degree in medicine, nursing, psychology, 
social work, or any other related health pro-
gram; 
‘‘(L) an environmental health service, in-
cluding a service provided by an epidemiologist, 
public health official, medical geographer, or 
medical anthropologist, or an individual special-
izing in biological, chemical, or environmental 
health determinants; 
‘‘(M) a primary care service that may lead 
to specialty or tertiary care; and
‘‘(N) a complimentary healing practice, in-
cluding a practice performed by a traditional 
Native Hawaiian healer. 
‘‘(5) NATIVE
HAWAIIAN.—The term ‘Native 
Hawaiian’ means any individual who is Kanaka 
Maoli (a descendant of the aboriginal people who, 
prior to 1778, occupied and exercised sovereignty in 
the area that now constitutes the State), as evi-
denced by—
‘‘(A) genealogical records; 
‘‘(B) kama‘aina witness verification from 
Native Hawaiian Kupuna (elders); or 
‘‘(C) birth records of the State or any 
other State or territory of the United States. 
‘‘(6) NATIVE
HAWAIIAN
HEALTH
CARE
SYS-
TEM.—The term ‘Native Hawaiian health care sys-
tem’ means any of up to 8 entities in the State 
that—
‘‘(A) is organized under the laws of the 
State; 
‘‘(B) provides or arranges for the provision 
of health services for Native Hawaiians in the 
State; 
‘‘(C) is a public or nonprofit private entity;
‘‘(D) has Native Hawaiians significantly 
participating in the planning, management, pro-
vision, monitoring, and evaluation of health 
services; 
‘‘(E) addresses the health care needs of an 
island’s Native Hawaiian population; and 
‘‘(F) is recognized by Papa Ola Lokahi—
‘‘(i) for the purpose of planning, con-
ducting, or administering programs, or 
portions of programs, authorized by this 
Act for the benefit of Native Hawaiians; 
and 
‘‘(ii) as having the qualifications and 
the capacity to provide the services and 
meet the requirements under—
‘‘(I) the contract that each Na-
tive Hawaiian health care system en-
ters into with the Secretary under this 
Act; and 
‘‘(II) the grant each Native Ha-
waiian health care system receives 
from the Secretary under this Act. 
‘‘(7) NATIVE HAWAIIAN HEALTH CENTER.—The 
term ‘Native Hawaiian Health Center’ means any
organization that is a primary health care provider 
that—
‘‘(A) has a governing board composed of 
individuals, at least 50 percent of whom are 
Native Hawaiians; 
‘‘(B) has demonstrated cultural com-
petency in a predominantly Native Hawaiian 
community; 
‘‘(C) serves a patient population that—
‘‘(i) is made up of individuals at least 
50 percent of whom are Native Hawaiian; 
or 
‘‘(ii) has not less than 2,500 Native 
Hawaiians as annual users of services; and 
‘‘(D) is recognized by Papa Ola Lokahi as 
having met each of the criteria described in 
subparagraphs (A) through (C). 
‘‘(8) 
NATIVE
HAWAIIAN
HEALTH
TASK 
FORCE.—The term ‘Native Hawaiian Health Task 
Force’ means a task force established by the State 
Council of Hawaiian Homestead Associations to im-
plement health and wellness strategies in Native Ha-
waiian communities.
‘‘(9) NATIVE
HAWAIIAN
ORGANIZATION.—The 
term ‘Native Hawaiian organization’ means any or-
ganization that—
‘‘(A) serves the interests of Native Hawai-
ians; and 
‘‘(B)(i) is recognized by Papa Ola Lokahi 
for planning, conducting, or administering pro-
grams authorized under this Act for the benefit 
of Native Hawaiians; and 
‘‘(ii) is a public or nonprofit private entity. 
‘‘(10) OFFICE
OF
HAWAIIAN
AFFAIRS.—The 
term ‘Office of Hawaiian Affairs’ means the govern-
mental entity that—
‘‘(A) is established under article XII, sec-
tions 5 and 6, of the Hawaii State Constitution; 
and 
‘‘(B) charged with the responsibility to for-
mulate policy relating to the affairs of Native 
Hawaiians. 
‘‘(11) PAPA OLA LOKAHI.—
‘‘(A) IN GENERAL.—The term ‘Papa Ola 
Lokahi’ means an organization that—
‘‘(i) is composed of public agencies 
and private organizations focusing on im-
proving the health status of Native Hawai-
ians; and 
‘‘(ii) governed by a board the mem-
bers of which may include representation 
from—
‘‘(I) E Ola Mau; 
‘‘(II) the Office of Hawaiian Af-
fairs; 
‘‘(III) Alu Like, Inc.; 
‘‘(IV) the University of Hawaii; 
‘‘(V) the Hawaii State Depart-
ment of Health; 
‘‘(VI) 
the 
Native 
Hawaiian 
Health Task Force; 
‘‘(VII) the Hawaii State Primary 
Care Association; 
‘‘(VIII) Ahahui O Na Kauka, the 
Native Hawaiian Physicians Associa-
tion; 
‘‘(IX) Ho‘ola Lahui Hawaii, or a 
health care system serving the islands 
of Kaua‘i or Ni‘ihau (which may be 
composed of as many health care cen-
ters as are necessary to meet the
health care needs of the Native Ha-
waiians of those islands); 
‘‘(X) Ke Ola Mamo, or a health 
care system serving the island of 
O‘ahu (which may be composed of as 
many health care centers as are nec-
essary to meet the health care needs 
of the Native Hawaiians of that is-
land); 
‘‘(XI) Na Pu‘uwai or a health 
care system serving the islands of 
Moloka‘i or Lana‘i (which may be 
composed of as many health care cen-
ters as are necessary to meet the 
health care needs of the Native Ha-
waiians of those islands); 
‘‘(XII) Hui No Ke Ola Pono, or 
a health care system serving the is-
land of Maui (which may be composed 
of as many health care centers as are 
necessary to meet the health care 
needs of the Native Hawaiians of that 
island); 
‘‘(XIII) Hui Malama Ola Na 
‘Oiwi, or a health care system serving
the island of Hawaii (which may be 
composed of as many health care cen-
ters as are necessary to meet the 
health care needs of the Native Ha-
waiians of that island); 
‘‘(XIV) such other Native Hawai-
ian health care systems as are cer-
tified and recognized by Papa Ola 
Lokahi in accordance with this Act; 
and 
‘‘(XV) such other member orga-
nizations as the Board of Papa Ola 
Lokahi shall admit from time to time, 
based on satisfactory demonstration of 
a record of contribution to the health 
and well-being of Native Hawaiians. 
‘‘(B) EXCLUSION.—The term ‘Papa Ola 
Lokahi’ does not include any organization de-
scribed in subparagraph (A) for which the Sec-
retary has made a determination that the orga-
nization has not developed a mission statement 
that includes—
‘‘(i) clearly-defined goals and objec-
tives for the contributions the organization 
will make to—
‘‘(I) Native Hawaiian health care 
systems; and 
‘‘(II) the national policy de-
scribed in section 4; and 
‘‘(ii) an action plan for carrying out 
those goals and objectives. 
‘‘(12) 
SECRETARY.—The 
term 
‘Secretary’ 
means the Secretary of Health and Human Services. 
‘‘(13) STATE.—The term ‘State’ means the 
State of Hawaii. 
‘‘(14) TRADITIONAL NATIVE HAWAIIAN HEAL-
ER.—The term ‘traditional Native Hawaiian healer’ 
means a practitioner—
‘‘(A) who—
‘‘(i) is of Native Hawaiian ancestry; 
and 
‘‘(ii) has the knowledge, skills, and ex-
perience in direct personal health care of 
individuals; and 
‘‘(B) the knowledge, skills, and experience 
of whom are based on demonstrated learning of 
Native Hawaiian healing practices acquired 
by—
‘‘(i) direct practical association with 
Native Hawaiian elders; and
‘‘(ii) oral traditions transmitted from 
generation to generation. 
‘‘SEC. 4. DECLARATION OF NATIONAL NATIVE HAWAIIAN 
HEALTH POLICY. 
‘‘(a) DECLARATION.—Congress declares that it is the 
policy of the United States, in fulfillment of special re-
sponsibilities and legal obligations of the United States to 
the indigenous people of Hawaii resulting from the unique 
and historical relationship between the United States and 
the indigenous people of Hawaii—
‘‘(1) to raise the health status of Native Hawai-
ians to the highest practicable health level; and 
‘‘(2) to provide Native Hawaiian health care 
programs with all resources necessary to effectuate 
that policy. 
‘‘(b) INTENT OF CONGRESS.—It is the intent of Con-
gress that—
‘‘(1) health care programs having a dem-
onstrated effect of substantially reducing or elimi-
nating the overrepresentation of Native Hawaiians 
among those suffering from chronic and acute dis-
ease and illness, and addressing the health needs of 
Native Hawaiians (including perinatal, early child 
development, and family-based health education 
needs), shall be established and implemented; and
‘‘(2) the United States—
‘‘(A) raise the health status of Native Ha-
waiians by the year 2010 to at least the levels 
described in the goals contained within Healthy 
People 2010 (or successor standards); and 
‘‘(B) incorporate within health programs in 
the United States activities defined and identi-
fied by Kanaka Maoli, such as—
‘‘(i) incorporating and supporting the 
integration of cultural approaches to health 
and well-being, including programs using 
traditional practices relating to the atmos-
phere (lewa lani), land (’aina), water (wai), 
or ocean (kai); 
‘‘(ii) increasing the number of Native 
Hawaiian health and allied-health pro-
viders who provide care to or have an im-
pact on the health status of Native Hawai-
ians; 
‘‘(iii) increasing the use of traditional 
Native Hawaiian foods in—
‘‘(I) the diets and dietary pref-
erences of people, including those of 
students; and 
‘‘(II) school feeding programs;
‘‘(iv) identifying and instituting Na-
tive Hawaiian cultural values and practices 
within the corporate cultures of organiza-
tions and agencies providing health serv-
ices to Native Hawaiians; 
‘‘(v) facilitating the provision of Na-
tive Hawaiian healing practices by Native 
Hawaiian healers for individuals desiring 
that assistance; 
‘‘(vi) supporting training and edu-
cation activities and programs in tradi-
tional Native Hawaiian healing practices 
by Native Hawaiian healers; and 
‘‘(vii) demonstrating the integration of 
health services for Native Hawaiians, par-
ticularly those that integrate mental, phys-
ical, and dental services in health care. 
‘‘(c) REPORT.—The Secretary shall submit to the 
President, for inclusion in each report required to be sub-
mitted to Congress under section 12, a report on the 
progress made toward meeting the national policy de-
scribed in this section. 
‘‘SEC. 5. COMPREHENSIVE HEALTH CARE MASTER PLAN 
FOR NATIVE HAWAIIANS. 
‘‘(a) DEVELOPMENT.—
‘‘(1) IN GENERAL.—The Secretary may make a 
grant to, or enter into a contract with, Papa Ola 
Lokahi for the purpose of coordinating, imple-
menting, and updating a Native Hawaiian com-
prehensive health care master plan that is de-
signed—
‘‘(A) to promote comprehensive health pro-
motion and disease prevention services; 
‘‘(B) to maintain and improve the health 
status of Native Hawaiians; and 
‘‘(C) to support community-based initia-
tives that are reflective of holistic approaches to 
health. 
‘‘(2) CONSULTATION.—
‘‘(A) IN GENERAL.—In carrying out this 
section, Papa Ola Lokahi and the Office of Ha-
waiian Affairs shall consult with representatives 
of—
‘‘(i) the Native Hawaiian health care 
systems; 
‘‘(ii) the Native Hawaiian health cen-
ters; and 
‘‘(iii) the Native Hawaiian commu-
nity.
‘‘(B) MEMORANDA OF UNDERSTANDING.—
Papa Ola Lokahi and the Office of Hawaiian 
Affairs may enter into memoranda of under-
standing or agreement for the purpose of ac-
quiring joint funding, or for such other pur-
poses as are necessary, to accomplish the objec-
tives of this section. 
‘‘(3) HEALTH
CARE
FINANCING
STUDY
RE-
PORT.—
‘‘(A) IN
GENERAL.—Not later than 18 
months after the date of enactment of the Na-
tive Hawaiian Health Care Improvement Reau-
thorization Act of 2003, Papa Ola Lokahi, in 
cooperation with the Office of Hawaiian Affairs 
and other appropriate agencies and organiza-
tions in the State (including the Department of 
Health and the Department of Human Services 
of the State) and appropriate Federal agencies 
(including the Centers for Medicare and Med-
icaid Services), shall submit to Congress a re-
port that describes the impact of Federal and 
State health care financing mechanisms and 
policies on the health and well-being of Native 
Hawaiians.
‘‘(B) COMPONENTS.—The report shall in-
clude—
‘‘(i) information concerning the im-
pact on Native Hawaiian health and well-
being of—
‘‘(I) cultural competency; 
‘‘(II) risk assessment data; 
‘‘(III) 
eligibility 
requirements 
and exemptions; and 
‘‘(IV) reimbursement policies and 
capitation rates in effect as of the 
date of the report for service pro-
viders; 
‘‘(ii) such other similar information as 
may be important to improving the health 
status of Native Hawaiians, as that infor-
mation relates to health care financing (in-
cluding barriers to health care); and 
‘‘(iii) recommendations for submission 
to the Secretary, for review in consultation 
with the Native Hawaiian community. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out subsection (a).
‘‘SEC. 6. FUNCTIONS OF PAPA OLA LOKAHI AND OFFICE OF 
HAWAIIAN AFFAIRS. 
‘‘(a) IN GENERAL.—Papa Ola Lokahi—
‘‘(1) shall be responsible for—
‘‘(A) the coordination, implementation, and 
updating, as appropriate, of the comprehensive 
health care master plan under section 5; 
‘‘(B) the training and education of individ-
uals providing health services; 
‘‘(C) the identification of and research (in-
cluding behavioral, biomedical, epidemiological, 
and health service research) into the diseases 
that are most prevalent among Native Hawai-
ians; and 
‘‘(D) the development and maintenance of 
an institutional review board for all research 
projects involving all aspects of Native Hawai-
ian health, including behavioral, biomedical, epi-
demiological, and health service research; 
‘‘(2) may receive special project funds (includ-
ing research endowments under section 736 of the 
Public Health Service Act (42 U.S.C. 293)) made 
available for the purpose of—
‘‘(A) research on the health status of Na-
tive Hawaiians; or
‘‘(B) addressing the health care needs of 
Native Hawaiians; and 
‘‘(3) shall serve as a clearinghouse for—
‘‘(A) the collection and maintenance of 
data associated with the health status of Native 
Hawaiians; 
‘‘(B) the identification and research into 
diseases affecting Native Hawaiians; 
‘‘(C) the availability of Native Hawaiian 
project funds, research projects, and publica-
tions; 
‘‘(D) the collaboration of research in the 
area of Native Hawaiian health; and 
‘‘(E) the timely dissemination of informa-
tion pertinent to the Native Hawaiian health 
care systems. 
‘‘(b) CONSULTATION.—
‘‘(1) IN GENERAL.—The Secretary and the Sec-
retary of each other Federal agency shall—
‘‘(A) consult with Papa Ola Lokahi; and 
‘‘(B) provide Papa Ola Lokahi and the Of-
fice of Hawaiian Affairs, at least once annually, 
an accounting of funds and services provided by 
the Secretary to assist in accomplishing the 
purposes described in section 4.
‘‘(2) COMPONENTS OF ACCOUNTING.—The ac-
counting under paragraph (1)(B) shall include an 
identification of—
‘‘(A) the amount of funds expended explic-
itly for and benefiting Native Hawaiians; 
‘‘(B) the number of Native Hawaiians af-
fected by those funds; 
‘‘(C) the collaborations between the appli-
cable Federal agency and Native Hawaiian 
groups and organizations in the expenditure of 
those funds; and 
‘‘(D) the amount of funds used for—
‘‘(i) Federal administrative purposes; 
and 
‘‘(ii) the provision of direct services to 
Native Hawaiians. 
‘‘(c) FISCAL ALLOCATION AND COORDINATION OF 
PROGRAMS AND SERVICES.—
‘‘(1) RECOMMENDATIONS.—Papa Ola Lokahi 
shall provide annual recommendations to the Sec-
retary with respect to the allocation of all amounts 
made available under this Act. 
‘‘(2) COORDINATION.—Papa Ola Lokahi shall, 
to the maximum extent practicable, coordinate and 
assist the health care programs and services pro-
vided to Native Hawaiians under this Act and other 
Federal laws. 
‘‘(3) REPRESENTATION ON COMMISSION.—The 
Secretary, in consultation with Papa Ola Lokahi, 
shall make recommendations for Native Hawaiian 
representation on the President’s Advisory Commis-
sion on Asian Americans and Pacific Islanders. 
‘‘(d) TECHNICAL SUPPORT.—Papa Ola Lokahi pro-
vide statewide infrastructure to provide technical support 
and coordination of training and technical assistance to—
‘‘(1) the Native Hawaiian health care systems; 
and 
‘‘(2) the Native Hawaiian health centers. 
‘‘(e) RELATIONSHIPS WITH OTHER AGENCIES.—
‘‘(1) AUTHORITY.—Papa Ola Lokahi may enter 
into agreements or memoranda of understanding 
with relevant institutions, agencies, or organizations 
that are capable of providing—
‘‘(A) health-related resources or services to 
Native Hawaiians and the Native Hawaiian 
health care systems; or 
‘‘(B) resources or services for the imple-
mentation of the national policy described in 
section 4. 
‘‘(2) HEALTH CARE FINANCING.—
‘‘(A) FEDERAL CONSULTATION.—
‘‘(i) IN
GENERAL.—Before adopting 
any policy, rule, or regulation that may af-
fect the provision of services or health in-
surance coverage for Native Hawaiians, a 
Federal agency that provides health care 
financing and carries out health care pro-
grams (including the Centers for Medicare 
and Medicaid Services) shall consult with 
representatives of—
‘‘(I) the Native Hawaiian com-
munity; 
‘‘(II) Papa Ola Lokahi; and 
‘‘(III) 
organizations 
providing 
health care services to Native Hawai-
ians in the State. 
‘‘(ii) IDENTIFICATION OF EFFECTS.—
Any consultation by a Federal agency 
under clause (i) shall include an identifica-
tion of the effect of any policy, rule, or 
regulation proposed by the Federal agency. 
‘‘(B) STATE CONSULTATION.—Before mak-
ing any change in an existing program or im-
plementing any new program relating to Native 
Hawaiian health, the State shall engage in
meaningful consultation with representatives 
of—
‘‘(i) the Native Hawaiian community; 
‘‘(ii) Papa Ola Lokahi; and 
‘‘(iii) organizations providing health 
care services to Native Hawaiians in the 
State. 
‘‘(C) 
CONSULTATION
ON
FEDERAL 
HEALTH INSURANCE PROGRAMS.—
‘‘(i) IN GENERAL.—The Office of Ha-
waiian Affairs, in collaboration with Papa 
Ola Lokahi, may develop consultative, con-
tractual, or other arrangements, including 
memoranda of understanding or agree-
ment, with—
‘‘(I) the Centers for Medicare 
and Medicaid Services; 
‘‘(II) the agency of the State that 
administers or supervises the adminis-
tration of the State plan or waiver ap-
proved under title XVIII, XIX, or 
XXI of the Social Security Act (42 
U.S.C. 1395 et seq.) for the payment 
of all or a part of the health care 
services provided to Native Hawaiians
who are eligible for medical assistance 
under the State plan or waiver; or 
‘‘(III) any other Federal agency 
providing full or partial health insur-
ance to Native Hawaiians. 
‘‘(ii) 
CONTENTS
OF
ARRANGE-
MENTS.—An arrangement under clause (i) 
may address—
‘‘(I) appropriate reimbursement 
for health care services, including 
capitation rates and fee-for-service 
rates for Native Hawaiians who are 
entitled to or eligible for insurance; 
‘‘(II) the scope of services; or 
‘‘(III) other matters that would 
enable Native Hawaiians to maximize 
health insurance benefits provided by 
Federal and State health insurance 
programs. 
‘‘(3) TRADITIONAL HEALERS.—
‘‘(A) IN
GENERAL.—The provision of 
health services under any program operated by 
the Department or another Federal agency (in-
cluding the Department of Veterans Affairs) 
may include the services of—
‘‘(i) traditional Native Hawaiian heal-
ers; or 
‘‘(ii) traditional healers providing tra-
ditional health care practices (as those 
terms are defined in section 4 of the In-
dian Health Care Improvement Act (25 
U.S.C. 1603). 
‘‘(B) EXEMPTION.—Services described in 
subparagraph (A) shall be exempt from national 
accreditation reviews, including reviews con-
ducted by—
‘‘(i) the Joint Accreditation Commis-
sion on Health Organizations; and 
‘‘(ii) the Rehabilitation Accreditation 
Commission. 
‘‘SEC. 7. NATIVE HAWAIIAN HEALTH CARE. 
‘‘(a) COMPREHENSIVE HEALTH PROMOTION, DIS-
EASE PREVENTION, AND OTHER HEALTH SERVICES.—
‘‘(1) GRANTS AND CONTRACTS.—The Secretary, 
in consultation with Papa Ola Lokahi, may make 
grants to, or enter into contracts with 1 or more Na-
tive Hawaiian health care systems for the purpose of 
providing comprehensive health promotion and dis-
ease prevention services, as well as other health serv-
ices, to Native Hawaiians who desire and are com-
mitted to bettering their own health. 
‘‘(2) LIMITATION ON NUMBER OF ENTITIES.—
The Secretary may make a grant to, or enter into 
a contract with, not more than 8 Native Hawaiian 
health care systems under this subsection for any 
fiscal year. 
‘‘(b) PLANNING GRANT OR CONTRACT.—In addition 
to grants and contracts under subsection (a), the Sec-
retary may make a grant to, or enter into a contract with, 
Papa Ola Lokahi for the purpose of planning Native Ha-
waiian health care systems to serve the health needs of 
Native Hawaiian communities on each of the islands of 
O‘ahu, 
Moloka‘i, 
Maui, 
Hawai‘i, 
Lana‘i, 
Kaua‘i, 
Kaho‘lawe, and Ni‘ihau in the State. 
‘‘(c) HEALTH SERVICES TO BE PROVIDED.—
‘‘(1) IN
GENERAL.—Each recipient of funds 
under subsection (a) may provide or arrange for—
‘‘(A) outreach services to inform and assist 
Native Hawaiians in accessing health services; 
‘‘(B) education in health promotion and 
disease prevention for Native Hawaiians that, 
wherever practicable, is provided by—
‘‘(i) Native Hawaiian health care 
practitioners;
‘‘(ii) community outreach workers; 
‘‘(iii) counselors; 
‘‘(iv) cultural educators; and 
‘‘(v) other disease prevention pro-
viders; 
‘‘(C) services of individuals providing 
health services; 
‘‘(D) collection of data relating to the pre-
vention of diseases and illnesses among Native 
Hawaiians; and 
‘‘(E) support of culturally appropriate ac-
tivities that enhance health and wellness, in-
cluding land-based, water-based, ocean-based, 
and spiritually-based projects and programs. 
‘‘(2) TRADITIONAL HEALERS.—The health care 
services referred to in paragraph (1) that are pro-
vided under grants or contracts under subsection (a) 
may be provided by traditional Native Hawaiian 
healers, as appropriate. 
‘‘(d) FEDERAL TORT CLAIMS ACT.—An individual 
who provides a medical, dental, or other service referred 
to in subsection (a)(1) for a Native Hawaiian health care 
system, including a provider of a traditional Native Ha-
waiian healing service, shall be—
‘‘(1) treated as if the individual were a member 
of the Public Health Service; and 
‘‘(2) subject to section 224 of the Public Health 
Service Act (42 U.S.C. 233). 
‘‘(e) SITE FOR OTHER FEDERAL PAYMENTS.—
‘‘(1) IN GENERAL.—A Native Hawaiian health 
care system that receives funds under subsection (a) 
may serve as a Federal loan repayment facility. 
‘‘(2) REMISSION OF PAYMENTS.—A facility de-
scribed in paragraph (1) shall be designed to enable 
health and allied-health professionals to remit pay-
ments with respect to loans provided to the profes-
sionals under any Federal loan program. 
‘‘(f) RESTRICTION ON USE OF GRANT AND CON-
TRACT FUNDS.—The Secretary shall not make a grant to, 
or enter into a contract with, an entity under subsection 
(a) unless the entity agrees that amounts received under 
the grant or contract will not, directly or through contract, 
be expended—
‘‘(1) for any service other than a service de-
scribed in subsection (c)(1); 
‘‘(2) to purchase or improve real property 
(other than minor remodeling of existing improve-
ments to real property); or 
‘‘(3) to purchase major medical equipment.
‘‘(g) LIMITATION ON CHARGES FOR SERVICES.—The 
Secretary shall not make a grant to, or enter into a con-
tract with, an entity under subsection (a) unless the entity 
agrees that, whether health services are provided directly 
or under a contract—
‘‘(1) any health service under the grant or con-
tract will be provided without regard to the ability 
of an individual receiving the health service to pay 
for the health service; and 
‘‘(2) the entity will impose for the delivery of 
such a health service a charge that is—
‘‘(A) made according to a schedule of 
charges that is made available to the public; 
and 
‘‘(B) adjusted to reflect the income of the 
individual involved. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) GENERAL GRANTS.—There are authorized 
to be appropriated such sums as are necessary to 
carry out subsection (a) for each of fiscal years 2004 
through 2009. 
‘‘(2) PLANNING GRANTS.—There are authorized 
to be appropriated such sums as are necessary to 
carry out subsection (b) for each of fiscal years 2004 
through 2009.
‘‘(3) HEALTH SERVICES.—There are authorized 
to be appropriated such sums as are necessary to 
carry out subsection (c) for each of fiscal years 2004 
through 2009. 
‘‘SEC. 8. ADMINISTRATIVE GRANT FOR PAPA OLA LOKAHI. 
‘‘(a) IN GENERAL.—In addition to any other grant 
or contract under this Act, the Secretary may make grants 
to, or enter into contracts with, Papa Ola Lokahi for—
‘‘(1) coordination, implementation, and updat-
ing (as appropriate) of the comprehensive health 
care master plan developed under section 5; 
‘‘(2) training and education for providers of 
health services; 
‘‘(3) identification of and research (including 
behavioral, biomedical, epidemiologic, and health 
service research) into the diseases that are most 
prevalent among Native Hawaiians; 
‘‘(4) a clearinghouse function for—
‘‘(A) the collection and maintenance of 
data associated with the health status of Native 
Hawaiians; 
‘‘(B) the identification and research into 
diseases affecting Native Hawaiians; and
‘‘(C) the availability of Native Hawaiian 
project funds, research projects, and publica-
tions; 
‘‘(5) the establishment and maintenance of an 
institutional review board for all health-related re-
search involving Native Hawaiians; 
‘‘(6) the coordination of the health care pro-
grams and services provided to Native Hawaiians; 
and 
‘‘(7) the administration of special project funds. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out subsection (a) for each of fiscal years 
2004 through 2009. 
‘‘SEC. 9. ADMINISTRATION OF GRANTS AND CONTRACTS. 
‘‘(a) TERMS AND CONDITIONS.—The Secretary shall 
include in any grant made or contract entered into under 
this Act such terms and conditions as the Secretary con-
siders necessary or appropriate to ensure that the objec-
tives of the grant or contract are achieved. 
‘‘(b) PERIODIC REVIEW.—The Secretary shall peri-
odically evaluate the performance of, and compliance with, 
grants and contracts under this Act.
‘‘(c) ADMINISTRATIVE REQUIREMENTS.—The Sec-
retary shall not make a grant or enter into a contract 
under this Act with an entity unless the entity—
‘‘(1) agrees to establish such procedures for fis-
cal control and fund accounting as the Secretary de-
termines are necessary to ensure proper disburse-
ment and accounting with respect to the grant or 
contract; 
‘‘(2) agrees to ensure the confidentiality of 
records maintained on individuals receiving health 
services under the grant or contract; 
‘‘(3) with respect to providing health services to 
any population of Native Hawaiians, a substantial 
portion of which has a limited ability to speak the 
English language—
‘‘(A) has developed and has the ability to 
carry out a reasonable plan to provide health 
services under the grant or contract through in-
dividuals who are able to communicate with the 
population involved in the language and cultural 
context that is most appropriate; and 
‘‘(B) has designated at least 1 individual 
who is fluent in English and the appropriate 
language to assist in carrying out the plan;
‘‘(4) with respect to health services that are 
covered under a program under title XVIII, XIX, or 
XXI of the Social Security Act (42 U.S.C. 1395 et 
seq.) (including any State plan), or under any other 
Federal health insurance plan—
‘‘(A) if the entity will provide under the 
grant or contract any of those health services 
directly—
‘‘(i) has entered into a participation 
agreement under each such plan; and 
‘‘(ii) is qualified to receive payments 
under the plan; and 
‘‘(B) if the entity will provide under the 
grant or contract any of those health services 
through a contract with an organization—
‘‘(i) ensures that the organization has 
entered into a participation agreement 
under each such plan; and 
‘‘(ii) ensures that the organization is 
qualified to receive payments under the 
plan; and 
‘‘(5) agrees to submit to the Secretary and 
Papa Ola Lokahi an annual report that—
‘‘(A) describes the use and costs of health 
services provided under the grant or contract
(including the average cost of health services 
per user); and 
‘‘(B) provides such other information as 
the Secretary determines to be appropriate. 
‘‘(d) CONTRACT EVALUATION.—
‘‘(1) DETERMINATION OF NONCOMPLIANCE.—
If, as a result of evaluations conducted by the Sec-
retary, the Secretary determines that an entity has 
not complied with or satisfactorily performed a con-
tract entered into under section 7, the Secretary 
shall, before renewing the contract—
‘‘(A) attempt to resolve the areas of non-
compliance or unsatisfactory performance; and 
‘‘(B) modify the contract to prevent future 
occurrences of the noncompliance or unsatisfac-
tory performance. 
‘‘(2) NONRENEWAL.—If the Secretary deter-
mines that the noncompliance or unsatisfactory per-
formance described in paragraph (1) with respect to 
an entity cannot be resolved and prevented in the fu-
ture, the Secretary—
‘‘(A) shall not renew the contract with the 
entity; and 
‘‘(B) may enter into a contract under sec-
tion 7 with another entity referred to in section
7(a)(3) that provides services to the same popu-
lation of Native Hawaiians served by the entity 
the contract with which was not renewed by 
reason of this paragraph. 
‘‘(3) CONSIDERATION OF RESULTS.—In deter-
mining whether to renew a contract entered into 
with an entity under this Act, the Secretary shall 
consider the results of the evaluations conducted 
under this section. 
‘‘(4) APPLICATION OF FEDERAL LAWS.—Each 
contract entered into by the Secretary under this 
Act shall be in accordance with all Federal con-
tracting laws (including regulations), except that, in 
the discretion of the Secretary, such a contract 
may—
‘‘(A) be negotiated without advertising; 
and 
‘‘(B) be exempted from subchapter III of 
chapter 31, United States Code. 
‘‘(5) PAYMENTS.—A payment made under any 
contract entered into under this Act—
‘‘(A) may be made—
‘‘(i) in advance; 
‘‘(ii) by means of reimbursement; or 
‘‘(iii) in installments; and
‘‘(B) shall be made on such conditions as 
the Secretary determines to be necessary to 
carry out this Act. 
‘‘(e) REPORT.—
‘‘(1) IN GENERAL.—For each fiscal year during 
which an entity receives or expends funds under a 
grant or contract under this Act, the entity shall 
submit to the Secretary and to Papa Ola Lokahi an 
annual report that describes—
‘‘(A) the activities conducted by the entity 
under the grant or contract; 
‘‘(B) the amounts and purposes for which 
Federal funds were expended; and 
‘‘(C) such other information as the Sec-
retary may request. 
‘‘(2) AUDITS.—The reports and records of any 
entity concerning any grant or contract under this 
Act shall be subject to audit by—
‘‘(A) the Secretary; 
‘‘(B) the Inspector General of the Depart-
ment of Health and Human Services; and 
‘‘(C) the Comptroller General of the 
United States. 
‘‘(f) ANNUAL PRIVATE AUDIT.—The Secretary shall 
allow as a cost of any grant made or contract entered into
under this Act the cost of an annual private audit con-
ducted by a certified public accountant to carry out this 
section. 
‘‘SEC. 10. ASSIGNMENT OF PERSONNEL. 
‘‘(a) IN GENERAL.—The Secretary may enter into an 
agreement with Papa Ola Lokahi or any of the Native Ha-
waiian health care systems for the assignment of personnel 
of the Department of Health and Human Services with 
relevant expertise for the purpose of—
‘‘(1) conducting research; or 
‘‘(2) providing comprehensive health promotion 
and disease prevention services and health services 
to Native Hawaiians. 
‘‘(b) APPLICABLE FEDERAL PERSONNEL PROVI-
SIONS.—Any assignment of personnel made by the Sec-
retary under any agreement entered into under subsection 
(a) shall be treated as an assignment of Federal personnel 
to a local government that is made in accordance with sub-
chapter VI of chapter 33 of title 5, United States Code. 
‘‘SEC. 11. NATIVE HAWAIIAN HEALTH SCHOLARSHIPS AND 
FELLOWSHIPS. 
‘‘(a) ELIGIBILITY.—Subject to the availability of 
amounts appropriated under subsection (c), the Secretary 
shall provide to Papa Ola Lokahi, through a direct grant 
or a cooperative agreement, funds for the purpose of pro-
viding scholarship assistance to students who are Native 
Hawaiians. 
‘‘(b) PRIORITY.—A priority for scholarships under 
subsection (a) may be provided to employees of—
‘‘(1) the Native Hawaiian Health Care Systems; 
and 
‘‘(2) the Native Hawaiian Health Centers. 
‘‘(c) TERMS AND CONDITIONS.—
‘‘(1) SCHOLARSHIP ASSISTANCE.—
‘‘(A) IN
GENERAL.—The scholarship as-
sistance under subsection (a) shall be provided 
in accordance with subparagraphs (B) through 
(G). 
‘‘(B) NEED.—The provision of scholar-
ships in each type of health profession training 
shall correspond to the need for each type of 
health professional to serve the Native Hawai-
ian community in providing health services, as 
identified by Papa Ola Lokahi. 
‘‘(C) ELIGIBLE APPLICANTS.—To the max-
imum extent practicable, the Secretary shall se-
lect scholarship recipients from a list of eligible 
applicants submitted by Papa Ola Lokahi. 
‘‘(D) 
OBLIGATED
SERVICE
REQUIRE-
MENT.—
‘‘(i) IN GENERAL.—An obligated serv-
ice requirement for each scholarship recipi-
ent (except for a recipient receiving assist-
ance under paragraph (2)) shall be fulfilled 
through service, in order of priority, in—
‘‘(I) any of the Native Hawaiian 
health care systems; 
‘‘(II) any of the Native Hawaiian 
health centers; 
‘‘(III) 1 or more health profes-
sions shortage areas, medically under-
served areas, or geographic areas or 
facilities similarly designated by the 
Public Health Service in the State; 
‘‘(IV) a Native Hawaiian organi-
zation that serves a geographical area, 
facility, or organization that serves a 
significant Native Hawaiian popu-
lation; 
‘‘(V) any public agency or non-
profit organization providing services 
to Native Hawaiians; or 
‘‘(VI) any of the uniformed serv-
ices of the United States.
‘‘(ii) ASSIGNMENT.—The placement 
service for a scholarship shall assign each 
Native Hawaiian scholarship recipient to 1 
or more appropriate sites for service in ac-
cordance with clause (i). 
‘‘(E) COUNSELING, RETENTION, AND SUP-
PORT
SERVICES.—The provision of academic 
and personal counseling, retention and other 
support services—
‘‘(i) shall not be limited to scholarship 
recipients under this section; and 
‘‘(ii) shall be made available to recipi-
ents of other scholarship and financial aid 
programs enrolled in appropriate health 
professions training programs. 
‘‘(F) FINANCIAL ASSISTANCE.—After con-
sultation with Papa Ola Lokahi, financial as-
sistance may be provided to a scholarship re-
cipient during the period that the recipient is 
fulfilling the service requirement of the recipi-
ent in any of—
‘‘(i) the Native Hawaiian health care 
systems; or 
‘‘(ii) the Native Hawaiians health cen-
ters.
‘‘(G) DISTANCE LEARNING RECIPIENTS.—
A scholarship may be provided to a Native Ha-
waiian who is enrolled in an appropriate dis-
tance learning program offered by an accredited 
educational institution. 
‘‘(2) FELLOWSHIPS.—
‘‘(A) IN GENERAL.—Papa Ola Lokahi may 
provide financial assistance in the form of a fel-
lowship to a Native Hawaiian health profes-
sional who is—
‘‘(i) a Native Hawaiian community 
health representative, outreach worker, or 
health program administrator in a profes-
sional training program; 
‘‘(ii) a Native Hawaiian providing 
health services; or 
‘‘(iii) a Native Hawaiian enrolled in a 
certificated program provided by tradi-
tional Native Hawaiian healers in any of 
the traditional Native Hawaiian healing 
practices 
(including 
lomi-lomi, 
la‘au 
lapa‘au, and ho‘oponopono). 
‘‘(B) TYPES OF ASSISTANCE.—Assistance 
under subparagraph (A) may include a stipend 
for, or reimbursement for costs associated with,
participation in a program described in that 
paragraph. 
‘‘(3) RIGHTS
AND
BENEFITS.—An individual 
who is a health profession designated in section 
338A of the Public Health Service Act (42 U.S.C. 
254l) who receives a scholarship under this sub-
section while fulfilling a service requirement under 
that Act shall retain the same rights and benefits as 
members of the National Health Service Corps dur-
ing the period of service. 
‘‘(4) NO INCLUSION OF ASSISTANCE IN GROSS 
INCOME.—Financial assistance provided under this 
section shall be considered to be qualified scholar-
ships for the purpose of section 117 of the Internal 
Revenue Code of 1986. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out subsections (a) and (c)(2) for each of 
fiscal years 2004 through 2009. 
‘‘SEC. 12. REPORT. 
‘‘For each fiscal year, the President shall, at the time 
at which the budget of the United States is submitted 
under section 1105 of title 31, United States Code, submit 
to Congress a report on the progress made in meeting the 
purposes of this Act, including—
‘‘(1) a review of programs established or as-
sisted in accordance with this Act; and 
‘‘(2) an assessment of and recommendations for 
additional programs or additional assistance nec-
essary to provide, at a minimum, health services to 
Native Hawaiians, and ensure a health status for 
Native Hawaiians, that are at a parity with the 
health services available to, and the health status of, 
the general population. 
‘‘SEC. 13. USE OF FEDERAL GOVERNMENT FACILITIES AND 
SOURCES OF SUPPLY. 
‘‘(a) IN GENERAL.—The Secretary shall permit an 
organization that enters into a contract or receives grant 
under this Act to use in carrying out projects or activities 
under the contract or grant all existing facilities under the 
jurisdiction of the Secretary (including all equipment of 
the facilities), in accordance with such terms and condi-
tions as may be agreed on for the use and maintenance 
of the facilities or equipment. 
‘‘(b) DONATION OF PROPERTY.—The Secretary may 
donate to an organization that enters into a contract or 
receives grant under this Act, for use in carrying out a 
project or activity under the contract or grant, any per-
sonal or real property determined to be in excess of the
needs of the Department or the General Services Adminis-
tration. 
‘‘(c) ACQUISITION
OF SURPLUS PROPERTY.—The 
Secretary may acquire excess or surplus Federal Govern-
ment personal or real property for donation to an organi-
zation under subsection (b) if the Secretary determines 
that the property is appropriate for use by the organiza-
tion for the purpose for which a contract entered into or 
grant received by the organization is authorized under this 
Act. 
‘‘SEC. 14. DEMONSTRATION PROJECTS OF NATIONAL SIG-
NIFICANCE. 
‘‘(a) AUTHORITY AND AREAS OF INTEREST.—
‘‘(1) IN GENERAL.—The Secretary, in consulta-
tion with Papa Ola Lokahi, may allocate amounts 
made available under this Act, or any other Act, to 
carry out Native Hawaiian demonstration projects of 
national significance. 
‘‘(2) AREAS
OF
INTEREST.—A demonstration 
project described in paragraph (1) may relate to 
such areas of interest as—
‘‘(A) the development of a centralized 
database and information system relating to the 
health care status, health care needs, and 
wellness of Native Hawaiians;
‘‘(B) the education of health professionals, 
and other individuals in institutions of higher 
learning, in health and allied health programs 
in healing practices, including Native Hawaiian 
healing practices; 
‘‘(C) the integration of Western medicine 
with complementary healing practices, including 
traditional Native Hawaiian healing practices; 
‘‘(D) the use of telewellness and tele-
communications in—
‘‘(i) chronic and infectious disease 
management; and 
‘‘(ii) health promotion and disease 
prevention; 
‘‘(E) the development of appropriate mod-
els of health care for Native Hawaiians and 
other indigenous people, including—
‘‘(i) the provision of culturally com-
petent health services; 
‘‘(ii) related activities focusing on 
wellness concepts; 
‘‘(iii) the development of appropriate 
kupuna care programs; and 
‘‘(iv) the development of financial 
mechanisms and collaborative relationships
leading to universal access to health care; 
and 
‘‘(F) the establishment of—
‘‘(i) a Native Hawaiian Center of Ex-
cellence for Nursing at the University of 
Hawaii at Hilo; 
‘‘(ii) a Native Hawaiian Center of Ex-
cellence for Mental Health at the Univer-
sity of Hawaii at Manoa; 
‘‘(iii) a Native Hawaiian Center of 
Excellence for Maternal Health and Nutri-
tion at the Waimanalo Health Center; 
‘‘(iv) a Native Hawaiian Center of Ex-
cellence for Research, Training, Integrated 
Medicine at Molokai General Hospital; and 
‘‘(v) a Native Hawaiian Center of Ex-
cellence for Complementary Health and 
Health Education and Training at the 
Waianae 
Coast 
Comprehensive 
Health 
Center. 
‘‘(3) CENTERS
OF
EXCELLENCE.—Papa Ola 
Lokahi, and any centers established under para-
graph (2)(F), shall be considered to be qualified as 
Centers of Excellence under sections 485F and
903(b)(2)(A) of the Public Health Service Act (42 
U.S.C. 287c–32, 299a–1). 
‘‘(b) NONREDUCTION IN OTHER FUNDING.—The al-
location of funds for demonstration projects under sub-
section (a) shall not result in any reduction in funds re-
quired by the Native Hawaiian health care systems, the 
Native Hawaiian Health Centers, the Native Hawaiian 
Health Scholarship Program, or Papa Ola Lokahi to carry 
out the respective responsibilities of those entities under 
this Act. 
‘‘SEC. 15. RULE OF CONSTRUCTION. 
‘‘Nothing in this Act restricts the authority of the 
State to require licensing of, and issue licenses to, health 
practitioners. 
‘‘SEC. 16. COMPLIANCE WITH BUDGET ACT. 
‘‘Any new spending authority described in subpara-
graph (A) or (B) of section 401(c)(2) of the Congressional 
Budget Act of 1974 (2 U.S.C. 651(c)(2)) that is provided 
under this Act shall be effective for any fiscal year only 
to such extent or in such amounts as are provided for in 
Acts of appropriation. 
‘‘SEC. 17. SEVERABILITY. 
‘‘If any provision of this Act, or the application of 
any such provision to any person or circumstance, is deter-
mined by a court of competent jurisdiction to be invalid,
the remainder of this Act, and the application of the provi-
sion to a person or circumstance other than that to which 
the provision is held invalid, shall not be affected by that 
holding.’’.
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