[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 285 Reported in Senate (RS)]






                                                       Calendar No. 143
108th CONGRESS
  1st Session
                                 S. 285

                          [Report No. 108-75]

To authorize the integration and consolidation of alcohol and substance 
abuse programs and services provided by Indian tribal governments, and 
                          for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            February 4, 2003

Mr. Campbell (for himself, Ms. Murkowski, Mr. Domenici, and Mr. Inouye) 
introduced the following bill; which was read twice and referred to the 
                      Committee on Indian Affairs

                             June 18, 2003

              Reported by Mr. Campbell, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
To authorize the integration and consolidation of alcohol and substance 
abuse programs and services provided by Indian tribal governments, and 
                          for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Native American Alcohol and 
Substance Abuse Program Consolidation Act of 2003''.</DELETED>

<DELETED>SEC. 2. PURPOSES.</DELETED>

<DELETED>    The purposes of this Act are--</DELETED>
        <DELETED>    (1) to enable Indian tribes to consolidate and 
        integrate alcohol and other substance abuse prevention, 
        diagnosis, and treatment programs, and mental health and 
        related programs, to provide unified and more effective and 
        efficient services to Indians afflicted with mental health, 
        alcohol, or other substance abuse problems;</DELETED>
        <DELETED>    (2) to recognize that Indian tribes can best 
        determine the goals and methods for establishing and 
        implementing prevention, diagnosis, and treatment programs for 
        their communities, consistent with the policy of self-
        determination;</DELETED>
        <DELETED>    (3) to encourage and facilitate the implementation 
        of an automated clinical information system to complement the 
        Indian health care delivery system;</DELETED>
        <DELETED>    (4) to authorize the use of Federal funds to 
        purchase, lease, license, or provide training for technology 
        for an automated clinical information ystem that incorporates 
        clinical, financial, and reporting capabilities for Indian 
        behavioral health care programs;</DELETED>
        <DELETED>    (5) to encourage quality assurance policies and 
        procedures, and empower Indian tribes through training and use 
        of technology, to significantly enhance the delivery of, and 
        treatment results from, Indian behavioral health care 
        programs;</DELETED>
        <DELETED>    (6) to assist Indian tribes in maximizing use of 
        public, tribal, human, and financial resources in developing 
        effective, understandable, and meaningful practices under 
        Indian behavioral health care programs; and</DELETED>
        <DELETED>    (7) to encourage and facilitate timely and 
        effective analysis and evaluation of Indian behavioral health 
        care programs.</DELETED>

<DELETED>SEC. 3. DEFINITIONS.</DELETED>

<DELETED>    In this Act:</DELETED>
        <DELETED>    (1) Automated clinical information system.--The 
        term ``automated clinical information system'' means an 
        automated computer software system that can be used to manage 
        clinical, financial, and reporting information for Indian 
        behavioral health care programs.</DELETED>
        <DELETED>    (2) Federal agency.--The term ``Federal agency'' 
        has the meaning given the term ``agency'' in section 551 of 
        title 5, United States Code.</DELETED>
        <DELETED>    (3) Indian.--The term ``Indian'' has the meaning 
        given the term in section 4 of the Indian Self-Determination 
        and Education Assistance Act (25 U.S.C. 450b).</DELETED>
        <DELETED>    (4) Indian behavioral health care program.--The 
        term ``Indian behavioral health care program'' means a 
        federally funded program, for the benefit of Indians, to 
        prevent, diagnose, or treat, or enhance the ability to prevent, 
        diagnose, or treat--</DELETED>
                <DELETED>    (A) mental health problems; or</DELETED>
                <DELETED>    (B) alcohol or other substance abuse 
                problems.</DELETED>
        <DELETED>    (5) Indian tribe.--</DELETED>
                <DELETED>    (A) In general.--The term ``Indian tribe'' 
                has the meaning given the term in section 4 of the 
                Indian Self Determination and Education Assistance Act 
                (25 U.S.C. 450b).</DELETED>
                <DELETED>    (B) Inclusions.--The term ``Indian 
                tribe'', in a case in which an intertribal consortium, 
                tribal organization, or Indian health center is 
                authorized to carry out 1 or more programs, services, 
                functions, or activities of an Indian tribe under this 
                Act, includes the intertribal consortium, tribal 
                organization, or Indian health center.</DELETED>
        <DELETED>    (6) Secretary.--The term ``Secretary'' means the 
        Secretary of Health and Human Services.</DELETED>
        <DELETED>    (7) Substance abuse.--The term ``substance abuse'' 
        includes--</DELETED>
                <DELETED>    (A) the illegal use or abuse of a drug or 
                an inhalant; and</DELETED>
                <DELETED>    (B) the abuse of tobacco or a related 
                product.</DELETED>

<DELETED>SEC. 4. PLANS.</DELETED>

<DELETED>    The Secretary, in cooperation with the Secretary of Labor, 
the Secretary of the Interior, the Secretary of Education, the 
Secretary of Housing and Urban Development, the Attorney General, and 
the Secretary of Transportation, as appropriate, shall, on receipt of a 
plan acceptable to the Secretary that is submitted by an Indian tribe, 
authorize the Indian tribe to carry out a demonstration project to 
coordinate, in accordance with the plan, the Indian behavioral health 
care programs of the Indian tribe in a manner that integrates the 
program services into a single, coordinated, comprehensive program that 
uses, to the extent necessary, an automated clinical information system 
to better manage administrative and clinical services, costs, and 
reporting requirements through the consolidation and integration of 
administrative and clinical functions.</DELETED>

<DELETED>SEC. 5. PROGRAMS AFFECTED.</DELETED>

<DELETED>    Programs that may be integrated in a demonstration project 
described in section 4 are--</DELETED>
        <DELETED>    (1) an Indian behavioral health care program under 
        which an Indian tribe is eligible for the receipt of funds 
        under a statutory or administrative formula;</DELETED>
        <DELETED>    (2) an Indian behavioral health care program under 
        which an Indian tribe is eligible for receipt of funds through 
        competitive or other grants, if--</DELETED>
                <DELETED>    (A)(i) the Indian tribe provides notice to 
                the appropriate agency regarding the intentions of the 
                Indian tribe to include the Indian behavioral health 
                care program in the plan that the Indian tribe submits 
                to the Secretary; and</DELETED>
                <DELETED>    (ii) the agency consents to the inclusion 
                of the grant in the plan; or</DELETED>
                <DELETED>    (B)(i) the Indian tribe elects to include 
                the Indian behavioral health care program in the plan; 
                and</DELETED>
                <DELETED>    (ii) the administrative requirements 
                contained in the plan are essentially the same as the 
                administrative requirements applicable to a grant under 
                the Indian behavioral health care program; 
                and</DELETED>
        <DELETED>    (3) an Indian behavioral health care program under 
        which an Indian tribe is eligible to receive funds under any 
        other funding scheme.</DELETED>

<DELETED>SEC. 6. PLAN REQUIREMENTS.</DELETED>

<DELETED>    A plan of an Indian tribe submitted under section 4 
shall--</DELETED>
        <DELETED>    (1) identify the programs to be 
        integrated;</DELETED>
        <DELETED>    (2) be consistent with this Act;</DELETED>
        <DELETED>    (3) describe a comprehensive strategy that--
        </DELETED>
                <DELETED>    (A) identifies the full range of existing 
                and potential alcohol and substance abuse and mental 
                health treatment and prevention programs available on 
                and near the service area of the Indian tribe; 
                and</DELETED>
                <DELETED>    (B) may include site and technology 
                assessments and any necessary computer hardware 
                installation and support;</DELETED>
        <DELETED>    (4) describe the manner in which services are to 
        be integrated and delivered and the results expected under the 
        plan (including, if implemented, the manner and expected 
        results of implementation of an automated clinical information 
        system);</DELETED>
        <DELETED>    (5) identify the projected expenditures under the 
        plan in a single budget;</DELETED>
        <DELETED>    (6) identify the agency or agencies in the Indian 
        tribe to be involved in the delivery of the services integrated 
        under the plan;</DELETED>
        <DELETED>    (7) identify any statutory provisions, 
        regulations, policies, or procedures that the Indian tribe 
        requests be waived in order to implement the plan; 
        and</DELETED>
        <DELETED>    (8) be approved by the governing body of the 
        Indian tribe.</DELETED>

<DELETED>SEC. 7. PLAN REVIEW.</DELETED>

<DELETED>    (a) Consultation.--On receipt of a plan from an Indian 
tribe under section 4, the Secretary shall consult with--</DELETED>
        <DELETED>    (1) the head of each Federal agency providing 
        funds to be used to implement the plan; and</DELETED>
        <DELETED>    (2) the Indian tribe.</DELETED>
<DELETED>    (b) Identification of Waivers.--Each party consulting on 
the implementation of a plan under section 4 shall identify any waivers 
of statutory requirements or of Federal agency regulations, policies, 
or procedures that the party determines to be necessary to enable the 
Indian tribe to implement the plan.</DELETED>
<DELETED>    (c) Waivers.--Notwithstanding any other provision of law, 
the head of a Federal agency may waive any statutory requirement, 
regulation, policy, or procedure promulgated by the Federal agency is 
identified by the Indian tribe or the Federal agency under subsection 
(b) unless the head of the affected Federal agency determines that a 
waiver is inconsistent with--</DELETED>
        <DELETED>    (1) this Act;</DELETED>
        <DELETED>    (2) any statutory requirement applicable to the 
        program to be integrated under the plan that is specifically 
        applicable to Indian programs; and</DELETED>
        <DELETED>    (3) any underlying statutory objective or purpose 
        of a program to be consolidated under the plan, to such a 
        degree as would render ineffectual activities funded under the 
        program.</DELETED>

<DELETED>SEC. 8. PLAN APPROVAL.</DELETED>

<DELETED>    (a) In General.--Not later than 90 days after the date of 
receipt by the Secretary of a plan under section 4, the Secretary shall 
inform the Indian tribe that submitted the plan, in writing, of the 
approval or disapproval of the plan (including any request for a waiver 
that is made as part of the plan).</DELETED>
<DELETED>    (b) Disapproval.--</DELETED>
        <DELETED>    (1) In general.--The Secretary may disapprove a 
        plan if--</DELETED>
                <DELETED>    (A) the plan does not provide sufficient 
                information for the Secretary to adequately review the 
                plan for compliance with this Act;</DELETED>
                <DELETED>    (B) the plan does not comply with this 
                Act;</DELETED>
                <DELETED>    (C) the plan provides for the purchase, 
                lease, license, or training for, an automated clinical 
                information system, but the purchase, lease, license, 
                or training would require aggregate expenditures of 
                program funding at such a level as would render other 
                program substantially ineffectual; or</DELETED>
                <DELETED>    (D)(i) the plan identifies waivers that 
                cannot be waived under section 7(c); and</DELETED>
                <DELETED>    (ii) the plan would be rendered 
                substantially ineffectual without the 
                waivers.</DELETED>
        <DELETED>    (2) Notice.--If a plan is disapproved under 
        subsection (a), the Secretary shall--</DELETED>
                <DELETED>    (A) inform the Indian tribe, in writing, 
                of the reasons for the disapproval; and</DELETED>
                <DELETED>    (B) provide the Indian tribe an 
                opportunity--</DELETED>
                        <DELETED>    (i) to amend and resubmit the 
                        plan; or</DELETED>
                        <DELETED>    (ii) to petition the Secretary to 
                        reconsider the disapproval (including 
                        reconsidering the disapproval of any waiver 
                        requested by the Indian tribe).</DELETED>

<DELETED>SEC. 9. USE OF FUNDS FOR TECHNOLOGY.</DELETED>

<DELETED>    Notwithstanding any requirement applicable to an Indian 
behavioral health care program of an Indian tribe that is integrated 
under a demonstration project described in section 4, the Indian tribe 
may use funds made available under the program to purchase, lease, 
license, or provide training for technology for an automated clinical 
information system if the purchase, lease, licensing of, or provision 
of training is conducted in accordance with a plan approved by the 
Secretary under section 8.</DELETED>

<DELETED>SEC. 10. FEDERAL RESPONSIBILITIES.</DELETED>

<DELETED>    (a) Responsibilities of the Indian Health Service.--
</DELETED>
        <DELETED>    (1) Memorandum of understanding.--Not later than 
        180 days after the date of enactment of this Act, the 
        Secretary, the Secretary of the Interior, the Secretary of 
        Labor, the Secretary of Education, the Secretary of Housing and 
        Urban Development, the Attorney General, and the Secretary of 
        Transportation shall enter into a memorandum of agreement 
        providing for the implementation of the plans approved under 
        section 8.</DELETED>
        <DELETED>    (2) Lead agency.--The lead agency under this Act 
        shall be the Indian Health Service.</DELETED>
        <DELETED>    (3) Responsibilities.--The responsibilities of the 
        lead agency under this Act shall include--</DELETED>
                <DELETED>    (A) the development of a single reporting 
                format--</DELETED>
                        <DELETED>    (i) relating to each plan for a 
                        demonstration project submitted under section 
                        4, which shall be used by an Indian tribe to 
                        report activities carried out under the plan; 
                        and</DELETED>
                        <DELETED>    (ii) relating to the projected 
                        expenditures for the individual plan, which 
                        shall be used by an Indian tribe to report all 
                        plan expenditures;</DELETED>
                <DELETED>    (B) the development of a single system of 
                Federal oversight for the plan, which shall be 
                implemented by the lead agency;</DELETED>
                <DELETED>    (C) the provision of, or arrangement for 
                provision of, technical assistance to an Indian tribe 
                that is appropriate to support and implement the plan, 
                delivered under an arrangement subject to the approval 
                of the Indian tribe participating in the project 
                (except that an Indian tribe shall have the authority 
                to accept or reject the plan for providing the 
                technical assistance and the technical assistance 
                provider); and</DELETED>
                <DELETED>    (D) the convening by an appropriate 
                official of the lead agency (who shall be an official 
                appointed by and with the advice and consent of the 
                Senate) and a representative of the Indian tribes that 
                carry out projects under this Act, in consultation with 
                each of the Indian tribes that participate in projects 
                under this Act, of a meeting at least twice during each 
                fiscal year, for the purpose of providing an 
                opportunity for all Indian tribes that carry out 
                projects under this Act to discuss issues relating to 
                the implementation of this Act with officials of each 
                agency specified in paragraph (1).</DELETED>
<DELETED>    (b) Report Requirements.--</DELETED>
        <DELETED>    (1) In general.--The single reporting formats 
        described in subsection (a)(3)(A) shall be developed by the 
        Secretary in accordance with this Act.</DELETED>
        <DELETED>    (2) Information.--The single reporting format, 
        together with records maintained on the consolidated program at 
        the tribal level, shall contain such information as the 
        Secretary determines will--</DELETED>
                <DELETED>    (A) allow the Secretary to determine 
                whether the Indian tribe has complied with the 
                requirements incorporated in the approved plan of the 
                Indian tribe; and</DELETED>
                <DELETED>    (B) provide assurances to the Secretary 
                that the Indian tribe has complied with all--</DELETED>
                        <DELETED>    (i) applicable statutory 
                        requirements; and</DELETED>
                        <DELETED>    (ii) applicable regulatory 
                        requirements that have not been 
                        waived.</DELETED>

<DELETED>SEC. 11. NO REDUCTION IN AMOUNTS.</DELETED>

<DELETED>    In no case shall the amount of Federal funds available to 
an Indian tribe involved in any project under this Act be reduced as a 
result of the enactment of this Act.</DELETED>

<DELETED>SEC. 12. INTERAGENCY FUND TRANSFERS.</DELETED>

<DELETED>    The Secretary, the Secretary of the Interior, the 
Secretary of Labor, the Secretary of Education, the Secretary of 
Housing and Urban Development, the Attorney General, or the Secretary 
of Transportation, as appropriate, may take such action as is necessary 
to provide for the interagency transfer of funds otherwise available to 
an Indian tribe in order to carry out this Act.</DELETED>

<DELETED>SEC. 13. ADMINISTRATION OF FUNDS; EXCESS FUNDS.</DELETED>

<DELETED>    (a) Administration of Funds.--</DELETED>
        <DELETED>    (1) In general.--Program funds shall be 
        administered under this Act in such a manner as to allow for a 
        determination by the Secretary that funds made available for 
        specific programs (or an amount equal to the amount used from 
        each program) are expended on activities authorized under the 
        program.</DELETED>
        <DELETED>    (2) Separate records not required.--Nothing in 
        this section requires an Indian tribe--</DELETED>
                <DELETED>    (A) to maintain separate records tracing 
                any service provided or activity conducted under the 
                approved plan of the Indian tribe to the individual 
                programs under which funds were authorized; 
                or</DELETED>
                <DELETED>    (B) to allocate expenditures among 
                individual programs.</DELETED>
<DELETED>    (b) Excess Funds.--With respect to administrative costs of 
carrying out the approved plan of an Indian tribe under this Act--
</DELETED>
        <DELETED>    (1) all administrative costs under the approved 
        plan may be commingled;</DELETED>
        <DELETED>    (2) an Indian tribe that carries out a 
        demonstration program under such an approved plan shall be 
        entitled to receive reimbursement for the full amount of those 
        costs in accordance with regulations of each program or 
        department; and</DELETED>
        <DELETED>    (3) if the Indian tribe, after paying 
        administrative costs associated with carrying out the approved 
        plans, realizes excess administrative funds, those funds shall 
        not be counted for Federal audit purposes if the excess funds 
        are used for the purposes provided for under this 
        Act.</DELETED>

<DELETED>SEC. 14. FISCAL ACCOUNTABILITY.</DELETED>

<DELETED>    Nothing in this Act affects the authority of the Secretary 
or the lead agency to safeguard Federal funds in accordance with 
chapter 75 of title 31, United States Code.</DELETED>

<DELETED>SEC. 15. REPORT ON STATUTORY AND OTHER BARRIERS TO 
              INTEGRATION.</DELETED>

<DELETED>    (a) Preliminary Report.--Not later than 2 years after the 
date of enactment of this Act, the Secretary shall submit to the 
Committee on Indian Affairs of the Senate and the Committee on 
Resources of the House of Representatives a preliminary report that 
describes the implementation of this Act.</DELETED>
<DELETED>    (b) Final Report.--Not later than 5 years after the date 
of enactment of this Act, the Secretary shall submit to the Committee 
on Indian Affairs of the Senate and the Committee on Resources of the 
House of Representatives a final report that--</DELETED>
        <DELETED>    (1) describes the results of implementation of 
        this Act; and</DELETED>
        <DELETED>    (2) identifies statutory barriers to the ability 
        of Indian tribes to integrate more effectively alcohol and 
        substance abuse services in a manner consistent with this 
        Act.</DELETED>

<DELETED>SEC. 15. ASSIGNMENT OF FEDERAL PERSONNEL TO STATE INDIAN 
              ALCOHOL AND DRUG TREATMENT OR MENTAL HEALTH 
              PROGRAMS.</DELETED>

<DELETED>    Any State with an alcohol and substance abuse or mental 
health program targeted toward Indian tribes shall be eligible to 
receive, at no cost to the State, such Federal personnel assignments as 
the Secretary, in accordance with the applicable provisions of 
subchapter IV of chapter 33 of title 5, United States Code, determines 
to be appropriate to help ensure the success of the program.</DELETED>

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Native American 
Alcohol and Substance Abuse Program Consolidation Act of 2003''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.

 TITLE I--INTEGRATION AND CONSOLIDATION OF ALCOHOL AND SUBSTANCE ABUSE 
                         PROGRAMS AND SERVICES

Sec. 101. Purposes.
Sec. 102. Definitions.
Sec. 103. Plans.
Sec. 104. Programs affected.
Sec. 105. Plan requirements.
Sec. 106. Plan review.
Sec. 107. Plan approval.
Sec. 108. Use of funds for technology.
Sec. 109. Federal responsibilities.
Sec. 110. No reduction in amounts.
Sec. 111. Interagency fund transfers.
Sec. 112. Administration of funds; excess funds.
Sec. 113. Fiscal accountability.
Sec. 114. Report on statutory and other barriers to integration.
Sec. 115. Assignment of Federal personnel to State Indian alcohol and 
                            drug treatment or mental health programs.

TITLE II--REAUTHORIZATION OF CERTAIN INDIAN ALCOHOL AND SUBSTANCE ABUSE 
                   PREVENTION AND TREATMENT PROGRAMS

Sec. 201. Indian Alcohol and Substance Abuse Prevention and Treatment 
                            Act of 1986.
Sec. 202. Effective date.

 TITLE I--INTEGRATION AND CONSOLIDATION OF ALCOHOL AND SUBSTANCE ABUSE 
                         PROGRAMS AND SERVICES

SEC. 101. PURPOSES.

    The purposes of this title are--
            (1) to enable Indian tribes to consolidate and integrate 
        alcohol and other substance abuse prevention, diagnosis, and 
        treatment programs, and mental health and related programs, to 
        provide unified and more effective and efficient services to 
        Indians afflicted with mental health, alcohol, or other 
        substance abuse problems;
            (2) to recognize that Indian tribes can best determine the 
        goals and methods for establishing and implementing prevention, 
        diagnosis, and treatment programs for their communities, 
        consistent with the policy of self-determination;
            (3) to encourage and facilitate the implementation of an 
        automated clinical information system to complement the Indian 
        health care delivery system;
            (4) to authorize the use of Federal funds to purchase, 
        lease, license, or provide training for technology for an 
        automated clinical information system that incorporates 
        clinical, financial, and reporting capabilities for Indian 
        behavioral health care programs;
            (5) to encourage quality assurance policies and procedures, 
        and empower Indian tribes through training and use of 
        technology, to significantly enhance the delivery of, and 
        treatment results from, Indian behavioral health care programs;
            (6) to assist Indian tribes in maximizing use of public, 
        tribal, human, and financial resources in developing effective, 
        understandable, and meaningful practices under Indian 
        behavioral health care programs;
            (7) to encourage and facilitate timely and effective 
        analysis and evaluation of Indian behavioral health care 
        programs; and
            (8) to reauthorize certain Indian alcohol and substance 
        abuse prevention and treatment programs.

SEC. 102. DEFINITIONS.

    In this title:
            (1) Automated clinical information system.--The term 
        ``automated clinical information system'' means an automated 
        computer software system that can be used to manage clinical, 
        financial, and reporting information for Indian behavioral 
        health care programs.
            (2) Federal agency.--The term ``Federal agency'' has the 
        meaning given the term ``agency'' in section 551 of title 5, 
        United States Code.
            (3) Indian.--The term ``Indian'' has the meaning given the 
        term in section 4 of the Indian Self-Determination and 
        Education Assistance Act (25 U.S.C. 450b).
            (4) Indian behavioral health care program.--The term 
        ``Indian behavioral health care program'' means a federally 
        funded program, for the benefit of Indians, to prevent, 
        diagnose, or treat, or enhance the ability to prevent, 
        diagnose, or treat--
                    (A) mental health problems; or
                    (B) alcohol or other substance abuse problems.
            (5) Indian tribe.--
                    (A) In general.--The term ``Indian tribe'' has the 
                meaning given the term in section 4 of the Indian Self 
                Determination and Education Assistance Act (25 U.S.C. 
                450b).
                    (B) Inclusions.--The term ``Indian tribe'', in a 
                case in which an intertribal consortium, tribal 
                organization, or Indian health center is authorized to 
                carry out 1 or more programs, services, functions, or 
                activities of an Indian tribe under this Act, includes 
                the intertribal consortium, tribal organization, or 
                Indian health center.
            (6) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (7) Substance abuse.--The term ``substance abuse'' 
        includes--
                    (A) the illegal use or abuse of a drug or an 
                inhalant; and
                    (B) the abuse of tobacco or a related product.

SEC. 103. PLANS.

    The Secretary, in cooperation with the Secretary of Labor, the 
Secretary of the Interior, the Secretary of Education, the Secretary of 
Housing and Urban Development, the Attorney General, and the Secretary 
of Transportation, as appropriate, shall, on receipt of a plan 
acceptable to the Secretary that is submitted by an Indian tribe, 
authorize the Indian tribe to carry out a demonstration project to 
coordinate, in accordance with the plan, the Indian behavioral health 
care programs of the Indian tribe in a manner that integrates the 
program services into a single, coordinated, comprehensive program that 
uses, to the extent necessary, an automated clinical information system 
to better manage administrative and clinical services, costs, and 
reporting requirements through the consolidation and integration of 
administrative and clinical functions.

SEC. 104. PROGRAMS AFFECTED.

    Programs that may be integrated in a demonstration project 
described in section 103 are--
            (1) an Indian behavioral health care program under which an 
        Indian tribe is eligible for the receipt of funds under a 
        statutory or administrative formula;
            (2) an Indian behavioral health care program under which an 
        Indian tribe is eligible for receipt of funds through 
        competitive or other grants, if--
                    (A)(i) the Indian tribe provides notice to the 
                appropriate agency regarding the intentions of the 
                Indian tribe to include the Indian behavioral health 
                care program in the plan that the Indian tribe submits 
                to the Secretary; and
                    (ii) the agency consents to the inclusion of the 
                grant in the plan; or
                    (B)(i) the Indian tribe elects to include the 
                Indian behavioral health care program in the plan; and
                    (ii) the administrative requirements contained in 
                the plan are essentially the same as the administrative 
                requirements applicable to a grant under the Indian 
                behavioral health care program; and
            (3) an Indian behavioral health care program under which an 
        Indian tribe is eligible to receive funds under any other 
        funding scheme.

SEC. 105. PLAN REQUIREMENTS.

    A plan of an Indian tribe submitted under section 103 shall--
            (1) identify the programs to be integrated;
            (2) be consistent with this title;
            (3) describe a comprehensive strategy that--
                    (A) identifies the full range of existing and 
                potential alcohol and substance abuse and mental health 
                treatment and prevention programs available on and near 
                the service area of the Indian tribe; and
                    (B) may include site and technology assessments and 
                any necessary computer hardware installation and 
                support;
            (4) describe the manner in which services are to be 
        integrated and delivered and the results expected under the 
        plan (including, if implemented, the manner and expected 
        results of implementation of an automated clinical information 
        system);
            (5) identify the projected expenditures under the plan in a 
        single budget;
            (6) identify the agency or agencies in the Indian tribe to 
        be involved in the delivery of the services integrated under 
        the plan;
            (7) identify any statutory provisions, regulations, 
        policies, or procedures that the Indian tribe requests be 
        waived in order to implement the plan; and
            (8) be approved by the governing body of the Indian tribe.

SEC. 106. PLAN REVIEW.

    (a) Consultation.--On receipt of a plan from an Indian tribe under 
section 103, the Secretary shall consult with--
            (1) the head of each Federal agency providing funds to be 
        used to implement the plan; and
            (2) the Indian tribe.
    (b) Identification of Waivers.--Each party consulting on the 
implementation of a plan under section 101 shall identify any waivers 
of statutory requirements or of Federal agency regulations, policies, 
or procedures that the party determines to be necessary to enable the 
Indian tribe to implement the plan.
    (c) Waivers.--Notwithstanding any other provision of law, the head 
of a Federal agency may waive any statutory requirement, regulation, 
policy, or procedure promulgated by the Federal agency that has been 
identified by the Indian tribe or the Federal agency under subsection 
(b) unless the head of the affected Federal agency determines that such 
a waiver is inconsistent with--
            (1) this title;
            (2) any statutory requirement applicable to the program to 
        be integrated under the plan that is specifically applicable to 
        Indian programs; and
            (3) any underlying statutory objective or purpose of a 
        program to be consolidated under the plan, to such a degree as 
        would render ineffectual activities funded under the program.

SEC. 107. PLAN APPROVAL.

    (a) In General.--Not later than 90 days after the date of receipt 
by the Secretary of a plan under section 103, the Secretary shall 
inform the Indian tribe that submitted the plan, in writing, of the 
approval or disapproval of the plan (including any request for a waiver 
that is made as part of the plan).
    (b) Disapproval.--
            (1) In general.--The Secretary may disapprove a plan if--
                    (A) the plan does not provide sufficient 
                information for the Secretary to adequately review the 
                plan for compliance with this title (including with 
                respect to information regarding the timing, 
                availability, and receipt of all program funding to be 
                consolidated or integrated);
                    (B) the plan does not comply with this title;
                    (C) the plan provides for the purchase, lease, 
                license, or training for, an automated clinical 
                information system, but the purchase, lease, license, 
                or training would require aggregate expenditures of 
                program funding at such a level as would render other 
program substantially ineffectual; or
                    (D)(i) the plan identifies waivers that cannot be 
                waived under section 106(c); and
                    (ii) the plan would be rendered substantially 
                ineffectual without the waivers.
            (2) Notice.--If a plan is disapproved under subsection (a), 
        the Secretary shall--
                    (A) inform the Indian tribe, in writing, of the 
                reasons for the disapproval; and
                    (B) provide the Indian tribe an opportunity--
                            (i) to amend and resubmit the plan; or
                            (ii) to petition the Secretary to 
                        reconsider the disapproval (including 
                        reconsidering the disapproval of any waiver 
                        requested by the Indian tribe).

SEC. 108. USE OF FUNDS FOR TECHNOLOGY.

    Notwithstanding any requirement applicable to an Indian behavioral 
health care program of an Indian tribe that is integrated under a 
demonstration project described in section 103, the Indian tribe may 
use funds made available under the program to purchase, lease, license, 
or provide training for technology for an automated clinical 
information system if the purchase, lease, licensing of, or provision 
of training is conducted in accordance with a plan approved by the 
Secretary under section 106.

SEC. 109. FEDERAL RESPONSIBILITIES.

    (a) Responsibilities of the Indian Health Service.--
            (1) Memorandum of understanding.--Not later than 180 days 
        after the date of enactment of this Act, the Secretary, the 
        Secretary of the Interior, the Secretary of Labor, the 
        Secretary of Education, the Secretary of Housing and Urban 
        Development, the Attorney General, and the Secretary of 
        Transportation shall enter into a memorandum of agreement 
        providing for the implementation of the plans approved under 
        section 107.
            (2) Coordinating agency.--The coordinating agency under 
        this title shall be the Indian Health Service.
            (3) Responsibilities.--The responsibilities of the 
        coordinating agency under this title shall include--
                    (A) the development of a single reporting format--
                            (i) relating to each plan for a 
                        demonstration project submitted under section 
                        103, which shall be used by an Indian tribe to 
                        report activities carried out under the plan; 
                        and
                            (ii) relating to the projected expenditures 
                        for the individual plan, which shall be used by 
                        an Indian tribe to report all plan 
                        expenditures;
                    (B) the development of a single system of Federal 
                oversight for the plan, which shall be implemented by 
                the coordinating agency;
                    (C) the provision of, or arrangement for provision 
                of, technical assistance to an Indian tribe that is 
                appropriate to support and implement the plan, 
                delivered under an arrangement subject to the approval 
                of the Indian tribe participating in the project 
                (except that an Indian tribe shall have the authority 
                to accept or reject the plan for providing the 
                technical assistance and the technical assistance 
                provider); and
                    (D) the convening by an appropriate official of the 
                coordinating agency (who shall be an official appointed 
                by and with the advice and consent of the Senate) and a 
                representative of the Indian tribes that carry out 
                projects under this title, in consultation with each of 
                the Indian tribes that participate in projects under 
                this title, of a meeting at least twice during each 
                fiscal year, for the purpose of providing an 
                opportunity for all Indian tribes that carry out 
                projects under this title to discuss issues relating to 
                the implementation of this title with officials of each 
                agency specified in paragraph (1).
    (b) Report Requirements.--
            (1) In general.--The single reporting format described in 
        subsection (a)(3)(A) shall be developed by the Secretary in 
        accordance with this title.
            (2) Information.--The single reporting format, together 
        with records maintained on the consolidated program at the 
        tribal level, shall contain such information as the Secretary 
        determines will--
                    (A) allow the Secretary to determine whether the 
                Indian tribe has complied with the requirements 
                incorporated in the approved plan of the Indian tribe; 
                and
                    (B) provide assurances to the Secretary that the 
                Indian tribe has complied with all--
                            (i) applicable statutory requirements; and
                            (ii) applicable regulatory requirements 
                        that have not been waived.

SEC. 110. NO REDUCTION IN AMOUNTS.

    In no case shall the amount of Federal funds available to an Indian 
tribe involved in any project under this title be reduced as a result 
of the enactment of this title.

SEC. 111. INTERAGENCY FUND TRANSFERS.

    The Secretary, the Secretary of the Interior, the Secretary of 
Labor, the Secretary of Education, the Secretary of Housing and Urban 
Development, the Attorney General, or the Secretary of Transportation, 
as appropriate, may take such action as is necessary to provide for the 
interagency transfer of funds otherwise available to an Indian tribe in 
order to carry out this title.

SEC. 112. ADMINISTRATION OF FUNDS; EXCESS FUNDS.

    (a) Administration of Funds.--
            (1) In general.--Program funds shall be administered under 
        this title in such a manner as to allow for a determination by 
        the Secretary that funds made available for specific programs 
        (or an amount equal to the amount used from each program) are 
        expended on activities authorized under the program.
            (2) Separate records not required.--Nothing in this section 
        requires an Indian tribe--
                    (A) to maintain separate records tracing any 
                service provided or activity conducted under the 
                approved plan of the Indian tribe to the individual 
                programs under which funds were authorized; or
                    (B) to allocate expenditures among individual 
                programs.
    (b) Excess Funds.--With respect to administrative costs of carrying 
out the approved plan of an Indian tribe under this title--
            (1) all administrative costs under the approved plan may be 
        commingled;
            (2) an Indian tribe that carries out a demonstration 
        program under such an approved plan shall be entitled to 
        receive reimbursement for the full amount of those costs in 
        accordance with regulations of each program or department; and
            (3) if the Indian tribe, after paying administrative costs 
        associated with carrying out the approved plans, realizes 
        excess administrative funds, those funds shall not be counted 
        for Federal audit purposes if the excess funds are used for the 
        purposes provided for under this title.

SEC. 113. FISCAL ACCOUNTABILITY.

    Nothing in this title affects the authority of the Secretary or the 
coordinating agency to safeguard Federal funds in accordance with 
chapter 75 of title 31, United States Code.

SEC. 114. REPORT ON STATUTORY AND OTHER BARRIERS TO INTEGRATION.

    (a) Preliminary Report.--Not later than 2 years after the date of 
enactment of this Act, the Secretary shall submit to the Committee on 
Indian Affairs of the Senate and the Committee on Resources of the 
House of Representatives a preliminary report that describes the 
implementation of this title.
    (b) Final Report.--Not later than 5 years after the date of 
enactment of this Act, the Secretary shall submit to the Committee on 
Indian Affairs of the Senate and the Committee on Resources of the 
House of Representatives a final report that--
            (1) describes the results of implementation of this title; 
        and
            (2) identifies statutory barriers to the ability of Indian 
        tribes to integrate more effectively alcohol and substance 
        abuse services in a manner consistent with this title.

SEC. 115. ASSIGNMENT OF FEDERAL PERSONNEL TO STATE INDIAN ALCOHOL AND 
              DRUG TREATMENT OR MENTAL HEALTH PROGRAMS.

    Any State with an alcohol and substance abuse or mental health 
program targeted toward Indian tribes shall be eligible to receive, at 
no cost to the State, such Federal personnel assignments as the 
Secretary, in accordance with the applicable provisions of subchapter 
IV of chapter 33 of title 5, United States Code, determines to be 
appropriate to help ensure the success of the program.

TITLE II--REAUTHORIZATION OF CERTAIN INDIAN ALCOHOL AND SUBSTANCE ABUSE 
                   PREVENTION AND TREATMENT PROGRAMS

SEC. 201. INDIAN ALCOHOL AND SUBSTANCE ABUSE PREVENTION AND TREATMENT 
              ACT OF 1986.

    (a) Tribal Action Plans.--
            (1) In general.--Section 4206(d) of the Indian Alcohol and 
        Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C. 
        2412(d)) is amended--
                    (A) by striking ``(1) The Secretary'' and inserting 
                the following:
            ``(1) In general.--The Secretary''; and
                    (B) by striking paragraph (2) and inserting the 
                following:
            ``(2) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this subsection such 
        sums as are necessary for each of fiscal years 2004 through 
        2008.''.
            (2) Additional authorization.--Section 4206(f) of the 
        Indian Alcohol and Substance Abuse Prevention and Treatment Act 
        of 1986 (25 U.S.C. 2412(f)), is amended--
                    (A) by striking ``(f)(1) The Secretary'' and 
                inserting the following:
    ``(f) Grants for In-School Training Programs.--
            ``(1) In general.--The Secretary'';
                    (B) in paragraph (2)--
                            (i) by striking ``(2) Funds'' and inserting 
                        the following:
            ``(2) Use of funds.--Funds''; and
                            (ii) by indenting subparagraphs (A) through 
                        (E) appropriately; and
                    (C) by striking paragraph (3) and inserting the 
                following:
            ``(3) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this subsection such 
        sums as are necessary for each of fiscal years 2004 through 
        2008.''.
    (b) Newsletter.--Section 4210 of the Indian Alcohol and Substance 
Abuse Prevention and Treatment Act of 1986 (25 U.S.C. 2416) is amended 
by striking subsection (b) and inserting the following:
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as are necessary for 
each of fiscal years 2004 through 2008.''.
    (c) Indian Education Programs.--Section 4212(a) of the Indian 
Alcohol and Substance Abuse Prevention and Treatment Act of 1986 (25 
U.S.C. 2432(a)) is amended--
            (1) in the first sentence, by striking ``The Assistant 
        Secretary of Indian Affairs'' and inserting the following:
            ``(1) In general.--The Assistant Secretary of Indian 
        Affairs'';
            (2) in the second sentence, by striking ``The Assistant 
        Secretary shall'' and inserting the following:
            ``(2) Defrayment of costs.--The Assistant Secretary 
        shall''; and
            (3) by striking the third sentence and inserting the 
        following:
            ``(3) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this subsection such 
        sums as are necessary for each of fiscal years 2004 through 
        2008.''.
    (d) Emergency Shelters.--Section 4213(e) of the Indian Alcohol and 
Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C. 
2433(e)) is amended--
            (1) by striking paragraphs (1) through (3) and inserting 
        the following:
            ``(1) In general.--There are authorized to be appropriated 
        to carry out planning and design, construction, and renovation 
        of, or to purchase or lease land or facilities for, emergency 
        shelters and halfway houses to provide emergency care for 
        Indian youth, such sums as are necessary for each of fiscal 
        years 2004 through 2008.
            ``(2) Staffing and operation.--There is authorized to be 
        appropriated for staffing and operation of emergency shelters 
        and halfway houses, described in paragraph (1), $7,000,000 for 
        each of fiscal years 2004 through 2008.
            ``(3) Allocation.--
                    ``(A) In general.--The Secretary of the Interior 
                shall allocate funds made available under this 
                subsection to Indian tribes on the basis of priority of 
                need of the Indian tribes.
                    ``(B) Contracting and grants.--Funds allocated 
                under subparagraph (A) shall be subject to contracting 
                or available for grants under the Indian Self-
                Determination Act (25 U.S.C. 450f et seq.).'';
            (2) in paragraph (4), by striking ``(4) Funds'' and 
        inserting the following:
            ``(4) Conditions for use.--Funds''; and
            (3) in paragraph (5)--
                    (A) by striking ``(5) Nothing in this Act may be 
                construed'' and inserting the following:
            ``(5) Effect on other authority.--Nothing in this Act'';
                    (B) in subparagraph (A)--
                            (i) by striking ``to limit'' and inserting 
                        ``limits''; and
                            (ii) by striking ``houses, or'' and 
                        inserting ``houses; or''; and
                    (C) in subparagraph (B), by striking ``to require'' 
                and inserting ``requires''.
    (e) Tohono O'Odham and St. Regis Reservations; Illegal Narcotics 
Traffic.--Section 4216(a) of the Indian Alcohol and Substance Abuse 
Prevention and Treatment Act of 1986 (25 U.S.C. 2442(a)) is amended by 
striking paragraph (3) and inserting the following:
            ``(3) Authorization of appropriations.--There is authorized 
        to be appropriated--
                    ``(A) to carry out paragraph (1)(A), $1,000,000 for 
                each of fiscal years 2004 through 2008; and
                    ``(B) to carry out provisions of this subsection 
                other than paragraph (1)(A), such sums as are necessary 
                for each of fiscal years 2004 through 2008.''.
    (f) Bureau of Indian Affairs Law Enforcement and Judicial 
Training.--Section 4218 of the Indian Alcohol and Substance Abuse 
Prevention and Treatment Act of 1986 (25 U.S.C. 2451) is amended by 
striking subsection (b) and inserting the following:
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as are necessary for 
each of fiscal years 2004 through 2008.''.
    (g) Juvenile Detention Centers.--Section 4220 of the Indian Alcohol 
and Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C. 
2453) is amended by striking subsection (b) and inserting the 
following:
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as are necessary for 
each of fiscal years 2004 through 2008.''.

SEC. 202. EFFECTIVE DATE.

    This title and the amendments made by this title take effect on the 
date of enactment of this Act.




                                                       Calendar No. 143

108th CONGRESS

  1st Session

                                 S. 285

                          [Report No. 108-75]

_______________________________________________________________________

                                 A BILL

To authorize the integration and consolidation of alcohol and substance 
abuse programs and services provided by Indian tribal governments, and 
                          for other purposes.

_______________________________________________________________________

                             June 18, 2003

                       Reported with an amendment