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<dublinCore>
<dc:title>110 HR 1328 RH: Indian Health Care Improvement Act Amendments
</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2008-06-06</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
	<form>
		<distribution-code display="yes">IB</distribution-code>
		<calendar display="yes">Union Calendar No. 444</calendar>
		<congress display="yes">110th CONGRESS</congress>
		<session display="yes">2d Session</session>
		<legis-num>H. R. 1328</legis-num>
		<associated-doc display="yes" role="report">[Report No. 110–564, Part
		  I]</associated-doc>
		<current-chamber display="yes">IN THE HOUSE OF
		  REPRESENTATIVES</current-chamber>
		<action>
			<action-date date="20070306">March 6, 2007</action-date>
			<action-desc><sponsor name-id="P000034">Mr. Pallone</sponsor> (for
			 himself, <cosponsor name-id="R000011">Mr. Rahall</cosponsor>,
			 <cosponsor name-id="Y000033">Mr. Young of Alaska</cosponsor>,
			 <cosponsor name-id="K000172">Mr. Kildee</cosponsor>,
			 <cosponsor name-id="M000725">Mr. George Miller of California</cosponsor>,
			 <cosponsor name-id="F000010">Mr. Faleomavaega</cosponsor>,
			 <cosponsor name-id="C000380">Mrs. Christensen</cosponsor>,
			 <cosponsor name-id="G000551">Mr. Grijalva</cosponsor>,
			 <cosponsor name-id="B001254">Mr. Boren</cosponsor>,
			 <cosponsor name-id="H000627">Mr. Hinchey</cosponsor>,
			 <cosponsor name-id="K000113">Mr. Kennedy</cosponsor>,
			 <cosponsor name-id="K000188">Mr. Kind</cosponsor>, <cosponsor name-id="I000026">Mr. Inslee</cosponsor>, <cosponsor name-id="B001234">Mr.
			 Baca</cosponsor>, <cosponsor name-id="U000039">Mr. Udall of New
			 Mexico</cosponsor>, <cosponsor name-id="R000574">Mr. Renzi</cosponsor>,
			 <cosponsor name-id="W000793">Mr. Wu</cosponsor>, <cosponsor name-id="C000714">Mr. Conyers</cosponsor>, <cosponsor name-id="O000006">Mr.
			 Oberstar</cosponsor>, <cosponsor name-id="T000460">Mr. Thompson of
			 California</cosponsor>, <cosponsor name-id="W000215">Mr. Waxman</cosponsor>,
			 <cosponsor name-id="C001053">Mr. Cole of Oklahoma</cosponsor>,
			 <cosponsor name-id="B000652">Mr. Boswell</cosponsor>,
			 <cosponsor name-id="H001037">Ms. Herseth</cosponsor>,
			 <cosponsor name-id="E000179">Mr. Engel</cosponsor>,
			 <cosponsor name-id="K000365">Mr. Kagen</cosponsor>,
			 <cosponsor name-id="B001245">Ms. Bordallo</cosponsor>,
			 <cosponsor name-id="B001228">Mrs. Bono</cosponsor>,
			 <cosponsor name-id="M000933">Mr. Moran of Virginia</cosponsor>,
			 <cosponsor name-id="M000404">Mr. McDermott</cosponsor>,
			 <cosponsor name-id="H001034">Mr. Honda</cosponsor>,
			 <cosponsor name-id="F000116">Mr. Filner</cosponsor>,
			 <cosponsor name-id="M000508">Mr. McKeon</cosponsor>, and
			 <cosponsor name-id="S001153">Ms. Solis</cosponsor>) introduced the following
			 bill; which was referred to the
			 <committee-name added-display-style="italic" committee-id="HII00" deleted-display-style="strikethrough">Committee on Natural
			 Resources</committee-name>, and in addition to the Committees on
			 <committee-name committee-id="HIF00">Energy and Commerce</committee-name> and
			 <committee-name committee-id="HWM00">Ways and Means</committee-name>, for a
			 period to be subsequently determined by the Speaker, in each case for
			 consideration of such provisions as fall within the jurisdiction of the
			 committee concerned</action-desc>
		</action>
		<action>
			<action-date date="20080404">April 4, 2008</action-date>
			<action-desc>Reported from the
			 <committee-name added-display-style="italic" committee-id="HII00" deleted-display-style="strikethrough">Committee on Natural
			 Resources</committee-name> with an amendment</action-desc>
			<action-instruction>Strike out all after the enacting clause and insert
			 the part printed in italic</action-instruction>
		</action>
		<action>
			<action-date date="20080404">April 4, 2008</action-date>
			<action-desc>Referral to the Committees on
			 <committee-name committee-id="HIF00">Energy and Commerce</committee-name> and
			 <committee-name committee-id="HWM00">Ways and Means</committee-name> extended
			 for a period ending not later than June 6, 2008 </action-desc>
		</action>
		<action>
			<action-date date="20080606">June 6, 2008</action-date>
			<action-desc>Additional sponsors: <cosponsor name-id="U000038">Mr.
			 Udall of Colorado</cosponsor>, <cosponsor name-id="A000357">Mr.
			 Allen</cosponsor>, <cosponsor name-id="W000791">Mr. Walden of
			 Oregon</cosponsor>, <cosponsor name-id="B000410">Mr. Berman</cosponsor>,
			 <cosponsor name-id="L000397">Ms. Zoe Lofgren of California</cosponsor>,
			 <cosponsor name-id="S001156">Ms. Linda T. Sánchez of California</cosponsor>,
			 <cosponsor name-id="L000557">Mr. Larson of Connecticut</cosponsor>,
			 <cosponsor name-id="C001036">Mrs. Capps</cosponsor>,
			 <cosponsor name-id="W000789">Mrs. Wilson of New Mexico</cosponsor>,
			 <cosponsor name-id="M001147">Mr. McCotter</cosponsor>,
			 <cosponsor name-id="M001167">Mr. Mitchell</cosponsor>,
			 <cosponsor name-id="H000636">Mr. Hinojosa</cosponsor>,
			 <cosponsor name-id="M001149">Mr. Michaud</cosponsor>,
			 <cosponsor name-id="G000309">Mr. Gordon of Tennessee</cosponsor>,
			 <cosponsor name-id="D000197">Ms. DeGette</cosponsor>,
			 <cosponsor name-id="GPOC000999">Ms. Carson</cosponsor>,
			 <cosponsor name-id="C001037">Mr. Capuano</cosponsor>,
			 <cosponsor name-id="B000574">Mr. Blumenauer</cosponsor>,
			 <cosponsor name-id="M001142">Mr. Matheson</cosponsor>,
			 <cosponsor name-id="P000258">Mr. Peterson of Minnesota</cosponsor>,
			 <cosponsor name-id="B001230">Ms. Baldwin</cosponsor>,
			 <cosponsor name-id="W000799">Mr. Walz of Minnesota</cosponsor>,
			 <cosponsor name-id="P000588">Mr. Pearce</cosponsor>,
			 <cosponsor name-id="M001137">Mr. Meeks of New York</cosponsor>, and
			 <cosponsor name-id="S001158">Mr. Salazar</cosponsor></action-desc>
		</action>
		<action>
			<action-date date="20080606">June 6, 2008</action-date>
			<action-desc> Committees on <committee-name committee-id="HIF00">Energy
			 and Commerce</committee-name> and <committee-name committee-id="HWM00">Ways and
			 Means</committee-name> discharged; committed to the Committee of the Whole
			 House on the State of the Union and ordered to be printed</action-desc>
			<action-instruction>For text of introduced bill, see copy of bill as
			 introduced on March 6, 2007</action-instruction>
		</action>
		<legis-type>A BILL</legis-type>
		<official-title display="yes">To amend the Indian Health Care Improvement
		  Act to revise and extend that Act.</official-title>
	</form>
	<legis-body changed="added" committee-id="HII00" display-enacting-clause="yes-display-enacting-clause" id="H18E0DE7C823D447FA7835045B8691C22" reported-display-style="italic" style="OLC">
		<section display-inline="no-display-inline" id="H9BD18E105A8641C298574C857881689D" section-type="section-one"><enum>1.</enum><header>Short title; table of
			 contents</header>
			<subsection id="H93632C2DF6654F67AA1915DD99B00000"><enum>(a)</enum><header>Short
			 title</header><text display-inline="yes-display-inline">This Act may be cited
			 as the <quote><short-title>Indian Health Care Improvement
			 Act Amendments of 2007</short-title></quote>.</text>
			</subsection><subsection commented="no" id="HD31F1303D5164A70B621857467B4BFC3"><enum>(b)</enum><header>Table of
			 contents</header><text>The table of contents of this Act is as follows:</text>
				<toc changed="added" committee-id="HII00" reported-display-style="italic">
					<toc-entry level="section">Sec. 1. Short title; table of
				contents.</toc-entry>
					<toc-entry idref="H032A4B7BA34F4C958EF5AB1F56D93202" level="title">TITLE I—Amendments to Indian laws</toc-entry>
					<toc-entry idref="H08B33438BE49486BB3B57290E4231F8C" level="section">Sec. 101. <act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>
				amended.</toc-entry>
					<toc-entry idref="H338773E6E9A54EE6BC8DEB8C78F07271" level="section">Sec. 102. Soboba sanitation
				facilities.</toc-entry>
					<toc-entry idref="H8E2971DAC79043BEA449BAD799CE2B03" level="section">Sec. 103. Native American Health and Wellness
				Foundation.</toc-entry>
					<toc-entry idref="H1E0C0CAF19D941A8829BC53829D295CC" level="title">TITLE II—Improvement of Indian Health Care
				Provided Under the Social Security Act </toc-entry>
					<toc-entry idref="H73EEBF30936C4B148BBBAC742BC2452" level="section">Sec. 201. Expansion of payments
				under Medicare, Medicaid, and SCHIP for all covered services furnished by
				Indian Health Programs.</toc-entry>
					<toc-entry idref="H4050E4F7C27F405F8CF9339738802230" level="section">Sec. 202. Increased outreach to Indians under
				Medicaid and SCHIP and improved cooperation in the provision of items and
				services to Indians under Social Security Act health benefit
				programs.</toc-entry>
					<toc-entry idref="HCB18F5AF31214F4BA44CF2F86755B4C2" level="section">Sec. 203. Additional provisions to increase
				outreach to, and enrollment of, Indians in SCHIP and Medicaid.</toc-entry>
					<toc-entry idref="H4AE82B5E8FFE4A89A6E4CC3417F05BB0" level="section">Sec. 204. Premiums and cost sharing protections
				under Medicaid, eligibility determinations under Medicaid and SCHIP, and
				protection of certain Indian property from Medicaid estate
				recovery.</toc-entry>
					<toc-entry idref="H1CB1083C7A3D47FD8DFB93D07EAD8FC4" level="section">Sec. 205. Nondiscrimination in qualifications
				for payment for services under Federal health care programs.</toc-entry>
					<toc-entry idref="HDB8B6FB0F1D947A892B66EE5AED88981" level="section">Sec. 206. Consultation on Medicaid, SCHIP, and
				other health care programs funded under the Social Security Act involving
				Indian Health Programs and Urban Indian Organizations.</toc-entry>
					<toc-entry idref="H28127B0333B44CDFA59509D4EC44CC1E" level="section">Sec. 207. Exclusion waiver authority for
				affected Indian Health Programs and safe harbor transactions under the Social
				Security Act.</toc-entry>
					<toc-entry idref="HFAC89C5EEF66473CA21DC7E8E2DE5147" level="section">Sec. 208. Rules applicable under Medicaid and
				SCHIP to managed care entities with respect to Indian enrollees and Indian
				health care providers and Indian managed care entities.</toc-entry>
					<toc-entry idref="HBD48078C96E9449BAB5C47A3017498D6" level="section">Sec. 209. Annual report on Indians served by
				Social Security Act health benefit programs.</toc-entry>
				</toc>
			</subsection></section><section id="H1E634897FC2F4E3A8ECE9762E5BF4D35"><enum>2.</enum><header>Report on third-party
			 payment collections</header>
			<subsection id="H6FCDE9D8612844B19FF0B38D3C00717E"><enum>(a)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services
			 shall conduct a thorough study of the system of third-party payment collections
			 for items and services furnished through the Indian Health Service.</text>
			</subsection><subsection id="H72034912DD144AF690F79F8ECDE274B"><enum>(b)</enum><header>Report</header><text>Not
			 later than 6 months after the date of the enactment of this Act, the Secretary
			 shall submit to each House of Congress a report on such study. Such report
			 shall include such recommendations on how to improve such third-party payment
			 collections as the Secretary determines appropriate.</text>
			</subsection></section><title id="H032A4B7BA34F4C958EF5AB1F56D93202"><enum>I</enum><header>Amendments to Indian
			 laws</header>
			<section id="H08B33438BE49486BB3B57290E4231F8C"><enum>101.</enum><header><act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>
			 amended</header>
				<subsection id="H347BC382D0124EC8954BAFAFD858008B"><enum>(a)</enum><header>In
			 general</header><text display-inline="yes-display-inline">The
			 <act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>
			 (<external-xref legal-doc="usc" parsable-cite="usc/25/1601">25 U.S.C. 1601 et seq.</external-xref>) is amended to read as follows:</text>
					<quoted-block act-name="Indian Health Care Improvement Act" changed="added" committee-id="HII00" id="HC8B0C454F1644B25A265859B436D4600" reported-display-style="italic" style="OLC">
						<section id="H89EC92CF4329426AB7466445555B21EE" section-type="section-one"><enum>1.</enum><header>Short title; table of
				contents</header>
							<subsection id="HE7E6AED4483647598D00CA2BDF007040"><enum>(a)</enum><header>Short
				title</header><text>This Act may be cited as the <quote><act-name parsable-cite="IHCIA">Indian
				Health Care Improvement Act</act-name></quote>.</text>
							</subsection><subsection id="HABC6B2BD940F46B688AD25B0D4FCA601"><enum>(b)</enum><header>Table of
				Contents</header><text>The table of contents for this Act is as follows:</text>
								<toc changed="added" committee-id="HII00" container-level="quoted-block-container" idref="HC8B0C454F1644B25A265859B436D4600" lowest-bolded-level="division-lowest-bolded" lowest-level="section" quoted-block="no-quoted-block" regeneration="yes-regeneration" reported-display-style="italic">
									<toc-entry idref="H89EC92CF4329426AB7466445555B21EE" level="section">Sec. 1. Short title; table of
				  contents.</toc-entry>
									<toc-entry idref="H70DD65E418E34D898D5857E9429CE87" level="section">Sec. 2. Findings.</toc-entry>
									<toc-entry idref="H9B94626728054E8283091FDB8FA39DC" level="section">Sec. 3. Declaration of national
				  Indian health policy.</toc-entry>
									<toc-entry idref="H7D1781FD852A429B8980FB43C5811B73" level="section">Sec. 4. Definitions.</toc-entry>
									<toc-entry idref="HC0FC6C4D1202481687008769A197B8EE" level="title">Title I—Indian health, human resources, and
				  development</toc-entry>
									<toc-entry idref="H6A7DFF8B9DBE42E68ECDD3ABADF0FF92" level="section">Sec. 101. Purpose.</toc-entry>
									<toc-entry idref="H9715FFEF6FE444E5A621EAFF4D7CB62D" level="section">Sec. 102. Health professions recruitment
				  program for Indians.</toc-entry>
									<toc-entry idref="HC675BB51E0754701BF4C9DF4310053BE" level="section">Sec. 103. Health professions preparatory
				  scholarship program for Indians.</toc-entry>
									<toc-entry idref="HC5EB2CB12AB24123AED840F1F118AD00" level="section">Sec. 104. Indian health professions
				  scholarships.</toc-entry>
									<toc-entry idref="H4491C87EBF2E42D9BEC82878FBF8DA24" level="section">Sec. 105. American Indians Into Psychology
				  Program.</toc-entry>
									<toc-entry idref="H894B9C75CADC461797192BBC68EAE602" level="section">Sec. 106. Scholarship programs for Indian
				  Tribes.</toc-entry>
									<toc-entry idref="H6AAC9A367ACB431CA27E2D9EB35CE033" level="section">Sec. 107. Indian Health Service extern
				  programs.</toc-entry>
									<toc-entry idref="H584652FF833A4AF7A1E9808429D67521" level="section">Sec. 108. Continuing education
				  allowances.</toc-entry>
									<toc-entry idref="HE96577A875BD420C97AB91B069B7C4C2" level="section">Sec. 109. Community Health Representative
				  Program.</toc-entry>
									<toc-entry idref="H64CEA50064704058BEC0ABFB105687D8" level="section">Sec. 110. Indian Health Service Loan Repayment
				  Program.</toc-entry>
									<toc-entry idref="H39951B6EA9BD442496D9020020727D92" level="section">Sec. 111. Scholarship and Loan Repayment
				  Recovery Fund.</toc-entry>
									<toc-entry idref="H7A91189698AE44DDBA6DF0501EFAC324" level="section">Sec. 112. Recruitment activities.</toc-entry>
									<toc-entry idref="HF4EA795E03DE4779B1075DC9DD560000" level="section">Sec. 113. Indian recruitment and retention
				  program.</toc-entry>
									<toc-entry idref="HF4817CC293194540883B83A46DD7C0FB" level="section">Sec. 114. Advanced training and
				  research.</toc-entry>
									<toc-entry idref="H2AA7ACA5E3D842218FA10337AA9E13B4" level="section">Sec. 115. Quentin N. Burdick American Indians
				  Into Nursing Program.</toc-entry>
									<toc-entry idref="HB64430576CA44CECB3F381FA3EC616E8" level="section">Sec. 116. Tribal cultural
				  orientation.</toc-entry>
									<toc-entry idref="HD331734C13564E3D98B0F06200586811" level="section">Sec. 117. INMED Program.</toc-entry>
									<toc-entry idref="HCEA510788D2C4E2988A076A286DB4C53" level="section">Sec. 118. Health training programs of community
				  colleges.</toc-entry>
									<toc-entry idref="HD7B6A0A87573482C9269E05BFC005F4B" level="section">Sec. 119. Retention bonus.</toc-entry>
									<toc-entry idref="H7FBB09F3229B44B38930F64415292DC7" level="section">Sec. 120. Nursing residency
				  program.</toc-entry>
									<toc-entry idref="H84FD0D55F3F14767B8867518CF1C2F31" level="section">Sec. 121. Community Health Aide
				  Program.</toc-entry>
									<toc-entry idref="HDE0D1B82BF2F4D9C838B3C3276D45507" level="section">Sec. 122. Tribal Health Program
				  administration.</toc-entry>
									<toc-entry idref="HA1FE737A18B14904B0C1315BDA108203" level="section">Sec. 123. Health professional chronic shortage
				  demonstration programs.</toc-entry>
									<toc-entry idref="HAE97E4C7A7744015B2B323F9F93FD42" level="section">Sec. 124. National Health
				  Service Corps.</toc-entry>
									<toc-entry idref="H2DFC74098FE2441ABAA6197D9CDA35F9" level="section">Sec. 125. Substance abuse counselor educational
				  curricula demonstration programs.</toc-entry>
									<toc-entry idref="HA4AF960FE56647C1A9DE45E6C7B183FB" level="section">Sec. 126. Behavioral health training and
				  community education programs.</toc-entry>
									<toc-entry idref="H29EE90EE5B6D4A5B96328FD1B0E4E2E9" level="section">Sec. 127. Authorization of
				  appropriations.</toc-entry>
									<toc-entry idref="H38AC93D4232046329CB17CE18200805C" level="title">Title II—Health Services</toc-entry>
									<toc-entry idref="H12CEDF6BBEAF4450B9A9302D00261377" level="section">Sec. 201. Indian Health Care Improvement
				  Fund.</toc-entry>
									<toc-entry idref="HA9C6523618C443A29E740053C589F203" level="section">Sec. 202. Catastrophic Health Emergency
				  Fund.</toc-entry>
									<toc-entry idref="HB92C041A376E442EBE7DF3B803B67ED" level="section">Sec. 203. Health promotion and
				  disease prevention services.</toc-entry>
									<toc-entry idref="HC717747DDB3546D9B2FBA2EC4F99A7F1" level="section">Sec. 204. Diabetes prevention, treatment, and
				  control.</toc-entry>
									<toc-entry idref="H5B15558FF0F34CF8AD2DA959BBE032A6" level="section">Sec. 205. Shared services for long-term
				  care.</toc-entry>
									<toc-entry idref="H43FB13082C5E4693B7FF04FEBAF5BD8" level="section">Sec. 206. Health services
				  research.</toc-entry>
									<toc-entry idref="H08B6D4E367D04AF79B2683D6656E3959" level="section">Sec. 207. Mammography and other cancer
				  screening.</toc-entry>
									<toc-entry idref="H1600DA2C726940F792604C49360695D2" level="section">Sec. 208. Patient travel costs.</toc-entry>
									<toc-entry idref="H6EF8DBAAF67B414982E6FE0518BF983B" level="section">Sec. 209. Epidemiology centers.</toc-entry>
									<toc-entry idref="H2F0241D4894E489CACA9A7D8E57DC814" level="section">Sec. 210. Comprehensive school health education
				  programs.</toc-entry>
									<toc-entry idref="HA1BFAD0F940246DEB6F8F852D6A922B3" level="section">Sec. 211. Indian youth program.</toc-entry>
									<toc-entry idref="H5593F7B8578D4AAB9C5BDCB3CFBE395" level="section">Sec. 212. Prevention, control,
				  and elimination of communicable and infectious diseases.</toc-entry>
									<toc-entry idref="H202B53E05E2D4AC79C6B5C3D00708CFA" level="section">Sec. 213. Authority for provision of other
				  services.</toc-entry>
									<toc-entry idref="HDF21A1B9F9B8461CADAA8D8B001D7CEE" level="section">Sec. 214. Indian women’s health
				  care.</toc-entry>
									<toc-entry idref="H8147151810F54475A6FE37714F71E848" level="section">Sec. 215. Environmental and nuclear health
				  hazards.</toc-entry>
									<toc-entry idref="HCC09D43FDAD44C1AA7CA4DEE98E6B53" level="section">Sec. 216. Arizona as a contract
				  health service delivery area.</toc-entry>
									<toc-entry idref="HB89FF10683ED4C1DAB05906D00358C76" level="section">Sec. 217. North Dakota and South Dakota as
				  contract health service delivery area.</toc-entry>
									<toc-entry idref="H3DF49AF3E950494BB6027EAC1BD7105B" level="section">Sec. 218. California contract health services
				  program.</toc-entry>
									<toc-entry idref="HA0DDD20212BB46E7BC6E88A57357B301" level="section">Sec. 219. California as a contract health
				  service delivery area.</toc-entry>
									<toc-entry idref="H6F09705A273149C8BFAAD708E717889F" level="section">Sec. 220. Contract health services for the
				  Trenton Service Area.</toc-entry>
									<toc-entry idref="H674CB5EE45B74EA39D047F6EB5502132" level="section">Sec. 221. Programs operated by Indian Tribes
				  and Tribal Organizations.</toc-entry>
									<toc-entry idref="H3C43D16888FB4E4696D5EDD574581140" level="section">Sec. 222. Licensing.</toc-entry>
									<toc-entry idref="HB1D9F17B05144522B56B948EB3D673FA" level="section">Sec. 223. Notification of provision of
				  emergency contract health services.</toc-entry>
									<toc-entry idref="H9962CC84099A48E19F1155080092AFFD" level="section">Sec. 224. Prompt action on payment of
				  claims.</toc-entry>
									<toc-entry idref="H155793156F3A45B59700A3FE09C70915" level="section">Sec. 225. Liability for payment.</toc-entry>
									<toc-entry idref="H8A9728AFCA5840519694473BAFB3F325" level="section">Sec. 226. Office of Indian Men's
				  Health.</toc-entry>
									<toc-entry idref="HEF340CB60E8649449ED7FC5780C6C6F1" level="section">Sec. 227. Authorization of
				  appropriations.</toc-entry>
									<toc-entry idref="H8B46CE8C42224601A4CC1BA709B3DEDC" level="title">Title III—Facilities</toc-entry>
									<toc-entry idref="HEEF36B8D59E0495A8EF88CD49D457C6" level="section">Sec. 301. Consultation;
				  construction and renovation of facilities; reports.</toc-entry>
									<toc-entry idref="H915998DD62AA40D4B9039CDA07F41D1E" level="section">Sec. 302. Sanitation facilities.</toc-entry>
									<toc-entry idref="H50AB5BD98F964AA58983A1DE302076FC" level="section">Sec. 303. Preference to Indians and Indian
				  firms.</toc-entry>
									<toc-entry idref="HBC84B9C517C0446DB6B19560627E58E4" level="section">Sec. 304. Expenditure of non-Service funds for
				  renovation.</toc-entry>
									<toc-entry idref="HF9B9FD4262D94F19B5E0E300B4AAE7E4" level="section">Sec. 305. Funding for the construction,
				  expansion, and modernization of small ambulatory care facilities.</toc-entry>
									<toc-entry idref="H2B210CDA1CBE44F1BC45E8BD39D008C" level="section">Sec. 306. Indian health care
				  delivery demonstration project.</toc-entry>
									<toc-entry idref="H86D531D4AE74448B9EFDF2EAD3C36FFB" level="section">Sec. 307. Land transfer.</toc-entry>
									<toc-entry idref="H9F0E4FBC505048C79B64ADDC961BFB23" level="section">Sec. 308. Leases, contracts, and other
				  agreements.</toc-entry>
									<toc-entry idref="HE3B23397C45445C38F7D0195CD000287" level="section">Sec. 309. Study on loans, loan guarantees, and
				  loan repayment.</toc-entry>
									<toc-entry idref="H1FF96DCE7CC14F51B73FB6AC129FAFA2" level="section">Sec. 310. Tribal leasing.</toc-entry>
									<toc-entry idref="HE20CEE604FE240A4AD58F66F3C4840CC" level="section">Sec. 311. Indian Health Service/tribal
				  facilities joint venture program.</toc-entry>
									<toc-entry idref="HDA67EBA540894EB700D8E3113E9DC72" level="section">Sec. 312. Location of
				  facilities.</toc-entry>
									<toc-entry idref="HFAF46CECB8A442688115CB4BE198F1D6" level="section">Sec. 313. Maintenance and improvement of health
				  care facilities.</toc-entry>
									<toc-entry idref="H8A7AF554E9D34FD4B723E76239A11DD3" level="section">Sec. 314. Tribal management of federally-owned
				  quarters.</toc-entry>
									<toc-entry idref="H3274E1CF5D79458881181C390840EB43" level="section">Sec. 315. Applicability of
				  <act-name parsable-cite="BAA">Buy American Act</act-name>
				  requirement.</toc-entry>
									<toc-entry idref="H7036D3080E674E7B95AEFF36D989AAC0" level="section">Sec. 316. Other funding for
				  facilities.</toc-entry>
									<toc-entry idref="HD61EC3F7CF474047B9784785F0265D5" level="section">Sec. 317. Authorization of
				  appropriations.</toc-entry>
									<toc-entry idref="H2EC08E5764E84108919626DA90DB1B29" level="title">Title IV—Access to health services</toc-entry>
									<toc-entry idref="HE3BF1FF179694F44B9F288FF16636606" level="section">Sec. 401. Treatment of payments under
				  <act-name parsable-cite="SSA">Social Security Act</act-name> health benefits
				  programs.</toc-entry>
									<toc-entry idref="HCF1982BB69AA47E0AB2122C80059E6D0" level="section">Sec. 402. Grants to and contracts with the
				  Service, Indian Tribes, Tribal Organizations, and Urban Indian Organizations to
				  facilitate outreach, enrollment, and coverage of Indians under Social Security
				  Act health benefit programs and other health benefits programs.</toc-entry>
									<toc-entry idref="H2F525F4DD9CE45A90003B4E4155C661" level="section">Sec. 403. Reimbursement from
				  certain third parties of costs of health services.</toc-entry>
									<toc-entry idref="HF8F489675CE14499BE2F65839400AFA" level="section">Sec. 404. Crediting of
				  reimbursements.</toc-entry>
									<toc-entry idref="HCDAD584313C546E4B2DE35C86DC589A9" level="section">Sec. 405. Purchasing health care
				  coverage.</toc-entry>
									<toc-entry idref="HC4CE67D6BF824026AC926D5841D46826" level="section">Sec. 406. Sharing arrangements with Federal
				  agencies.</toc-entry>
									<toc-entry idref="H9E6724D3591D43F08484C874C8E907B1" level="section">Sec. 407. Payor of last resort.</toc-entry>
									<toc-entry idref="H5D5537DD3619439A9EC3027D93CCB326" level="section">Sec. 408. Nondiscrimination under Federal
				  health care programs in qualifications for reimbursement for
				  services.</toc-entry>
									<toc-entry idref="H25DCC99536B543C1968DCBBD4ED59FDF" level="section">Sec. 409. Consultation.</toc-entry>
									<toc-entry idref="H959DB0B120BD4F0EA690D89B0509BAB" level="section">Sec. 410. State Children's
				  Health Insurance Program (SCHIP).</toc-entry>
									<toc-entry idref="H4CA6BC4142344444BCE4D6CCD048836" level="section">Sec. 411. Exclusion waiver
				  authority for affected Indian Health Programs and safe harbor transactions
				  under the Social Security Act.</toc-entry>
									<toc-entry idref="H1F9162AAC8844414B93D00191FD85FCE" level="section">Sec. 412. Premium and cost sharing protections
				  and eligibility determinations under Medicaid and SCHIP and protection of
				  certain Indian property from Medicaid estate recovery.</toc-entry>
									<toc-entry idref="H02D357C3942644C997881402D1C051AB" level="section">Sec. 413. Treatment under Medicaid and SCHIP
				  managed care.</toc-entry>
									<toc-entry idref="HCB468071386A4460855124F0F45B4B94" level="section">Sec. 414. Navajo Nation Medicaid Agency
				  feasibility study.</toc-entry>
									<toc-entry idref="HDB5FE3A4DDF94E1393223ECA0710D9F4" level="section">Sec. 415. General exceptions.</toc-entry>
									<toc-entry idref="H82A2807E7515474F8EC5D63B1CD66200" level="section">Sec. 416. Authorization of
				  appropriations.</toc-entry>
									<toc-entry idref="H6851C0DBF35F4907A65762645B275731" level="title">Title V—Health services for Urban
				  Indians</toc-entry>
									<toc-entry idref="HACDDCBDDCE974DEBA615E64E3F9E12E0" level="section">Sec. 501. Purpose.</toc-entry>
									<toc-entry idref="H4AD84909E6ED43158D00122E00FA6F7F" level="section">Sec. 502. Contracts with, and grants to, Urban
				  Indian Organizations.</toc-entry>
									<toc-entry idref="HC2F7CDD654A541489CDA21620020B126" level="section">Sec. 503. Contracts and grants for the
				  provision of health care and referral services.</toc-entry>
									<toc-entry idref="H4C5C4BC166394B3DA66F51BDCD9E4549" level="section">Sec. 504. Contracts and grants for the
				  determination of unmet health care needs.</toc-entry>
									<toc-entry idref="H9D1644ADD1C14C7092F9D00C322CA3D" level="section">Sec. 505. Evaluations;
				  renewals.</toc-entry>
									<toc-entry idref="HA14BDE8AE11A49F88439749C6CC7D95B" level="section">Sec. 506. Other contract and grant
				  requirements.</toc-entry>
									<toc-entry idref="H8B82D515FA584BA2B741B0C73FDA2123" level="section">Sec. 507. Reports and records.</toc-entry>
									<toc-entry idref="H66364ADC12664A35BAE300260522FBCD" level="section">Sec. 508. Limitation on contract
				  authority.</toc-entry>
									<toc-entry idref="HCA4E293F92714752B6EDE646375E8155" level="section">Sec. 509. Facilities.</toc-entry>
									<toc-entry idref="HD119E30487814872B2D9BE27C2260852" level="section">Sec. 510. Division of Urban Indian
				  Health.</toc-entry>
									<toc-entry idref="H22C91CB2F14E4CB185BE003822726952" level="section">Sec. 511. Grants for alcohol and substance
				  abuse-related services.</toc-entry>
									<toc-entry idref="HC4CF351E67F148F8A0E9EA5987B79559" level="section">Sec. 512. Treatment of certain demonstration
				  projects.</toc-entry>
									<toc-entry idref="HDBE826FADFAB4011AB8C2057791365A3" level="section">Sec. 513. Urban NIAAA transferred
				  programs.</toc-entry>
									<toc-entry idref="H35B64385678947E08992BD641ED6A4C6" level="section">Sec. 514. Consultation with Urban Indian
				  Organizations.</toc-entry>
									<toc-entry idref="HA1DD93920F6A4D36A0D77D3BFDE5003B" level="section">Sec. 515. Urban youth treatment center
				  demonstration.</toc-entry>
									<toc-entry idref="HB1C4F65CF6FC4E22AB70E682EAC2057D" level="section">Sec. 516. Grants for diabetes prevention,
				  treatment, and control.</toc-entry>
									<toc-entry idref="H6EEAA27177B74282A84E5C6FA74B5543" level="section">Sec. 517. Community health
				  representatives.</toc-entry>
									<toc-entry idref="H4A8ECF18307D4E2897A6F9E6C09232F" level="section">Sec. 518. Effective
				  date.</toc-entry>
									<toc-entry idref="HC2D72D89B236467D00F5DEE1509F133F" level="section">Sec. 519. Eligibility for services.</toc-entry>
									<toc-entry idref="H421A3B67B44447A08FE44CD2B261DEF" level="section">Sec. 520. Authorization of
				  appropriations.</toc-entry>
									<toc-entry idref="H68E572909A864344B6A16BC3702D1D5D" level="title">Title VI—Organizational
				  improvements</toc-entry>
									<toc-entry idref="H3353D0EFE6D644F6B954840705487FFF" level="section">Sec. 601. Establishment of the Indian Health
				  Service as an agency of the Public Health Service.</toc-entry>
									<toc-entry idref="HE990B1235AB94E03ADF19E5536FDC0DC" level="section">Sec. 602. Automated management information
				  system.</toc-entry>
									<toc-entry idref="H077E53D0213D496FAC72AAF51C1CBE84" level="section">Sec. 603. Authorization of
				  appropriations.</toc-entry>
									<toc-entry idref="H1C35625D7BDF405D94000062F800E093" level="title">Title VII—Behavioral health
				  programs</toc-entry>
									<toc-entry idref="H3E46D697950244A883D058A6F126DA62" level="section">Sec. 701. Behavioral health prevention and
				  treatment services.</toc-entry>
									<toc-entry idref="H15AF39EC36A341D1A083E73C5458B99" level="section">Sec. 702. Memoranda of
				  agreement with the Department of the Interior.</toc-entry>
									<toc-entry idref="HDB66C4AA56334066A47DC055417C3C03" level="section">Sec. 703. Comprehensive behavioral health
				  prevention and treatment program.</toc-entry>
									<toc-entry idref="HC956226FF04548D4B7DD7F1DCB8500B0" level="section">Sec. 704. Mental health technician
				  program.</toc-entry>
									<toc-entry idref="HF6E8D124387847A99C97DEB8EA64EDE3" level="section">Sec. 705. Licensing requirement for mental
				  health care workers.</toc-entry>
									<toc-entry idref="H69644AF270724B9496E1E137522FB4EB" level="section">Sec. 706. Indian women treatment
				  programs.</toc-entry>
									<toc-entry idref="H87E6D793AFA149A4BA92CED1C22DB9F" level="section">Sec. 707. Indian youth
				  program.</toc-entry>
									<toc-entry idref="HFBAEC4339EBE4D86979439D8EBF52306" level="section">Sec. 708. Indian youth telemental health
				  demonstration project.</toc-entry>
									<toc-entry idref="HE682B898CE59474583F5A23F7927D464" level="section">Sec. 709. Inpatient and community-based mental
				  health facilities design, construction, and staffing.</toc-entry>
									<toc-entry idref="HEE5D0D734ABA4CFCB4F89B005700AB30" level="section">Sec. 710. Training and community
				  education.</toc-entry>
									<toc-entry idref="H2C0628BB92AF4990B0432543A86291C2" level="section">Sec. 711. Behavioral health
				  program.</toc-entry>
									<toc-entry idref="H64384E9989B843CDB89D5B61F65DFFF5" level="section">Sec. 712. Fetal alcohol disorder
				  programs.</toc-entry>
									<toc-entry idref="H00DC5AE3AD5C417997E19B84DF1F4FC6" level="section">Sec. 713. Child sexual abuse and prevention
				  treatment programs.</toc-entry>
									<toc-entry idref="H3B54670F7F3E4031AFD05C2D8C9C60C2" level="section">Sec. 714. Behavioral health
				  research.</toc-entry>
									<toc-entry idref="H9961AAD653CD4148BAC77C3BCDCECFC" level="section">Sec. 715. Definitions.</toc-entry>
									<toc-entry idref="H902EB842A0F54895A11890373D35355B" level="section">Sec. 716. Authorization of
				  appropriations.</toc-entry>
									<toc-entry idref="HA9588BAA38D24EAFAA647F97EB1B76C3" level="title">Title VIII—Miscellaneous</toc-entry>
									<toc-entry idref="HD452209416F04A50AFDD24BD7B13E709" level="section">Sec. 801. Reports.</toc-entry>
									<toc-entry idref="H39F73D3B0C304F0B917EC7614E77F2DE" level="section">Sec. 802. Regulations.</toc-entry>
									<toc-entry idref="HCF3224E6DEF94CAB99E0E9A9D606E521" level="section">Sec. 803. Plan of implementation.</toc-entry>
									<toc-entry idref="H932E0A4983F3448B852B1BD6BAE004E" level="section">Sec. 804. Availability of
				  funds.</toc-entry>
									<toc-entry idref="H40AC43D19556438F93FBCF9E528E0043" level="section">Sec. 805. Limitation on use of funds
				  appropriated to Indian Health Service.</toc-entry>
									<toc-entry idref="H0E74163F15F0405100B07D2C9F9FC22B" level="section">Sec. 806. Eligibility of California
				  Indians.</toc-entry>
									<toc-entry idref="HCAD439E817CB43F09EBB45C6A38D86DE" level="section">Sec. 807. Health services for ineligible
				  persons.</toc-entry>
									<toc-entry idref="HEB648E93A039419AAAA90587A2AACC9" level="section">Sec. 808. Reallocation of base
				  resources.</toc-entry>
									<toc-entry idref="HC7C71675C1A84F6EAF6B92E5AC7038BA" level="section">Sec. 809. Results of demonstration
				  projects.</toc-entry>
									<toc-entry idref="HAEF451F470E1456CA52C29163EB1D4F" level="section">Sec. 810. Provision of services
				  in Montana.</toc-entry>
									<toc-entry idref="HFBAC499C2D52484BB2C6416D94003150" level="section">Sec. 811. Moratorium.</toc-entry>
									<toc-entry idref="H0222E861D5F044189E60748C1C9F9239" level="section">Sec. 812. Severability provisions.</toc-entry>
									<toc-entry idref="H9980F771F6594CD1BCB5CD0064602462" level="section">Sec. 813. Establishment of National Bipartisan
				  Commission on Indian Health Care.</toc-entry>
									<toc-entry idref="H153D2272AFD549EAB68ED2A2B9E5EA66" level="section">Sec. 814. Confidentiality of medical quality
				  assurance records; qualified immunity for participants.</toc-entry>
									<toc-entry idref="H8C024D92F64D47779748C52BF09E03F" level="section">Sec. 815. Appropriations;
				  availability.</toc-entry>
									<toc-entry idref="H0511340702C44363A49673F5356B6409" level="section">Sec. 816. Authorization of
				  appropriations.</toc-entry>
								</toc>
							</subsection></section><section id="H70DD65E418E34D898D5857E9429CE87"><enum>2.</enum><header>Findings</header><text display-inline="no-display-inline">Congress makes the following
				findings:</text>
							<paragraph id="H6E2E07CB419448FA9BC97DD645005E8B"><enum>(1)</enum><text>Federal health services
				to maintain and improve the health of the Indians are consonant with and
				required by the Federal Government’s historical and unique legal relationship
				with, and resulting responsibility to, the American Indian people.</text>
							</paragraph><paragraph id="HF72398D8FEF44E2F87E73109DD2D06E"><enum>(2)</enum><text>A major national goal of
				the United States is to provide the quantity and quality of health services
				which will permit the health status of Indians to be raised to the highest
				possible level and to encourage the maximum participation of Indians in the
				planning and management of those services.</text>
							</paragraph><paragraph id="HF701D81607984D0D0075210024036200"><enum>(3)</enum><text>Federal health services
				to Indians have resulted in a reduction in the prevalence and incidence of
				preventable illnesses among, and unnecessary and premature deaths of,
				Indians.</text>
							</paragraph><paragraph id="H326D4E9197D34685AD566C2533402ECB"><enum>(4)</enum><text>Despite such services,
				the unmet health needs of the American Indian people are severe and the health
				status of the Indians is far below that of the general population of the United
				States.</text>
							</paragraph></section><section id="H9B94626728054E8283091FDB8FA39DC"><enum>3.</enum><header>Declaration of national
				Indian health policy</header><text display-inline="no-display-inline">Congress
				declares that it is the policy of this Nation, in fulfillment of its special
				trust responsibilities and legal obligations to Indians—</text>
							<paragraph id="HD26763D43E1B4D6D8B0055283F3C4B63"><enum>(1)</enum><text>to assure the highest
				possible health status for Indians and Urban Indians and to provide all
				resources necessary to effect that policy;</text>
							</paragraph><paragraph id="HE9AA8091146C400AAA01A592E003CAA"><enum>(2)</enum><text display-inline="yes-display-inline">to raise the health status of Indians and
				Urban Indians to at least the levels set forth in the goals contained within
				the Healthy People 2010 or successor objectives;</text>
							</paragraph><paragraph id="HAE365C4C84C14C90AC14D082C32EFCD"><enum>(3)</enum><text>to the greatest extent
				possible, to allow Indians to set their own health care priorities and
				establish goals that reflect their unmet needs;</text>
							</paragraph><paragraph id="HD107822F6FCE4D7AAACB65E845002C3C"><enum>(4)</enum><text>to increase the
				proportion of all degrees in the health professions and allied and associated
				health professions awarded to Indians so that the proportion of Indian health
				professionals in each Service Area is raised to at least the level of that of
				the general population;</text>
							</paragraph><paragraph id="HCB9EB542EC964E2B8DD637C7C45BD09B"><enum>(5)</enum><text>to require meaningful
				consultation with Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations to implement this Act and the national policy of Indian
				self-determination; and</text>
							</paragraph><paragraph id="HCF19CFD1701B41CEB92018080637CACC"><enum>(6)</enum><text>to provide funding for
				programs and facilities operated by Indian Tribes and Tribal Organizations in
				amounts that are not less than the amounts provided to programs and facilities
				operated directly by the Service.</text>
							</paragraph></section><section id="H7D1781FD852A429B8980FB43C5811B73"><enum>4.</enum><header>Definitions</header><text display-inline="no-display-inline">For purposes of this Act:</text>
							<paragraph id="H166103E4E0204B7A9F0658E4CBBD4117"><enum>(1)</enum><text>The term <term>accredited
				and accessible</term> means on or near a reservation and accredited by a
				national or regional organization with accrediting authority.</text>
							</paragraph><paragraph id="HBBABBBD2A4194E1799F94F878F96EEDF"><enum>(2)</enum><text>The term <term>Area
				Office</term> means an administrative entity, including a program office,
				within the Service through which services and funds are provided to the Service
				Units within a defined geographic area.</text>
							</paragraph><paragraph id="H914AA9F1F42648E4A3BE529B00D13D00"><enum>(3)</enum><text>The term <term>Assistant
				Secretary</term> means the Assistant Secretary of Indian Health.</text>
							</paragraph><paragraph id="H510CFE964C184AF8823D1E7000A0DFF7"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H7F30CB66471A466CA045BF88D54100B7"><enum>(A)</enum><text>The term
				<term>behavioral health</term> means the blending of substance (alcohol, drugs,
				inhalants, and tobacco) abuse and mental health prevention and treatment, for
				the purpose of providing comprehensive services.</text>
								</subparagraph><subparagraph changed="added" committee-id="HII00" id="H75264A065ED14687833B00EB89772029" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>The term <term>behavioral
				health</term> includes the joint development of substance abuse and mental
				health treatment planning and coordinated case management using a
				multidisciplinary approach.</text>
								</subparagraph></paragraph><paragraph id="H1CB75BCF1967485B85DCA47E178F2855"><enum>(5)</enum><text>The term <term>California
				Indians</term> means those Indians who are eligible for health services of the
				Service pursuant to section 806.</text>
							</paragraph><paragraph id="H2B2A740CEB6243598BA38B15FECA52A8"><enum>(6)</enum><text>The term <term>community
				college</term> means—</text>
								<subparagraph id="HA8F0999F86F24909AACD7727CE0032DD"><enum>(A)</enum><text>a tribal college or
				university, or</text>
								</subparagraph><subparagraph id="H040717BC42CE405BB29EAFB357ACDB17"><enum>(B)</enum><text>a junior or community
				college.</text>
								</subparagraph></paragraph><paragraph id="H0BC38618B7204C629785214409EB74AE"><enum>(7)</enum><text>The term <term>contract
				health service</term> means health services provided at the expense of the
				Service or a Tribal Health Program by public or private medical providers or
				hospitals, other than the Service Unit or the Tribal Health Program at whose
				expense the services are provided.</text>
							</paragraph><paragraph id="H2D56B864BB4645A78EC5DE2B78CD6B37"><enum>(8)</enum><text>The term
				<term>Department</term> means, unless otherwise designated, the Department of
				Health and Human Services.</text>
							</paragraph><paragraph id="HA27BF9136EFC406C9593598D127942F5"><enum>(9)</enum><text>The term <term>disease
				prevention</term> means the reduction, limitation, and prevention of disease
				and its complications and reduction in the consequences of disease,
				including—</text>
								<subparagraph id="H7987A33E66F243008749105744CAE290"><enum>(A)</enum><text>controlling—</text>
									<clause id="HFE88CB3A3BB44D1DB419A7862FD94E40"><enum>(i)</enum><text>the development of
				diabetes;</text>
									</clause><clause id="H8629DC3F6FC547519565C005ECCCF17"><enum>(ii)</enum><text>high blood
				pressure;</text>
									</clause><clause id="H57C032E96E634C2789DD666D4771DDF2"><enum>(iii)</enum><text>infectious
				agents;</text>
									</clause><clause id="HD8E9F4F6614D425999F1E11E4770F7B4"><enum>(iv)</enum><text>injuries;</text>
									</clause><clause id="H837528DB0D3B459AABB8B1F451EFE099"><enum>(v)</enum><text>occupational hazards and
				disabilities;</text>
									</clause><clause id="H0F3CC808A9DE421C003FEB2C00B919DC"><enum>(vi)</enum><text>sexually transmittable
				diseases; and</text>
									</clause><clause id="H98EAB4ACB0EF4DA1890068E23C71B74"><enum>(vii)</enum><text>toxic agents;
				and</text>
									</clause></subparagraph><subparagraph id="H3792AC5B269B419B81B02C60FBE3F5F1"><enum>(B)</enum><text>providing—</text>
									<clause id="H65E659C11EAB4DD099143793E4ED8C05"><enum>(i)</enum><text>fluoridation of water;
				and</text>
									</clause><clause id="HC56FA4F782A5494691DAFE45E0941C9B"><enum>(ii)</enum><text>immunizations.</text>
									</clause></subparagraph></paragraph><paragraph id="HD0F4E6540A144EF1BBD453F8FDC07765"><enum>(10)</enum><text>The term <term>health
				profession</term> means allopathic medicine, family medicine, internal
				medicine, pediatrics, geriatric medicine, obstetrics and gynecology, podiatric
				medicine, nursing, public health nursing, dentistry, psychiatry, osteopathy,
				optometry, pharmacy, psychology, public health, social work, marriage and
				family therapy, chiropractic medicine, environmental health and engineering,
				allied health professions, naturopathic medicine, and any other health
				profession.</text>
							</paragraph><paragraph id="H50E6A88AA7C243149801B45DCFFE831"><enum>(11)</enum><text>The term <term>health
				promotion</term> means—</text>
								<subparagraph id="H8AC0125068E84D7394261F7843BFE69"><enum>(A)</enum><text>fostering social,
				economic, environmental, and personal factors conducive to health, including
				raising public awareness about health matters and enabling the people to cope
				with health problems by increasing their knowledge and providing them with
				valid information;</text>
								</subparagraph><subparagraph id="H4C3D8CF2ECFE4576BBD9A8A2475D085"><enum>(B)</enum><text>encouraging adequate and
				appropriate diet, exercise, and sleep;</text>
								</subparagraph><subparagraph id="H211D19514A554BB2A322A42F81AC87BA"><enum>(C)</enum><text>promoting education and
				work in conformity with physical and mental capacity;</text>
								</subparagraph><subparagraph id="HD3F0D75951C94A76B689B4A55B261696"><enum>(D)</enum><text>making available safe
				water and sanitary facilities;</text>
								</subparagraph><subparagraph id="H8A1C6E64A6274772B061277B015C9E7B"><enum>(E)</enum><text>improving the physical,
				economic, cultural, psychological, and social environment;</text>
								</subparagraph><subparagraph id="H0FE5EDD7F67645B6A4A637113EF27994"><enum>(F)</enum><text>promoting culturally
				competent care; and</text>
								</subparagraph><subparagraph id="H6DBD09920B244ADBAF1D160809BA4BD6"><enum>(G)</enum><text>providing adequate and
				appropriate programs, which may include—</text>
									<clause id="H791BC21510C64471A1BEB9B900F9A1E7"><enum>(i)</enum><text>abuse prevention (mental
				and physical);</text>
									</clause><clause id="HD043941A7714487DB1D32E57FA52F474"><enum>(ii)</enum><text>community health;</text>
									</clause><clause id="H06090EB9899B4E868CB4AEC8FC2D9035"><enum>(iii)</enum><text>community
				safety;</text>
									</clause><clause id="H950A1D3410AA483992009695AF06C786"><enum>(iv)</enum><text>consumer health
				education;</text>
									</clause><clause id="H0407F8572E374613824B0463DA958382"><enum>(v)</enum><text>diet and
				nutrition;</text>
									</clause><clause id="H34E0522504784C71A9787040C9DA99D1"><enum>(vi)</enum><text>immunization and other
				prevention of communicable diseases, including HIV/AIDS;</text>
									</clause><clause id="H5BD17481AC4243D2A87E62DD64139E6F"><enum>(vii)</enum><text>environmental
				health;</text>
									</clause><clause id="H5A7EF3E786A44B3A82B1C93CED374F33"><enum>(viii)</enum><text>exercise and physical
				fitness;</text>
									</clause><clause id="HE234262B2695411A8C7FE900BDA1D211"><enum>(ix)</enum><text>avoidance of fetal
				alcohol disorders;</text>
									</clause><clause id="H17684881182547B0B79600C3B5E72F73"><enum>(x)</enum><text>first aid and CPR
				education;</text>
									</clause><clause id="HE7628CB337544BC89D95D4B64128729"><enum>(xi)</enum><text>human growth and
				development;</text>
									</clause><clause id="H6C57D5181D71467695256C32B440505B"><enum>(xii)</enum><text>injury prevention and
				personal safety;</text>
									</clause><clause id="H0CC642E7C3C14E2CB6CA10F37900A227"><enum>(xiii)</enum><text>behavioral
				health;</text>
									</clause><clause id="H5185583352644031A0AA3EE7D9A36631"><enum>(xiv)</enum><text>monitoring of disease
				indicators between health care provider visits, through appropriate means,
				including Internet-based health care management systems;</text>
									</clause><clause id="HF02FD2F25FFB4A5EA3E89CEE8918DEDA"><enum>(xv)</enum><text>personal health and
				wellness practices;</text>
									</clause><clause id="H6613F05B4C5047E5B9678F523574E597"><enum>(xvi)</enum><text>personal capacity
				building;</text>
									</clause><clause id="H109253F72AED408500ED66896FC5361E"><enum>(xvii)</enum><text>prenatal, pregnancy,
				and infant care;</text>
									</clause><clause id="H00F3013AB70345860091BBBDDF822C2"><enum>(xviii)</enum><text>psychological
				well-being;</text>
									</clause><clause id="H6348F4C7C8A34F49AC5D70F07272A289"><enum>(xix)</enum><text>reproductive health and
				family planning;</text>
									</clause><clause id="HBFDF4E6508BF489D8D8B2F922B7530CA"><enum>(xx)</enum><text>safe and adequate
				water;</text>
									</clause><clause id="H9B40822BD97F44AC8480C5BAB6022CFA"><enum>(xxi)</enum><text>healthy work
				environments;</text>
									</clause><clause id="HDAB8F23A523F4E7BAC57BA65F000505C"><enum>(xxii)</enum><text>elimination,
				reduction, and prevention of contaminants that create unhealthy household
				conditions (including mold and other allergens);</text>
									</clause><clause id="H218A4D0485E6444880E3ADD5EE21006"><enum>(xxiii)</enum><text>stress
				control;</text>
									</clause><clause id="HB9E2B3E3C14B4D4E990056719C215808"><enum>(xxiv)</enum><text>substance
				abuse;</text>
									</clause><clause id="HDDD3CAB292464DEC8D655E9F5F6F6BEF"><enum>(xxv)</enum><text>sanitary
				facilities;</text>
									</clause><clause id="H6332D31B590240358064EE99F508F89"><enum>(xxvi)</enum><text>sudden infant death
				syndrome prevention;</text>
									</clause><clause id="H288F1E1F80144A31AC678BA494C52892"><enum>(xxvii)</enum><text>tobacco use cessation
				and reduction;</text>
									</clause><clause id="HC290A7173AB14DF59571E11F2B86F952"><enum>(xxviii)</enum><text>violence prevention;
				and</text>
									</clause><clause id="H2FB2100397AA490CA8A2BB700887614"><enum>(xxix)</enum><text>such other activities
				identified by the Service, a Tribal Health Program, or an Urban Indian
				Organization, to promote achievement of any of the objectives described in
				section 3(2).</text>
									</clause></subparagraph></paragraph><paragraph id="H63620D868110440CA65576659B2CA613"><enum>(12)</enum><text>The term
				<term>Indian</term>, unless otherwise designated, means any person who is a
				member of an Indian Tribe or is eligible for health services under section 806,
				except that, for the purpose of sections 102 and 103, the term also means any
				individual who—</text>
								<subparagraph id="H15A8C208D2D645ECA0DC755717A4D800"><enum>(A)</enum><clause commented="no" display-inline="yes-display-inline" id="H440FF532055846FB00617D8B75CBDB63"><enum>(i)</enum><text>irrespective of whether
				the individual lives on or near a reservation, is a member of a tribe, band, or
				other organized group of Indians, including those tribes, bands, or groups
				terminated since 1940 and those recognized now or in the future by the State in
				which they reside; or</text>
									</clause><clause changed="added" committee-id="HII00" id="H88D2920C989349D3B13EC1B0479B1312" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text>is a descendant, in the
				first or second degree, of any such member;</text>
									</clause></subparagraph><subparagraph id="H7C5995A4D3AF4369A9E462F09D2F2FD1"><enum>(B)</enum><text>is an Eskimo or Aleut or
				other Alaska Native;</text>
								</subparagraph><subparagraph id="H510C3C648DEA4241916EE8E53CCCEA64"><enum>(C)</enum><text>is considered by the
				Secretary of the Interior to be an Indian for any purpose; or</text>
								</subparagraph><subparagraph id="H80261739E17D4238A48F13859C79A83B"><enum>(D)</enum><text>is determined to be an
				Indian under regulations promulgated by the Secretary.</text>
								</subparagraph></paragraph><paragraph id="HF2C5E9FDB92148C491FEA7CA7918724"><enum>(13)</enum><text>The term <term>Indian
				Health Program</term> means—</text>
								<subparagraph id="HE3BE244228FA4C23812FA9474899005B"><enum>(A)</enum><text>any health program
				administered directly by the Service;</text>
								</subparagraph><subparagraph id="H32EDFA551128407AB051B9B5C333758"><enum>(B)</enum><text>any Tribal Health
				Program; or</text>
								</subparagraph><subparagraph id="H1A0F933ECB4849D3B5A32F785B679081"><enum>(C)</enum><text>any Indian Tribe or
				Tribal Organization to which the Secretary provides funding pursuant to section
				23 of the Act of June 25, 1910 (<external-xref legal-doc="usc" parsable-cite="usc/25/47">25 U.S.C. 47</external-xref>) (commonly known as the <quote>Buy
				Indian Act</quote>).</text>
								</subparagraph></paragraph><paragraph id="HCF776E435D24403381A93800DAFF6885"><enum>(14)</enum><text>The term <term>Indian
				Tribe</term> has the meaning given the term in the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>).</text>
							</paragraph><paragraph id="HBDFFE7AC9FA64F189B3C5D6DB88EC17"><enum>(15)</enum><text>The term <term>junior or
				community college</term> has the meaning given the term by section 312(e) of
				the <act-name parsable-cite="HEA65">Higher Education Act of 1965</act-name> (20
				U.S.C. 1058(e)).</text>
							</paragraph><paragraph id="H7197D3F4DA614589BC677D50073E53A7"><enum>(16)</enum><text>The term
				<term>reservation</term> means any federally recognized Indian Tribe’s
				reservation, Pueblo, or colony, including former reservations in Oklahoma,
				Indian allotments, and Alaska Native Regions established pursuant to the Alaska
				Native Claims Settlement Act (<external-xref legal-doc="usc" parsable-cite="usc/43/1601">43 U.S.C. 1601 et seq.</external-xref>).</text>
							</paragraph><paragraph id="HC2FF6071EBE14B57A8CE370404EFB0BF"><enum>(17)</enum><text>The term
				<term>Secretary</term>, unless otherwise designated, means the Secretary of
				Health and Human Services.</text>
							</paragraph><paragraph id="HCCC5F0F0D831470DA300C02346979100"><enum>(18)</enum><text>The term
				<term>Service</term> means the Indian Health Service.</text>
							</paragraph><paragraph id="HCA2854DA7D33410AABE7ED7818356B3B"><enum>(19)</enum><text>The term <term>Service
				Area</term> means the geographical area served by each Area Office.</text>
							</paragraph><paragraph id="H9DE3D925C5634067ADD501B36217DD8B"><enum>(20)</enum><text>The term <term>Service
				Unit</term> means an administrative entity of the Service, or a Tribal Health
				Program through which services are provided, directly or by contract, to
				eligible Indians within a defined geographic area.</text>
							</paragraph><paragraph id="H63525FCA2E284F729DE9A2C67D2CE760"><enum>(21)</enum><text>The term
				<term>telehealth</term> has the meaning given the term in section 330K(a) of
				the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42
				U.S.C. 254c–16(a)).</text>
							</paragraph><paragraph id="H7FAE44FDBBF0410CB9E900863EFAF630"><enum>(22)</enum><text>The term
				<term>telemedicine</term> means a telecommunications link to an end user
				through the use of eligible equipment that electronically links health
				professionals or patients and health professionals at separate sites in order
				to exchange health care information in audio, video, graphic, or other format
				for the purpose of providing improved health care services.</text>
							</paragraph><paragraph id="H3B57B8B423424AB6A64B69DC30078C5"><enum>(23)</enum><text>The term <term>tribal
				college or university</term> has the meaning given the term in section
				316(b)(3) of the Higher Education Act (<external-xref legal-doc="usc" parsable-cite="usc/20/1059c">20 U.S.C. 1059c(b)(3)</external-xref>).</text>
							</paragraph><paragraph id="H7CF2060848F245C4882E3CF6C2FEA08"><enum>(24)</enum><text>The term <term>Tribal
				Health Program</term> means an Indian Tribe or Tribal Organization that
				operates any health program, service, function, activity, or facility funded,
				in whole or part, by the Service through, or provided for in, a contract or
				compact with the Service under the <act-name parsable-cite="ISDA">Indian
				Self-Determination and Education Assistance Act</act-name> (25 U.S.C. 450 et
				seq.).</text>
							</paragraph><paragraph id="H9BF6481A84794B04B63E79F1C943000"><enum>(25)</enum><text>The term <term>Tribal
				Organization</term> has the meaning given the term in the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>).</text>
							</paragraph><paragraph id="H90789840C47D4119A106DECEC5935579"><enum>(26)</enum><text>The term <term>Urban
				Center</term> means any community which has a sufficient Urban Indian
				population with unmet health needs to warrant assistance under title V of this
				Act, as determined by the Secretary.</text>
							</paragraph><paragraph id="HB0A41F149B5E4A8F95548C4D6F7EEDF7"><enum>(27)</enum><text>The term <term>Urban
				Indian</term> means any individual who resides in an Urban Center and who meets
				1 or more of the following criteria:</text>
								<subparagraph id="H0EBA359897774D5D8D6997D4180354BB"><enum>(A)</enum><text>Irrespective of whether
				the individual lives on or near a reservation, the individual is a member of a
				tribe, band, or other organized group of Indians, including those tribes,
				bands, or groups terminated since 1940 and those tribes, bands, or groups that
				are recognized by the States in which they reside, or who is a descendant in
				the first or second degree of any such member.</text>
								</subparagraph><subparagraph id="HE49A75191E1741C5B1451BBC50FFEAB3"><enum>(B)</enum><text>The individual is an
				Eskimo, Aleut, or other Alaska Native.</text>
								</subparagraph><subparagraph id="HE54019C783E44A80A184D52C8E345BBD"><enum>(C)</enum><text>The individual is
				considered by the Secretary of the Interior to be an Indian for any
				purpose.</text>
								</subparagraph><subparagraph id="H3CEDFC37F9944B6E8C6F422E266651BB"><enum>(D)</enum><text>The individual is
				determined to be an Indian under regulations promulgated by the
				Secretary.</text>
								</subparagraph></paragraph><paragraph id="H12E0645C6E9145C69FBAA3CD2CD96FC"><enum>(28)</enum><text>The term <term>Urban
				Indian Organization</term> means a nonprofit corporate body that (A) is
				situated in an Urban Center; (B) is governed by an Urban Indian-controlled
				board of directors; (C) provides for the participation of all interested Indian
				groups and individuals; and (D) is capable of legally cooperating with other
				public and private entities for the purpose of performing the activities
				described in section 503(a).</text>
							</paragraph></section><title id="HC0FC6C4D1202481687008769A197B8EE"><enum>I</enum><header>Indian health, human
				resources, and development</header>
							<section id="H6A7DFF8B9DBE42E68ECDD3ABADF0FF92"><enum>101.</enum><header>Purpose</header><text display-inline="no-display-inline">The purpose of this title is to increase, to
				the maximum extent feasible, the number of Indians entering the health
				professions and providing health services, and to assure an optimum supply of
				health professionals to the Indian Health Programs and Urban Indian
				Organizations involved in the provision of health services to Indians.</text>
							</section><section id="H9715FFEF6FE444E5A621EAFF4D7CB62D"><enum>102.</enum><header>Health professions
				recruitment program for Indians</header>
								<subsection id="HC5CD3D6FE373470990CE315869F8BCBE"><enum>(a)</enum><header>In
				general</header><text>The Secretary, acting through the Service, shall make
				grants to public or nonprofit private health or educational entities, Tribal
				Health Programs, or Urban Indian Organizations to assist such entities in
				meeting the costs of—</text>
									<paragraph id="H185013B8C77F45CC8BF4418307E08DE1"><enum>(1)</enum><text>identifying Indians with
				a potential for education or training in the health professions and encouraging
				and assisting them—</text>
										<subparagraph id="H4F423982B47848838289D63492B6BD0"><enum>(A)</enum><text>to enroll in courses of
				study in such health professions; or</text>
										</subparagraph><subparagraph id="H3DB842CE8E90486EB777DF9D3E007FD2"><enum>(B)</enum><text>if they are not qualified
				to enroll in any such courses of study, to undertake such postsecondary
				education or training as may be required to qualify them for enrollment;</text>
										</subparagraph></paragraph><paragraph id="H4432BF35454244019E37A221D0A38699"><enum>(2)</enum><text>publicizing existing
				sources of financial aid available to Indians enrolled in any course of study
				referred to in paragraph (1) or who are undertaking training necessary to
				qualify them to enroll in any such course of study; or</text>
									</paragraph><paragraph id="H99FC1A732E684B6D8EB7AA9F5EF30723"><enum>(3)</enum><text>establishing other
				programs which the Secretary determines will enhance and facilitate the
				enrollment of Indians in, and the subsequent pursuit and completion by them of,
				courses of study referred to in paragraph (1).</text>
									</paragraph></subsection><subsection id="HF5E604CB6F9141BB85921F6B66DC1977"><enum>(b)</enum><header>Grants</header>
									<paragraph id="H052C4DCAAA87413AB39458AD15003465"><enum>(1)</enum><header>Application</header><text>The
				Secretary shall not make a grant under this section unless an application has
				been submitted to, and approved by, the Secretary. Such application shall be in
				such form, submitted in such manner, and contain such information, as the
				Secretary shall by regulation prescribe pursuant to this Act. The Secretary
				shall give a preference to applications submitted by Tribal Health Programs or
				Urban Indian Organizations.</text>
									</paragraph><paragraph id="H4D2B2DDD291B41EF938FEB9E6482D1F"><enum>(2)</enum><header>Amount of grants;
				payment</header><text>The amount of a grant under this section shall be
				determined by the Secretary. Payments pursuant to this section may be made in
				advance or by way of reimbursement, and at such intervals and on such
				conditions as provided for in regulations issued pursuant to this Act. To the
				extent not otherwise prohibited by law, grants shall be for 3 years, as
				provided in regulations issued pursuant to this Act.</text>
									</paragraph></subsection></section><section id="HC675BB51E0754701BF4C9DF4310053BE"><enum>103.</enum><header>Health professions
				preparatory scholarship program for Indians</header>
								<subsection id="H9443A9BCC9E54BADB5D4EE36BBDD8218"><enum>(a)</enum><header>Scholarships
				authorized</header><text>The Secretary, acting through the Service, shall
				provide scholarship grants to Indians who—</text>
									<paragraph id="H5F402410DB244DCEB8D73CD29EB0224B"><enum>(1)</enum><text>have successfully
				completed their high school education or high school equivalency; and</text>
									</paragraph><paragraph id="H1150C697605045E8843FE469C27C83BB"><enum>(2)</enum><text>have demonstrated the
				potential to successfully complete courses of study in the health
				professions.</text>
									</paragraph></subsection><subsection id="H31BC66ABCF5B4AB09282E92FD7772F1"><enum>(b)</enum><header>Purposes</header><text>Scholarship
				grants provided pursuant to this section shall be for the following
				purposes:</text>
									<paragraph id="H83A8512962474BD0A0E49F1685B81EEA"><enum>(1)</enum><text>Compensatory
				preprofessional education of any recipient, such scholarship not to exceed 2
				years on a full-time basis (or the part-time equivalent thereof, as determined
				by the Secretary pursuant to regulations issued under this Act).</text>
									</paragraph><paragraph id="H4AF9ED3F686B4230AD16298D4B00A761"><enum>(2)</enum><text>Pregraduate education of
				any recipient leading to a baccalaureate degree in an approved course of study
				preparatory to a field of study in a health profession, such scholarship not to
				exceed 4 years. An extension of up to 2 years (or the part-time equivalent
				thereof, as determined by the Secretary pursuant to regulations issued pursuant
				to this Act) may be approved.</text>
									</paragraph></subsection><subsection id="H9DC4602B3E89448AB8759CCDF5A523F"><enum>(c)</enum><header>Other
				conditions</header><text>Scholarships under this section—</text>
									<paragraph id="H6CF6A2775BAA4BD18DECB168C8DDA753"><enum>(1)</enum><text>may cover costs of
				tuition, books, transportation, board, and other necessary related expenses of
				a recipient while attending school;</text>
									</paragraph><paragraph id="H9DCCEDA6C9FB4F1EB4594804E5061815"><enum>(2)</enum><text>shall not be denied
				solely on the basis of the applicant’s scholastic achievement if such applicant
				has been admitted to, or maintained good standing at, an accredited
				institution; and</text>
									</paragraph><paragraph id="H404A2C055BDA4FFD8E38862ECED6D892"><enum>(3)</enum><text>shall not be denied
				solely by reason of such applicant’s eligibility for assistance or benefits
				under any other Federal program.</text>
									</paragraph></subsection></section><section id="HC5EB2CB12AB24123AED840F1F118AD00"><enum>104.</enum><header>Indian health
				professions scholarships</header>
								<subsection id="H4BC63862059F4D02BBBAC0B5CF13BCA1"><enum>(a)</enum><header>In general</header>
									<paragraph id="H2471A17EF1C4470E88B943F12855DE98"><enum>(1)</enum><header>Authority</header><text>The
				Secretary, acting through the Service, shall make scholarship grants to Indians
				who are enrolled full or part time in accredited schools pursuing courses of
				study in the health professions. Such scholarships shall be designated Indian
				Health Scholarships and shall be made in accordance with section 338A of the
				Public Health Services Act (42 U.S.C. 254<added-phrase reported-display-style="italic">l</added-phrase>), except as provided in
				subsection (b) of this section.</text>
									</paragraph><paragraph id="H71CCC03DF9A44A04A8863B7FE66657CC"><enum>(2)</enum><header>Determinations by
				Secretary</header><text>The Secretary, acting through the Service, shall
				determine—</text>
										<subparagraph id="H5C69B3271F724F788432303D2ED2F33"><enum>(A)</enum><text>who shall receive
				scholarship grants under subsection (a); and</text>
										</subparagraph><subparagraph id="HD00E97A857064DBFA5ADF746BA943271"><enum>(B)</enum><text>the distribution of the
				scholarships among health professions on the basis of the relative needs of
				Indians for additional service in the health professions.</text>
										</subparagraph></paragraph><paragraph id="H7403FABE67E24261AA233EFC19E13F06"><enum>(3)</enum><header>Certain delegation not
				allowed</header><text>The administration of this section shall be a
				responsibility of the Assistant Secretary and shall not be delegated in a
				contract or compact under the <act-name parsable-cite="ISDA">Indian
				Self-Determination and Education Assistance Act</act-name> (25 U.S.C. 450 et
				seq.).</text>
									</paragraph></subsection><subsection id="HFFF4A7F670F240338D0013BCF2EB7B3B"><enum>(b)</enum><header>Active duty service
				obligation</header>
									<paragraph id="H22C37EDBFBF7482D9C3BE2D2CEB9C662"><enum>(1)</enum><header>Obligation
				met</header><text>The active duty service obligation under a written contract
				with the Secretary under this section that an Indian has entered into shall, if
				that individual is a recipient of an Indian Health Scholarship, be met in
				full-time practice equal to 1 year for each school year for which the
				participant receives a scholarship award under this part, or 2 years, whichever
				is greater, by service in 1 or more of the following:</text>
										<subparagraph id="H9F9E02ACCF29471790C4EF238600878C"><enum>(A)</enum><text>In an Indian Health
				Program.</text>
										</subparagraph><subparagraph id="HA63FFBBB84F545B3B6862B453BE911D9"><enum>(B)</enum><text>In a program assisted
				under title V of this Act.</text>
										</subparagraph><subparagraph id="H30C41C33A4434006A259C29437208F82"><enum>(C)</enum><text>In the private practice
				of the applicable profession if, as determined by the Secretary, in accordance
				with guidelines promulgated by the Secretary, such practice is situated in a
				physician or other health professional shortage area and addresses the health
				care needs of a substantial number of Indians.</text>
										</subparagraph><subparagraph id="HA147AAF052714C428DEF6000BCE501CB"><enum>(D)</enum><text>In a teaching capacity in
				a tribal college or university nursing program (or a related health profession
				program) if, as determined by the Secretary, the health service provided to
				Indians would not decrease.</text>
										</subparagraph></paragraph><paragraph id="HF063AAE6CF2443DABB83FCE6DD7F0174"><enum>(2)</enum><header>Obligation
				deferred</header><text>At the request of any individual who has entered into a
				contract referred to in paragraph (1) and who receives a degree in medicine
				(including osteopathic or allopathic medicine), dentistry, optometry, podiatry,
				or pharmacy, the Secretary shall defer the active duty service obligation of
				that individual under that contract, in order that such individual may complete
				any internship, residency, or other advanced clinical training that is required
				for the practice of that health profession, for an appropriate period (in
				years, as determined by the Secretary), subject to the following
				conditions:</text>
										<subparagraph id="HC5984686A8E242F6BFC6E6EDEABCE234"><enum>(A)</enum><text>No period of internship,
				residency, or other advanced clinical training shall be counted as satisfying
				any period of obligated service under this subsection.</text>
										</subparagraph><subparagraph id="HEFD6B3C56E174A66A1E5B6DCCE95FEFE"><enum>(B)</enum><text>The active duty service
				obligation of that individual shall commence not later than 90 days after the
				completion of that advanced clinical training (or by a date specified by the
				Secretary).</text>
										</subparagraph><subparagraph id="HDAE205007C924BF4AE04B6318C7D96E"><enum>(C)</enum><text>The active duty service
				obligation will be served in the health profession of that individual in a
				manner consistent with paragraph (1).</text>
										</subparagraph><subparagraph id="HB5A1198AC9694DA3B2C2EBED1F10BB1B"><enum>(D)</enum><text>A recipient of a
				scholarship under this section may, at the election of the recipient, meet the
				active duty service obligation described in paragraph (1) by service in a
				program specified under that paragraph that—</text>
											<clause id="HF229F5D295DC42A2A705C367E7342779"><enum>(i)</enum><text>is located on the
				reservation of the Indian Tribe in which the recipient is enrolled; or</text>
											</clause><clause id="HD748FE63961C477F80E3DAEE8145D42"><enum>(ii)</enum><text>serves the Indian Tribe
				in which the recipient is enrolled.</text>
											</clause></subparagraph></paragraph><paragraph id="H2988D8992B624F6D8D884CC0230074CB"><enum>(3)</enum><header>Priority when making
				assignments</header><text>Subject to paragraph (2), the Secretary, in making
				assignments of Indian Health Scholarship recipients required to meet the active
				duty service obligation described in paragraph (1), shall give priority to
				assigning individuals to service in those programs specified in paragraph (1)
				that have a need for health professionals to provide health care services as a
				result of individuals having breached contracts entered into under this
				section.</text>
									</paragraph></subsection><subsection id="H2B736116081746F898FF60C6F9F7FF6"><enum>(c)</enum><header>Part-time
				students</header><text>In the case of an individual receiving a scholarship
				under this section who is enrolled part time in an approved course of
				study—</text>
									<paragraph id="HE040EAC258224E789093D8B9C600F1FD"><enum>(1)</enum><text>such scholarship shall be
				for a period of years not to exceed the part-time equivalent of 4 years, as
				determined by the Secretary;</text>
									</paragraph><paragraph id="H3DF8CC989EE64432ADFB42DBF074AB38"><enum>(2)</enum><text>the period of obligated
				service described in subsection (b)(1) shall be equal to the greater of—</text>
										<subparagraph id="HB37F9971CD85454BA3923D00E8460309"><enum>(A)</enum><text>the part-time equivalent
				of 1 year for each year for which the individual was provided a scholarship (as
				determined by the Secretary); or</text>
										</subparagraph><subparagraph id="H876DF9BDAB344B7EAC43B3265EDE117C"><enum>(B)</enum><text>2 years; and</text>
										</subparagraph></paragraph><paragraph id="H24554B098F62400AB7DDB530114E19F8"><enum>(3)</enum><text>the amount of the monthly
				stipend specified in section 338A(g)(1)(B) of the
				<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
				254<added-phrase reported-display-style="italic">l</added-phrase>(g)(1)(B))
				shall be reduced pro rata (as determined by the Secretary) based on the number
				of hours such student is enrolled.</text>
									</paragraph></subsection><subsection id="HEAF61108D3664F4CAE4D2736814BD02B"><enum>(d)</enum><header>Breach of
				contract</header>
									<paragraph id="H38B03875639F47F2A68DCBF731BB3044"><enum>(1)</enum><header>Specified
				breaches</header><text>An individual shall be liable to the United States for
				the amount which has been paid to the individual, or on behalf of the
				individual, under a contract entered into with the Secretary under this section
				on or after the date of enactment of the <short-title>Indian Health Care Improvement Act Amendments of
				2007</short-title> if that individual—</text>
										<subparagraph id="H201F7E974A7D4E21A7F7FE36EB8321BB"><enum>(A)</enum><text>fails to maintain an
				acceptable level of academic standing in the educational institution in which
				he or she is enrolled (such level determined by the educational institution
				under regulations of the Secretary);</text>
										</subparagraph><subparagraph id="H79EA0F08F627461EAB64E408E95E6E22"><enum>(B)</enum><text>is dismissed from such
				educational institution for disciplinary reasons;</text>
										</subparagraph><subparagraph id="HA2348DB7EF364C7DB4A0669C1B3E9474"><enum>(C)</enum><text>voluntarily terminates
				the training in such an educational institution for which he or she is provided
				a scholarship under such contract before the completion of such training;
				or</text>
										</subparagraph><subparagraph id="H0FE1FA9E79254C13AEF63C731DE131FE"><enum>(D)</enum><text>fails to accept payment,
				or instructs the educational institution in which he or she is enrolled not to
				accept payment, in whole or in part, of a scholarship under such contract, in
				lieu of any service obligation arising under such contract.</text>
										</subparagraph></paragraph><paragraph id="H65CFB7F3E72846BCA4FE9FFE3B31D799"><enum>(2)</enum><header>Other
				breaches</header><text>If for any reason not specified in paragraph (1) an
				individual breaches a written contract by failing either to begin such
				individual’s service obligation required under such contract or to complete
				such service obligation, the United States shall be entitled to recover from
				the individual an amount determined in accordance with the formula specified in
				subsection (l) of section 110 in the manner provided for in such
				subsection.</text>
									</paragraph><paragraph id="H960CC5E61F85478E82A613AC68EAE34F"><enum>(3)</enum><header>Cancellation upon death
				of recipient</header><text>Upon the death of an individual who receives an
				Indian Health Scholarship, any outstanding obligation of that individual for
				service or payment that relates to that scholarship shall be canceled.</text>
									</paragraph><paragraph id="H7AF482836B8347EB9925AAA55BA249C7"><enum>(4)</enum><header>Waivers and
				suspensions</header>
										<subparagraph id="H880281987D044BE9A94039E02C94CF35"><enum>(A)</enum><header>In
				general</header><text>The Secretary shall provide for the partial or total
				waiver or suspension of any obligation of service or payment of a recipient of
				an Indian Health Scholarship if the Secretary determines that—</text>
											<clause id="H1AA8838DF8CB426FAAEC4ECD728E0135"><enum>(i)</enum><text>it is not possible for
				the recipient to meet that obligation or make that payment;</text>
											</clause><clause id="HFA9390CC9C0849748D62BE2C8217012"><enum>(ii)</enum><text>requiring that recipient
				to meet that obligation or make that payment would result in extreme hardship
				to the recipient; or</text>
											</clause><clause id="HB46293E4B64F4B9E880059FDE303E1BC"><enum>(iii)</enum><text>the enforcement of the
				requirement to meet the obligation or make the payment would be
				unconscionable.</text>
											</clause></subparagraph><subparagraph id="H62DDEC36B9D14AD6A229D882269E88F2"><enum>(B)</enum><header>Factors for
				consideration</header><text>Before waiving or suspending an obligation of
				service or payment under subparagraph (A), the Secretary shall consult with the
				affected Area Office, Indian Tribes, Tribal Organizations, or Urban Indian
				Organizations, and may take into consideration whether the obligation may be
				satisfied in a teaching capacity at a tribal college or university nursing
				program under subsection (b)(1)(D).</text>
										</subparagraph></paragraph><paragraph id="H9ED9EF324B57405DBC0444A74E76FEC1"><enum>(5)</enum><header>Extreme
				hardship</header><text>Notwithstanding any other provision of law, in any case
				of extreme hardship or for other good cause shown, the Secretary may waive, in
				whole or in part, the right of the United States to recover funds made
				available under this section.</text>
									</paragraph><paragraph id="H61F2FDCC2C014B13BA01F215EA143723"><enum>(6)</enum><header>Bankruptcy</header><text>Notwithstanding
				any other provision of law, with respect to a recipient of an Indian Health
				Scholarship, no obligation for payment may be released by a discharge in
				bankruptcy under title 11, United States Code, unless that discharge is granted
				after the expiration of the 5-year period beginning on the initial date on
				which that payment is due, and only if the bankruptcy court finds that the
				nondischarge of the obligation would be unconscionable.</text>
									</paragraph></subsection></section><section id="H4491C87EBF2E42D9BEC82878FBF8DA24"><enum>105.</enum><header>American Indians Into
				Psychology Program</header>
								<subsection id="H9CB883D5C5644972A170CAA84DB8EAB"><enum>(a)</enum><header>Grants
				authorized</header><text>The Secretary, acting through the Service, shall make
				grants of not more than $300,000 to each of 9 colleges and universities for the
				purpose of developing and maintaining Indian psychology career recruitment
				programs as a means of encouraging Indians to enter the behavioral health
				field. These programs shall be located at various locations throughout the
				country to maximize their availability to Indian students and new programs
				shall be established in different locations from time to time.</text>
								</subsection><subsection id="HCC0FDABD0D8440EF86D3C4ECBA17DA68"><enum>(b)</enum><header>Quentin N. Burdick
				program grant</header><text>The Secretary shall provide a grant authorized
				under subsection (a) to develop and maintain a program at the University of
				North Dakota to be known as the <quote>Quentin N. Burdick American Indians Into
				Psychology Program</quote>. Such program shall, to the maximum extent feasible,
				coordinate with the Quentin N. Burdick Indian Health Programs authorized under
				section 117(b), the Quentin N. Burdick American Indians Into Nursing Program
				authorized under section 115(e), and existing university research and
				communications networks.</text>
								</subsection><subsection id="H1DFE9CE6847F4BC2953887DCD5EAF152"><enum>(c)</enum><header>Regulations</header><text>The
				Secretary shall issue regulations pursuant to this Act for the competitive
				awarding of grants provided under this section.</text>
								</subsection><subsection id="HF2838885BB864375876B3DDB83605DED"><enum>(d)</enum><header>Conditions of
				grant</header><text>Applicants under this section shall agree to provide a
				program which, at a minimum—</text>
									<paragraph id="H70C73267B8D7475485604F2573CAC81"><enum>(1)</enum><text>provides outreach and
				recruitment for health professions to Indian communities including elementary,
				secondary, and accredited and accessible community colleges that will be served
				by the program;</text>
									</paragraph><paragraph id="H2F7A213A6A804D71AB26BB70972090F5"><enum>(2)</enum><text>incorporates a program
				advisory board comprised of representatives from the tribes and communities
				that will be served by the program;</text>
									</paragraph><paragraph id="HD12A4461F18A43BB814ECD837FD612D5"><enum>(3)</enum><text>provides summer
				enrichment programs to expose Indian students to the various fields of
				psychology through research, clinical, and experimental activities;</text>
									</paragraph><paragraph id="HCFA97E8506EB4130BEB3B5EFB940EF9B"><enum>(4)</enum><text>provides stipends to
				undergraduate and graduate students to pursue a career in psychology;</text>
									</paragraph><paragraph id="H02C3472D00364131B7AC6B8ECC04C9B1"><enum>(5)</enum><text>develops affiliation
				agreements with tribal colleges and universities, the Service, university
				affiliated programs, and other appropriate accredited and accessible entities
				to enhance the education of Indian students;</text>
									</paragraph><paragraph id="H130004ED67724BFEA5BD6E787B72F4C8"><enum>(6)</enum><text>to the maximum extent
				feasible, uses existing university tutoring, counseling, and student support
				services; and</text>
									</paragraph><paragraph id="HE7BC347BD7AD4874B48FBEB153CD65A9"><enum>(7)</enum><text>to the maximum extent
				feasible, employs qualified Indians in the program.</text>
									</paragraph></subsection><subsection id="H392577E93C2E4B70804735851CACF000"><enum>(e)</enum><header>Active duty service
				requirement</header><text>The active duty service obligation prescribed under
				section 338C of the <act-name parsable-cite="PHSA">Public Health Service
				Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/254m">42 U.S.C. 254m</external-xref>) shall be met by each graduate who receives a
				stipend described in subsection (d)(4) that is funded under this section. Such
				obligation shall be met by service—</text>
									<paragraph id="H0726845ACA6740F6A863BED02968BF81"><enum>(1)</enum><text>in an Indian Health
				Program;</text>
									</paragraph><paragraph id="H382315F1292A414CADEE008EA030BCC9"><enum>(2)</enum><text>in a program assisted
				under title V of this Act; or</text>
									</paragraph><paragraph id="H0D163034A40B4E12B6D51110F9435B3"><enum>(3)</enum><text>in the private practice
				of psychology if, as determined by the Secretary, in accordance with guidelines
				promulgated by the Secretary, such practice is situated in a physician or other
				health professional shortage area and addresses the health care needs of a
				substantial number of Indians.</text>
									</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H102C32E1C8744ED7B848E13423418BA"><enum>(f)</enum><header>Authorization of
				appropriations</header><text display-inline="yes-display-inline">There is
				authorized to be appropriated to carry out this section $2,700,000 for each of
				fiscal years 2008 through 2017.</text>
								</subsection></section><section id="H894B9C75CADC461797192BBC68EAE602"><enum>106.</enum><header>Scholarship programs
				for Indian Tribes</header>
								<subsection id="H82814A2835724CA5A1421D2FB440D7BF"><enum>(a)</enum><header>In general</header>
									<paragraph id="HB97EDE108AA24921A00175C72DEB9CA7"><enum>(1)</enum><header>Grants
				authorized</header><text>The Secretary, acting through the Service, shall make
				grants to Tribal Health Programs for the purpose of providing scholarships for
				Indians to serve as health professionals in Indian communities.</text>
									</paragraph><paragraph id="H29EF94D28C7B439491910566EAA9CA04"><enum>(2)</enum><header>Amount</header><text>Amounts
				available under paragraph (1) for any fiscal year shall not exceed 5 percent of
				the amounts available for each fiscal year for Indian Health Scholarships under
				section 104.</text>
									</paragraph><paragraph id="HD4E12E8EFE9844A3B8EBD7992107BBC9"><enum>(3)</enum><header>Application</header><text>An
				application for a grant under paragraph (1) shall be in such form and contain
				such agreements, assurances, and information as consistent with this
				section.</text>
									</paragraph></subsection><subsection id="H1EBD46CEEDFF47F39C60B1E2E8755D8D"><enum>(b)</enum><header>Requirements</header>
									<paragraph id="H1FEF5FCF77964AD2AE7BA3E533E5C09"><enum>(1)</enum><header>In
				general</header><text>A Tribal Health Program receiving a grant under
				subsection (a) shall provide scholarships to Indians in accordance with the
				requirements of this section.</text>
									</paragraph><paragraph id="H776C52EF4258478C8B968F23005BEA5"><enum>(2)</enum><header>Costs</header><text>With
				respect to costs of providing any scholarship pursuant to subsection
				(a)—</text>
										<subparagraph id="H6B7D27B4BF3B4879BC5D692721573643"><enum>(A)</enum><text>80 percent of the costs
				of the scholarship shall be paid from the funds made available pursuant to
				subsection (a)(1) provided to the Tribal Health Program; and</text>
										</subparagraph><subparagraph id="H1D5DBD0173444361AB412F1D9CE3E19B"><enum>(B)</enum><text>20 percent of such costs
				may be paid from any other source of funds.</text>
										</subparagraph></paragraph></subsection><subsection id="HBA626C347643457690F7A645D525C6D"><enum>(c)</enum><header>Course of
				study</header><text>A Tribal Health Program shall provide scholarships under
				this section only to Indians enrolled or accepted for enrollment in a course of
				study (approved by the Secretary) in 1 of the health professions contemplated
				by this Act.</text>
								</subsection><subsection id="H6BBDAC6135F44B7DBB9EB50079D9DE92"><enum>(d)</enum><header>Contract</header>
									<paragraph id="HBC53DE632D9545789F65EDA846FA0081"><enum>(1)</enum><header>In
				general</header><text>In providing scholarships under subsection (b), the
				Secretary and the Tribal Health Program shall enter into a written contract
				with each recipient of such scholarship.</text>
									</paragraph><paragraph id="H14BACB14C72C46DAA857E34C5270CE9D"><enum>(2)</enum><header>Requirements</header><text>Such
				contract shall—</text>
										<subparagraph id="H6D17B14D32FC4E64885E456679BD3CAA"><enum>(A)</enum><text>obligate such recipient
				to provide service in an Indian Health Program or Urban Indian Organization, in
				the same Service Area where the Tribal Health Program providing the scholarship
				is located, for—</text>
											<clause id="HAB0FF2335C264FA99672041C8CEC4BD9"><enum>(i)</enum><text>a number of years for
				which the scholarship is provided (or the part-time equivalent thereof, as
				determined by the Secretary), or for a period of 2 years, whichever period is
				greater; or</text>
											</clause><clause id="H4B55F8AC85AE4E56B5E87B9E2861685F"><enum>(ii)</enum><text>such greater period of
				time as the recipient and the Tribal Health Program may agree;</text>
											</clause></subparagraph><subparagraph id="H4E8344FAEB9A4FB096F60565992645BB"><enum>(B)</enum><text>provide that the amount
				of the scholarship—</text>
											<clause id="H7D58EA59AD9B4A79877961A0C1DBC888"><enum>(i)</enum><text>may only be expended
				for—</text>
												<subclause id="H38FE7E69E7C44747943E7631A09D1402"><enum>(I)</enum><text>tuition expenses, other
				reasonable educational expenses, and reasonable living expenses incurred in
				attendance at the educational institution; and</text>
												</subclause><subclause id="HF7369AE6E4E24E2187A1D13FCABF3D3C"><enum>(II)</enum><text>payment to the recipient
				of a monthly stipend of not more than the amount authorized by section
				338(g)(1)(B) of the <act-name parsable-cite="PHSA">Public Health Service
				Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/254m">42 U.S.C. 254m(g)(1)(B)</external-xref>), with such amount to be reduced pro
				rata (as determined by the Secretary) based on the number of hours such student
				is enrolled, and not to exceed, for any year of attendance for which the
				scholarship is provided, the total amount required for the year for the
				purposes authorized in this clause; and</text>
												</subclause></clause><clause id="HCC5EBB851F4C4552802F16AE4E70AF14"><enum>(ii)</enum><text>may not exceed, for any
				year of attendance for which the scholarship is provided, the total amount
				required for the year for the purposes authorized in clause (i);</text>
											</clause></subparagraph><subparagraph id="H345E751A31E5464E90EA7C64C4B30969"><enum>(C)</enum><text>require the recipient of
				such scholarship to maintain an acceptable level of academic standing as
				determined by the educational institution in accordance with regulations issued
				pursuant to this Act; and</text>
										</subparagraph><subparagraph id="H8AD381501577413A9CB9F823757BBE0"><enum>(D)</enum><text>require the recipient of
				such scholarship to meet the educational and licensure requirements appropriate
				to each health profession.</text>
										</subparagraph></paragraph><paragraph id="H1B28CDC76EDB45B5A9FCC482A0209632"><enum>(3)</enum><header>Service in other
				service areas</header><text>The contract may allow the recipient to serve in
				another Service Area, provided the Tribal Health Program and Secretary approve
				and services are not diminished to Indians in the Service Area where the Tribal
				Health Program providing the scholarship is located.</text>
									</paragraph></subsection><subsection id="HDD5DE902CBCA40F79CFBCA6B41F5EC6F"><enum>(e)</enum><header>Breach of
				contract</header>
									<paragraph id="H5C42A90B778B4E97B91D9112EC7BBE6F"><enum>(1)</enum><header>Specific
				breaches</header><text>An individual who has entered into a written contract
				with the Secretary and a Tribal Health Program under subsection (d) shall be
				liable to the United States for the Federal share of the amount which has been
				paid to him or her, or on his or her behalf, under the contract if that
				individual—</text>
										<subparagraph id="H36CC05413A5A4AABBD77B84254FD9F12"><enum>(A)</enum><text>fails to maintain an
				acceptable level of academic standing in the educational institution in which
				he or she is enrolled (such level as determined by the educational institution
				under regulations of the Secretary);</text>
										</subparagraph><subparagraph id="H4A65BCA288B6481BA0B084FB6CE2707"><enum>(B)</enum><text>is dismissed from such
				educational institution for disciplinary reasons;</text>
										</subparagraph><subparagraph id="H9DEA58885D4F4A52B8A8D85EC0EBF704"><enum>(C)</enum><text>voluntarily terminates
				the training in such an educational institution for which he or she is provided
				a scholarship under such contract before the completion of such training;
				or</text>
										</subparagraph><subparagraph id="H4410D40681BF474BB937CA8870F0F047"><enum>(D)</enum><text>fails to accept payment,
				or instructs the educational institution in which he or she is enrolled not to
				accept payment, in whole or in part, of a scholarship under such contract, in
				lieu of any service obligation arising under such contract.</text>
										</subparagraph></paragraph><paragraph id="HCD26FAF1A1B44FAD91009F88B1F120E3"><enum>(2)</enum><header>Other
				breaches</header><text>If for any reason not specified in paragraph (1), an
				individual breaches a written contract by failing to either begin such
				individual’s service obligation required under such contract or to complete
				such service obligation, the United States shall be entitled to recover from
				the individual an amount determined in accordance with the formula specified in
				subsection (l) of section 110 in the manner provided for in such
				subsection.</text>
									</paragraph><paragraph id="H10E14A7362264361B6CF9D6224C47C6E"><enum>(3)</enum><header>Cancellation upon death
				of recipient</header><text>Upon the death of an individual who receives an
				Indian Health Scholarship, any outstanding obligation of that individual for
				service or payment that relates to that scholarship shall be canceled.</text>
									</paragraph><paragraph id="H618EF607190F475A8CD3DAACC861214"><enum>(4)</enum><header>Information</header><text>The
				Secretary may carry out this subsection on the basis of information received
				from Tribal Health Programs involved or on the basis of information collected
				through such other means as the Secretary deems appropriate.</text>
									</paragraph></subsection><subsection id="HE279D0938CF54377AC65882EAF9844B9"><enum>(f)</enum><header>Relation to
				<act-name parsable-cite="SSA">Social Security Act</act-name></header><text>The
				recipient of a scholarship under this section shall agree, in providing health
				care pursuant to the requirements herein—</text>
									<paragraph id="H8C101998700543F59D77ED37CBAECE8F"><enum>(1)</enum><text>not to discriminate
				against an individual seeking care on the basis of the ability of the
				individual to pay for such care or on the basis that payment for such care will
				be made pursuant to a program established in title XVIII of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> or pursuant to the
				programs established in title XIX or title XXI of such Act; and</text>
									</paragraph><paragraph id="H51264FB49B3A4408BFEB00FD85E9F941"><enum>(2)</enum><text>to accept assignment
				under section 1842(b)(3)(B)(ii) of the <act-name parsable-cite="SSA">Social
				Security Act</act-name> for all services for which payment may be made under
				part B of title XVIII of such Act, and to enter into an appropriate agreement
				with the State agency that administers the State plan for medical assistance
				under title XIX, or the State child health plan under title XXI, of such Act to
				provide service to individuals entitled to medical assistance or child health
				assistance, respectively, under the plan.</text>
									</paragraph></subsection><subsection id="H164D66DA6ADD4F6FBC62F675DC52E99"><enum>(g)</enum><header>Continuance of
				funding</header><text>The Secretary shall make payments under this section to a
				Tribal Health Program for any fiscal year subsequent to the first fiscal year
				of such payments unless the Secretary determines that, for the immediately
				preceding fiscal year, the Tribal Health Program has not complied with the
				requirements of this section.</text>
								</subsection></section><section id="H6AAC9A367ACB431CA27E2D9EB35CE033"><enum>107.</enum><header>Indian Health Service
				extern programs</header>
								<subsection id="H52BDBC8883C2467C98C2B69F4CFABBD"><enum>(a)</enum><header>Employment
				preference</header><text>Any individual who receives a scholarship pursuant to
				section 104 or 106 shall be given preference for employment in the Service, or
				may be employed by a Tribal Health Program or an Urban Indian Organization, or
				other agencies of the Department as available, during any nonacademic period of
				the year.</text>
								</subsection><subsection id="H9CF9DAE8BC5B4D80A08CD0E667E700D0"><enum>(b)</enum><header>Not counted toward
				active duty service obligation</header><text>Periods of employment pursuant to
				this subsection shall not be counted in determining fulfillment of the service
				obligation incurred as a condition of the scholarship.</text>
								</subsection><subsection id="HBE50DD97F17040789FC396AAF21CB3C5"><enum>(c)</enum><header>Timing; length of
				employment</header><text>Any individual enrolled in a program, including a high
				school program, authorized under section 102(a) may be employed by the Service
				or by a Tribal Health Program or an Urban Indian Organization during any
				nonacademic period of the year. Any such employment shall not exceed 120 days
				during any calendar year.</text>
								</subsection><subsection id="H2C3AF3436BDE462A9C7F4268637CE7D"><enum>(d)</enum><header>Nonapplicability of
				competitive personnel system</header><text>Any employment pursuant to this
				section shall be made without regard to any competitive personnel system or
				agency personnel limitation and to a position which will enable the individual
				so employed to receive practical experience in the health profession in which
				he or she is engaged in study. Any individual so employed shall receive payment
				for his or her services comparable to the salary he or she would receive if he
				or she were employed in the competitive system. Any individual so employed
				shall not be counted against any employment ceiling affecting the Service or
				the Department.</text>
								</subsection></section><section id="H584652FF833A4AF7A1E9808429D67521"><enum>108.</enum><header>Continuing education
				allowances</header><text display-inline="no-display-inline">In order to
				encourage scholarship and stipend recipients under sections 104, 105, 106, and
				115 and health professionals, including community health representatives and
				emergency medical technicians, to join or continue in an Indian Health Program
				and to provide their services in the rural and remote areas where a significant
				portion of Indians reside, the Secretary, acting through the Service,
				may—</text>
								<paragraph id="H762BD90E166E400980E63FC8DE333D80"><enum>(1)</enum><text display-inline="yes-display-inline">provide programs or allowances to
				transition into an Indian Health Program, including licensing, board or
				certification examination assistance, and technical assistance in fulfilling
				service obligations under sections 104, 105, 106, and 115; and</text>
								</paragraph><paragraph id="H0122432D503C45A58CA75BE9918E47D2"><enum>(2)</enum><text display-inline="yes-display-inline">provide programs or allowances to health
				professionals employed in an Indian Health Program to enable them for a period
				of time each year prescribed by regulation of the Secretary to take leave of
				their duty stations for professional consultation, management, leadership, and
				refresher training courses.</text>
								</paragraph></section><section id="HE96577A875BD420C97AB91B069B7C4C2"><enum>109.</enum><header>Community Health
				Representative Program</header>
								<subsection id="HB753E4767DEB492F823158FBF2FF84D9"><enum>(a)</enum><header>In
				general</header><text>Under the authority of the Act of November 2, 1921 (25
				U.S.C. 13) (commonly known as the <quote>Snyder Act</quote>), the Secretary,
				acting through the Service, shall maintain a Community Health Representative
				Program under which Indian Health Programs—</text>
									<paragraph id="H2475A34A98A54881924E3179D35FEF48"><enum>(1)</enum><text>provide for the training
				of Indians as community health representatives; and</text>
									</paragraph><paragraph id="HF278C5946A184D58A556B66FDC0038C7"><enum>(2)</enum><text>use such community health
				representatives in the provision of health care, health promotion, and disease
				prevention services to Indian communities.</text>
									</paragraph></subsection><subsection id="H7688122203764A1D8365FDC6C090F690"><enum>(b)</enum><header>Duties</header><text>The
				Community Health Representative Program of the Service, shall—</text>
									<paragraph id="HBCDBF73194DF4787B7869CDA8F97322"><enum>(1)</enum><text>provide a high standard
				of training for community health representatives to ensure that the community
				health representatives provide quality health care, health promotion, and
				disease prevention services to the Indian communities served by the
				Program;</text>
									</paragraph><paragraph id="H47EE98322D3744AB89E200DDFCE144F1"><enum>(2)</enum><text>in order to provide such
				training, develop and maintain a curriculum that—</text>
										<subparagraph id="H1D985089FBFA41F0900013D562FF8F4"><enum>(A)</enum><text>combines education in the
				theory of health care with supervised practical experience in the provision of
				health care; and</text>
										</subparagraph><subparagraph id="HC42AF54B337F4608A7061E4D4C38ED94"><enum>(B)</enum><text>provides instruction and
				practical experience in health promotion and disease prevention activities,
				with appropriate consideration given to lifestyle factors that have an impact
				on Indian health status, such as alcoholism, family dysfunction, and
				poverty;</text>
										</subparagraph></paragraph><paragraph id="H78A36D411A8345CE952BFF6B855B682F"><enum>(3)</enum><text>maintain a system which
				identifies the needs of community health representatives for continuing
				education in health care, health promotion, and disease prevention and develop
				programs that meet the needs for continuing education;</text>
									</paragraph><paragraph id="HB7AD8502DAE94CD8969E258782B21F05"><enum>(4)</enum><text>maintain a system that
				provides close supervision of Community Health Representatives;</text>
									</paragraph><paragraph id="H1BD77A17440644A69CCDB29DA5D28576"><enum>(5)</enum><text>maintain a system under
				which the work of Community Health Representatives is reviewed and evaluated;
				and</text>
									</paragraph><paragraph id="H918398CB038C4E1CBD3F9313C9B8A19C"><enum>(6)</enum><text>promote traditional
				health care practices of the Indian Tribes served consistent with the Service
				standards for the provision of health care, health promotion, and disease
				prevention.</text>
									</paragraph></subsection></section><section id="H64CEA50064704058BEC0ABFB105687D8"><enum>110.</enum><header>Indian Health Service
				Loan Repayment Program</header>
								<subsection id="HF926BDC3F0CA4D028DF8A4C100C7F0E8"><enum>(a)</enum><header>Establishment</header><text>The
				Secretary, acting through the Service, shall establish and administer a program
				to be known as the Service Loan Repayment Program (hereinafter referred to as
				the <quote>Loan Repayment Program</quote>) in order to ensure an adequate
				supply of trained health professionals necessary to maintain accreditation of,
				and provide health care services to Indians through, Indian Health Programs and
				Urban Indian Organizations.</text>
								</subsection><subsection id="HB75574D3A578447000C04CAC5BB5603F"><enum>(b)</enum><header>Eligible
				individuals</header><text>To be eligible to participate in the Loan Repayment
				Program, an individual must—</text>
									<paragraph id="H8D66C6AD2C6446F1A3C2FAD487C1A0E4"><enum>(1)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H7440F84A0A3D4D20BA80504143B81080"><enum>(A)</enum><text>be enrolled—</text>
											<clause changed="added" committee-id="HII00" id="H07B2FBF0943B4EA582E414FE25C7810" indent="up1" reported-display-style="italic"><enum>(i)</enum><text>in a course of study or
				program in an accredited educational institution (as determined by the
				Secretary under section 338B(b)(1)(c)(i) of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
				254<added-phrase reported-display-style="italic">l</added-phrase>–1(b)(1)(c)(i))) and be
				scheduled to complete such course of study in the same year such individual
				applies to participate in such program; or</text>
											</clause><clause changed="added" committee-id="HII00" id="H737A5E3A46124A5889089F44E7124EF9" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text>in an approved graduate
				training program in a health profession; or</text>
											</clause></subparagraph><subparagraph changed="added" committee-id="HII00" id="HBFA9A804776D49B190DAE6B9FD22A9F9" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>have—</text>
											<clause id="H846480EA298549D492C895A28EF80045"><enum>(i)</enum><text>a degree in a health
				profession; and</text>
											</clause><clause id="HD9613E6B80084865B32506A235C0F2A3"><enum>(ii)</enum><text>a license to practice a
				health profession;</text>
											</clause></subparagraph></paragraph><paragraph id="H28783FF6217E4F7388DB51C5A400711E"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="HFDE380CD52054B79923E12F8C9E3D300"><enum>(A)</enum><text>be eligible for, or
				hold, an appointment as a commissioned officer in the Regular or Reserve Corps
				of the Public Health Service;</text>
										</subparagraph><subparagraph changed="added" committee-id="HII00" id="H35DBB2F4ABD3473CAB7B20E727BC8806" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>be eligible for selection
				for civilian service in the Regular or Reserve Corps of the Public Health
				Service;</text>
										</subparagraph><subparagraph changed="added" committee-id="HII00" id="H2AD58C3EB8FC489089F3298F84B052A1" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>meet the professional
				standards for civil service employment in the Service; or</text>
										</subparagraph><subparagraph changed="added" committee-id="HII00" id="H60977553FA154E03A0F8126D24B4734D" indent="up1" reported-display-style="italic"><enum>(D)</enum><text>be employed in an Indian
				Health Program or Urban Indian Organization without a service obligation;
				and</text>
										</subparagraph></paragraph><paragraph id="H0163C2C4A5094FD38C252109B2C18200"><enum>(3)</enum><text>submit to the Secretary
				an application for a contract described in subsection (e).</text>
									</paragraph></subsection><subsection id="HBEBEA941263641F1B0F480CF6300544D"><enum>(c)</enum><header>Application</header>
									<paragraph id="H4C824ABC70CD4EC8A7972CE82CCC01F0"><enum>(1)</enum><header>Information to be
				included with forms</header><text>In disseminating application forms and
				contract forms to individuals desiring to participate in the Loan Repayment
				Program, the Secretary shall include with such forms a fair summary of the
				rights and liabilities of an individual whose application is approved (and
				whose contract is accepted) by the Secretary, including in the summary a clear
				explanation of the damages to which the United States is entitled under
				subsection (l) in the case of the individual’s breach of contract. The
				Secretary shall provide such individuals with sufficient information regarding
				the advantages and disadvantages of service as a commissioned officer in the
				Regular or Reserve Corps of the Public Health Service or a civilian employee of
				the Service to enable the individual to make a decision on an informed
				basis.</text>
									</paragraph><paragraph id="H6E25BEC9397041A48C707F3BD3F4FADB"><enum>(2)</enum><header>Clear
				language</header><text>The application form, contract form, and all other
				information furnished by the Secretary under this section shall be written in a
				manner calculated to be understood by the average individual applying to
				participate in the Loan Repayment Program.</text>
									</paragraph><paragraph id="HA9FD66F704D44D3191BC37CCA7D1C92D"><enum>(3)</enum><header>Timely availability of
				forms</header><text>The Secretary shall make such application forms, contract
				forms, and other information available to individuals desiring to participate
				in the Loan Repayment Program on a date sufficiently early to ensure that such
				individuals have adequate time to carefully review and evaluate such forms and
				information.</text>
									</paragraph></subsection><subsection id="H49204F0187894076B9D7334C2286787D"><enum>(d)</enum><header>Priorities</header>
									<paragraph id="HD7E9374D9E8549B5BCEFB248DEC5B914"><enum>(1)</enum><header>List</header><text>Consistent
				with subsection (k), the Secretary shall annually—</text>
										<subparagraph id="H7B66FD8960C34AD1B1A7E455AFE70900"><enum>(A)</enum><text>identify the positions in
				each Indian Health Program or Urban Indian Organization for which there is a
				need or a vacancy; and</text>
										</subparagraph><subparagraph id="H6156447B5F974BEFA5BA588EA41A5CB"><enum>(B)</enum><text>rank those positions in
				order of priority.</text>
										</subparagraph></paragraph><paragraph id="H0DC02427582044D587E1E8D6676F13D8"><enum>(2)</enum><header>Approvals</header><text>Notwithstanding
				the priority determined under paragraph (1), the Secretary, in determining
				which applications under the Loan Repayment Program to approve (and which
				contracts to accept), shall—</text>
										<subparagraph id="H34B92804BAC24491A0005DE4756FB7D8"><enum>(A)</enum><text>give first priority to
				applications made by individual Indians; and</text>
										</subparagraph><subparagraph id="HABCD1EBF769D4EE899003E68FF513288"><enum>(B)</enum><text>after making
				determinations on all applications submitted by individual Indians as required
				under subparagraph (A), give priority to—</text>
											<clause id="H49A08501BDD144D1B63C1CAA285D39C5"><enum>(i)</enum><text>individuals recruited
				through the efforts of an Indian Health Program or Urban Indian Organization;
				and</text>
											</clause><clause id="H7B56C0F49B1D4919BDD044333FBCC499"><enum>(ii)</enum><text>other individuals based
				on the priority rankings under paragraph (1).</text>
											</clause></subparagraph></paragraph></subsection><subsection id="H32ED97FE1ACE44D0B025822284F00F0"><enum>(e)</enum><header>Recipient
				contracts</header>
									<paragraph id="HE69344F1F8244F6FA5C0F4CAFD755BFF"><enum>(1)</enum><header>Contract
				required</header><text>An individual becomes a participant in the Loan
				Repayment Program only upon the Secretary and the individual entering into a
				written contract described in paragraph (2).</text>
									</paragraph><paragraph id="HF8B59909B78C4872A3316C6FEC300680"><enum>(2)</enum><header>Contents of
				contract</header><text>The written contract referred to in this section between
				the Secretary and an individual shall contain—</text>
										<subparagraph id="H665403B806764A7381748EEC872970D"><enum>(A)</enum><text>an agreement under
				which—</text>
											<clause id="H68DB9B783520415AAC09EA8C3C10DFF3"><enum>(i)</enum><text>subject to subparagraph
				(C), the Secretary agrees—</text>
												<subclause id="HE797C2DA429D42A49DC7406649A23FFE"><enum>(I)</enum><text>to pay loans on behalf of
				the individual in accordance with the provisions of this section; and</text>
												</subclause><subclause id="H00C9E739772D4991BC36BEDD1B56579E"><enum>(II)</enum><text>to accept (subject to
				the availability of appropriated funds for carrying out this section) the
				individual into the Service or place the individual with a Tribal Health
				Program or Urban Indian Organization as provided in clause (ii)(III);
				and</text>
												</subclause></clause><clause id="H48700D306B564E768F1026AC93591F68"><enum>(ii)</enum><text>subject to subparagraph
				(C), the individual agrees—</text>
												<subclause id="HDD24E47213A14082B4858B809FD8D7BF"><enum>(I)</enum><text>to accept loan payments
				on behalf of the individual;</text>
												</subclause><subclause id="HB8754DC1C31C4152BE38DDBDB9383304"><enum>(II)</enum><text>in the case of an
				individual described in subsection (b)(1)—</text>
													<item id="H4F346324DBA0482B86E7DE1EF015E63C"><enum>(aa)</enum><text>to maintain enrollment
				in a course of study or training described in subsection (b)(1)(A) until the
				individual completes the course of study or training; and</text>
													</item><item id="HA49B0FEB2C08407DBF7F0071DA4D133F"><enum>(bb)</enum><text>while enrolled in such
				course of study or training, to maintain an acceptable level of academic
				standing (as determined under regulations of the Secretary by the educational
				institution offering such course of study or training); and</text>
													</item></subclause><subclause id="H3D106A323CBB4BF0B074BA33CF564D06"><enum>(III)</enum><text>to serve for a time
				period (hereinafter in this section referred to as the <quote>period of
				obligated service</quote>) equal to 2 years or such longer period as the
				individual may agree to serve in the full-time clinical practice of such
				individual’s profession in an Indian Health Program or Urban Indian
				Organization to which the individual may be assigned by the Secretary;</text>
												</subclause></clause></subparagraph><subparagraph id="H190BCDE603D34ABE9CB169998DC700E"><enum>(B)</enum><text>a provision permitting
				the Secretary to extend for such longer additional periods, as the individual
				may agree to, the period of obligated service agreed to by the individual under
				subparagraph (A)(ii)(III);</text>
										</subparagraph><subparagraph id="H1F268887A8EE433787E1E100AFBF5DA6"><enum>(C)</enum><text>a provision that any
				financial obligation of the United States arising out of a contract entered
				into under this section and any obligation of the individual which is
				conditioned thereon is contingent upon funds being appropriated for loan
				repayments under this section;</text>
										</subparagraph><subparagraph id="H8F005BC89D214E8A97B3F00E4E4A64F"><enum>(D)</enum><text>a statement of the
				damages to which the United States is entitled under subsection (l) for the
				individual’s breach of the contract; and</text>
										</subparagraph><subparagraph id="H6E8BDB6770434BC789882EB73D06FAF"><enum>(E)</enum><text>such other statements of
				the rights and liabilities of the Secretary and of the individual, not
				inconsistent with this section.</text>
										</subparagraph></paragraph></subsection><subsection id="H9D350B41EF98482FB36613FC9C897130"><enum>(f)</enum><header>Deadline for decision
				on application</header><text>The Secretary shall provide written notice to an
				individual within 21 days on—</text>
									<paragraph id="H16AF91C648B747B4A1645F55554DCE4E"><enum>(1)</enum><text>the Secretary’s
				approving, under subsection (e)(1), of the individual’s participation in the
				Loan Repayment Program, including extensions resulting in an aggregate period
				of obligated service in excess of 4 years; or</text>
									</paragraph><paragraph id="H022E7C578B874A1E90D15D268BB6A700"><enum>(2)</enum><text>the Secretary’s
				disapproving an individual’s participation in such Program.</text>
									</paragraph></subsection><subsection id="HE4322F36EB9443C59B88EBF3E0F9FB2D"><enum>(g)</enum><header>Payments</header>
									<paragraph id="H65FC3DFF77FE4C2BA16E454918E4D3B6"><enum>(1)</enum><header>In
				general</header><text>A loan repayment provided for an individual under a
				written contract under the Loan Repayment Program shall consist of payment, in
				accordance with paragraph (2), on behalf of the individual of the principal,
				interest, and related expenses on government and commercial loans received by
				the individual regarding the undergraduate or graduate education of the
				individual (or both), which loans were made for—</text>
										<subparagraph id="H7F1D5A8B361B46A5B2FACD6FAB081192"><enum>(A)</enum><text>tuition expenses;</text>
										</subparagraph><subparagraph id="HE265DD12CCC34DACA826DCEB56F85215"><enum>(B)</enum><text>all other reasonable
				educational expenses, including fees, books, and laboratory expenses, incurred
				by the individual; and</text>
										</subparagraph><subparagraph id="HCC37A5DA69DC499DB233852B711B6F37"><enum>(C)</enum><text>reasonable living
				expenses as determined by the Secretary.</text>
										</subparagraph></paragraph><paragraph id="H0AFDE47CDF264F189FDCB4369BA09C5"><enum>(2)</enum><header>Amount</header><text>For
				each year of obligated service that an individual contracts to serve under
				subsection (e), the Secretary may pay up to $35,000 or an amount equal to the
				amount specified in section 338B(g)(2)(A) of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>, whichever is more,
				on behalf of the individual for loans described in paragraph (1). In making a
				determination of the amount to pay for a year of such service by an individual,
				the Secretary shall consider the extent to which each such
				determination—</text>
										<subparagraph id="H9E752EC99F884C2DB45E89282C053FD5"><enum>(A)</enum><text>affects the ability of
				the Secretary to maximize the number of contracts that can be provided under
				the Loan Repayment Program from the amounts appropriated for such
				contracts;</text>
										</subparagraph><subparagraph id="H4AFD22386F424A83A6F347D412133884"><enum>(B)</enum><text>provides an incentive to
				serve in Indian Health Programs and Urban Indian Organizations with the
				greatest shortages of health professionals; and</text>
										</subparagraph><subparagraph id="HAA09D2B333BA47D288089FF720BC687C"><enum>(C)</enum><text>provides an incentive
				with respect to the health professional involved remaining in an Indian Health
				Program or Urban Indian Organization with such a health professional shortage,
				and continuing to provide primary health services, after the completion of the
				period of obligated service under the Loan Repayment Program.</text>
										</subparagraph></paragraph><paragraph id="HC0A9D9A1CAF14C1DBCCCDB90743468A7"><enum>(3)</enum><header>Timing</header><text>Any
				arrangement made by the Secretary for the making of loan repayments in
				accordance with this subsection shall provide that any repayments for a year of
				obligated service shall be made no later than the end of the fiscal year in
				which the individual completes such year of service.</text>
									</paragraph><paragraph id="H248C8FC0D2B240E7B74399320037B950"><enum>(4)</enum><header>Reimbursements for tax
				liability</header><text>For the purpose of providing reimbursements for tax
				liability resulting from a payment under paragraph (2) on behalf of an
				individual, the Secretary—</text>
										<subparagraph id="H7FB8EE26626140AE986CB4CC2CA9465B"><enum>(A)</enum><text>in addition to such
				payments, may make payments to the individual in an amount equal to not less
				than 20 percent and not more than 39 percent of the total amount of loan
				repayments made for the taxable year involved; and</text>
										</subparagraph><subparagraph id="H00DC241D38B94B5BB0EAAEFC353C5D42"><enum>(B)</enum><text>may make such additional
				payments as the Secretary determines to be appropriate with respect to such
				purpose.</text>
										</subparagraph></paragraph><paragraph id="H305CCC3ACB32411BB090DDD5D271A837"><enum>(5)</enum><header>Payment
				schedule</header><text>The Secretary may enter into an agreement with the
				holder of any loan for which payments are made under the Loan Repayment Program
				to establish a schedule for the making of such payments.</text>
									</paragraph></subsection><subsection id="HE3A12AA036A54833A1C9D49BECE586"><enum>(h)</enum><header>Employment
				ceiling</header><text>Notwithstanding any other provision of law, individuals
				who have entered into written contracts with the Secretary under this section
				shall not be counted against any employment ceiling affecting the Department
				while those individuals are undergoing academic training.</text>
								</subsection><subsection id="H89D504B9FAFC495198C31977704FFBF2"><enum>(i)</enum><header>Recruitment</header><text>The
				Secretary shall conduct recruiting programs for the Loan Repayment Program and
				other manpower programs of the Service at educational institutions training
				health professionals or specialists identified in subsection (a).</text>
								</subsection><subsection id="HF0938E7B077E4CE099BB371C6B3FE174"><enum>(j)</enum><header>Applicability of
				law</header><text>Section 214 of the <act-name parsable-cite="PHSA">Public
				Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/215">42 U.S.C. 215</external-xref>) shall not apply to individuals
				during their period of obligated service under the Loan Repayment
				Program.</text>
								</subsection><subsection id="HB6BA62B315D844AF9D4940D25FACB625"><enum>(k)</enum><header>Assignment of
				individuals</header><text>The Secretary, in assigning individuals to serve in
				Indian Health Programs or Urban Indian Organizations pursuant to contracts
				entered into under this section, shall—</text>
									<paragraph id="H75C9FF25B5894871B67750FB436CAF82"><enum>(1)</enum><text>ensure that the staffing
				needs of Tribal Health Programs and Urban Indian Organizations receive
				consideration on an equal basis with programs that are administered directly by
				the Service; and</text>
									</paragraph><paragraph id="H1CBCD7D4C84541BEA3A4FD64A0D7215D"><enum>(2)</enum><text>give priority to
				assigning individuals to Indian Health Programs and Urban Indian Organizations
				that have a need for health professionals to provide health care services as a
				result of individuals having breached contracts entered into under this
				section.</text>
									</paragraph></subsection><subsection id="H2620201F7A2F4755A3DCF100BAFAB92F"><enum>(l)</enum><header>Breach of
				contract</header>
									<paragraph id="H0C7DA2E6C283489DA9288D7892AFE3C"><enum>(1)</enum><header>Specific
				breaches</header><text>An individual who has entered into a written contract
				with the Secretary under this section and has not received a waiver under
				subsection (m) shall be liable, in lieu of any service obligation arising under
				such contract, to the United States for the amount which has been paid on such
				individual’s behalf under the contract if that individual—</text>
										<subparagraph id="H22855F34EB614156803200FA78BE9968"><enum>(A)</enum><text>is enrolled in the final
				year of a course of study and—</text>
											<clause id="HB9ED098C18814E05992E1394B100CAEB"><enum>(i)</enum><text>fails to maintain an
				acceptable level of academic standing in the educational institution in which
				he or she is enrolled (such level determined by the educational institution
				under regulations of the Secretary);</text>
											</clause><clause id="HDFBBE98AE2D8440BB198CC2E587FC35F"><enum>(ii)</enum><text>voluntarily terminates
				such enrollment; or</text>
											</clause><clause id="H4EF06166F6E4473DB5E9A1AEB2F67382"><enum>(iii)</enum><text>is dismissed from such
				educational institution before completion of such course of study; or</text>
											</clause></subparagraph><subparagraph id="H102D729DF78246399EB4CB7BE4585E23"><enum>(B)</enum><text>is enrolled in a graduate
				training program and fails to complete such training program.</text>
										</subparagraph></paragraph><paragraph id="H42C1EB9593F04E07B78165037EAF0064"><enum>(2)</enum><header>Other breaches; formula
				for amount owed</header><text>If, for any reason not specified in paragraph
				(1), an individual breaches his or her written contract under this section by
				failing either to begin, or complete, such individual’s period of obligated
				service in accordance with subsection (e)(2), the United States shall be
				entitled to recover from such individual an amount to be determined in
				accordance with the following formula: A=3Z(t−s/t) in which—</text>
										<subparagraph id="H8AC1AD6F45744D95AFF1C053470901E"><enum>(A)</enum><text><quote>A</quote> is the
				amount the United States is entitled to recover;</text>
										</subparagraph><subparagraph id="HEEE61B115FBB478FA772E3BC525FAB84"><enum>(B)</enum><text><quote>Z</quote> is the
				sum of the amounts paid under this section to, or on behalf of, the individual
				and the interest on such amounts which would be payable if, at the time the
				amounts were paid, they were loans bearing interest at the maximum legal
				prevailing rate, as determined by the Secretary of the Treasury;</text>
										</subparagraph><subparagraph id="HAEF1DA2EF9BC4050A6F507FC58F15756"><enum>(C)</enum><text><quote>t</quote> is the
				total number of months in the individual’s period of obligated service in
				accordance with subsection (f); and</text>
										</subparagraph><subparagraph id="H0BC9E50B3B1C49349F997CB58BA8239B"><enum>(D)</enum><text><quote>s</quote> is the
				number of months of such period served by such individual in accordance with
				this section.</text>
										</subparagraph></paragraph><paragraph id="H43A132AE49404C77987106FF87D08739"><enum>(3)</enum><header>Deductions in Medicare
				payments</header><text>Amounts not paid within such period shall be subject to
				collection through deductions in Medicare payments pursuant to section 1892 of
				the <act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
									</paragraph><paragraph id="HE3CED9DBDD144582A3004705ABE132B1"><enum>(4)</enum><header>Time period for
				repayment</header><text>Any amount of damages which the United States is
				entitled to recover under this subsection shall be paid to the United States
				within the 1-year period beginning on the date of the breach or such longer
				period beginning on such date as shall be specified by the Secretary.</text>
									</paragraph><paragraph id="HF0D28B3D350540B18FCF2CE42780AFDB"><enum>(5)</enum><header>Recovery of
				delinquency</header>
										<subparagraph id="HE262ACAABE7D4930B2E08FA0ED4959BA"><enum>(A)</enum><header>In
				general</header><text>If damages described in paragraph (4) are delinquent for
				3 months, the Secretary shall, for the purpose of recovering such
				damages—</text>
											<clause id="HA648F815B6924DF5BC2DE11C4357FCF"><enum>(i)</enum><text>use collection agencies
				contracted with by the Administrator of General Services; or</text>
											</clause><clause id="H2258A05D0EB7448CB000B564F821336B"><enum>(ii)</enum><text>enter into contracts for
				the recovery of such damages with collection agencies selected by the
				Secretary.</text>
											</clause></subparagraph><subparagraph id="H9A3AC7375A5D4A05A47EA00A7E26781"><enum>(B)</enum><header>Report</header><text>Each
				contract for recovering damages pursuant to this subsection shall provide that
				the contractor will, not less than once each 6 months, submit to the Secretary
				a status report on the success of the contractor in collecting such damages.
				<external-xref legal-doc="usc" parsable-cite="usc/31/3718">Section 3718</external-xref> of title 31, United States Code, shall apply to any such contract
				to the extent not inconsistent with this subsection.</text>
										</subparagraph></paragraph></subsection><subsection id="H15EED30042744855A27E69ED6BB016D"><enum>(m)</enum><header>Waiver or suspension of
				obligation</header>
									<paragraph id="HBB739C2BA9134CFF8259B797EBF00120"><enum>(1)</enum><header>In
				general</header><text>The Secretary shall by regulation provide for the partial
				or total waiver or suspension of any obligation of service or payment by an
				individual under the Loan Repayment Program whenever compliance by the
				individual is impossible or would involve extreme hardship to the individual
				and if enforcement of such obligation with respect to any individual would be
				unconscionable.</text>
									</paragraph><paragraph id="H3C4E7D2524CD414F87F0132498B1D83"><enum>(2)</enum><header>Canceled upon
				death</header><text>Any obligation of an individual under the Loan Repayment
				Program for service or payment of damages shall be canceled upon the death of
				the individual.</text>
									</paragraph><paragraph id="H179050B8D80B45FDAE35D323B83D2308"><enum>(3)</enum><header>Hardship
				waiver</header><text>The Secretary may waive, in whole or in part, the rights
				of the United States to recover amounts under this section in any case of
				extreme hardship or other good cause shown, as determined by the
				Secretary.</text>
									</paragraph><paragraph id="H6BA714FEE519467AB666E5180063752C"><enum>(4)</enum><header>Bankruptcy</header><text>Any
				obligation of an individual under the Loan Repayment Program for payment of
				damages may be released by a discharge in bankruptcy under title 11 of the
				United States Code only if such discharge is granted after the expiration of
				the 5-year period beginning on the first date that payment of such damages is
				required, and only if the bankruptcy court finds that nondischarge of the
				obligation would be unconscionable.</text>
									</paragraph></subsection><subsection id="HAD6E46AC580B4228AB1049845470965C"><enum>(n)</enum><header>Report</header><text>The
				Secretary shall submit to the President, for inclusion in the report required
				to be submitted to Congress under section 801, a report concerning the previous
				fiscal year which sets forth by Service Area the following:</text>
									<paragraph id="H38C28C6AFD364A66A9B165ECB6A0679C"><enum>(1)</enum><text>A list of the health
				professional positions maintained by Indian Health Programs and Urban Indian
				Organizations for which recruitment or retention is difficult.</text>
									</paragraph><paragraph id="HB5B42265BCF8457CA482A1D700D7D87"><enum>(2)</enum><text>The number of Loan
				Repayment Program applications filed with respect to each type of health
				profession.</text>
									</paragraph><paragraph id="HA867DCF7DC434C1A8BFAAFEDFACC5C9"><enum>(3)</enum><text>The number of contracts
				described in subsection (e) that are entered into with respect to each health
				profession.</text>
									</paragraph><paragraph id="H0134E3C0F66A4F73B227D806D77E65BD"><enum>(4)</enum><text>The amount of loan
				payments made under this section, in total and by health profession.</text>
									</paragraph><paragraph id="H3179777E1D414E0CB5001734AB039197"><enum>(5)</enum><text>The number of
				scholarships that are provided under sections 104 and 106 with respect to each
				health profession.</text>
									</paragraph><paragraph id="H9F8D5AED208E437FB5D8159DFE007BE4"><enum>(6)</enum><text>The amount of scholarship
				grants provided under section 104 and 106, in total and by health
				profession.</text>
									</paragraph><paragraph id="H6CA22A3906B74D5500704268C264A1F0"><enum>(7)</enum><text>The number of providers
				of health care that will be needed by Indian Health Programs and Urban Indian
				Organizations, by location and profession, during the 3 fiscal years beginning
				after the date the report is filed.</text>
									</paragraph><paragraph id="H83264BCE90EB47C3A714A654EA904447"><enum>(8)</enum><text>The measures the
				Secretary plans to take to fill the health professional positions maintained by
				Indian Health Programs or Urban Indian Organizations for which recruitment or
				retention is difficult.</text>
									</paragraph></subsection></section><section id="H39951B6EA9BD442496D9020020727D92"><enum>111.</enum><header>Scholarship and Loan
				Repayment Recovery Fund</header>
								<subsection id="HB0AF64C48F7848C5B62E283BCBA930B6"><enum>(a)</enum><header>Establishment</header><text>There
				is established in the Treasury of the United States a fund to be known as the
				Indian Health Scholarship and Loan Repayment Recovery Fund (hereafter in this
				section referred to as the <quote>LRRF</quote>). The LRRF shall consist of such
				amounts as may be collected from individuals under section 104(d), section
				106(e), and section 110(l) for breach of contract, such funds as may be
				appropriated to the LRRF, and interest earned on amounts in the LRRF. All
				amounts collected, appropriated, or earned relative to the LRRF shall remain
				available until expended.</text>
								</subsection><subsection id="HD3CFBFF447E14EF28DAA777E4B7F42B0"><enum>(b)</enum><header>Use of funds</header>
									<paragraph id="H37FE68C401454CEB945C9281836E432E"><enum>(1)</enum><header>By
				Secretary</header><text>Amounts in the LRRF may be expended by the Secretary,
				acting through the Service, to make payments to an Indian Health
				Program—</text>
										<subparagraph id="HF19DCB18E56C43249C4FAF3909D208AE"><enum>(A)</enum><text>to which a scholarship
				recipient under section 104 and 106 or a loan repayment program participant
				under section 110 has been assigned to meet the obligated service requirements
				pursuant to such sections; and</text>
										</subparagraph><subparagraph id="HDE93F5EC85AE401BB1ACBD1D3111F0"><enum>(B)</enum><text>that has a need for a
				health professional to provide health care services as a result of such
				recipient or participant having breached the contract entered into under
				section 104, 106, or section 110.</text>
										</subparagraph></paragraph><paragraph id="H42B17696E23B4FC9AFD485F6F10735AF"><enum>(2)</enum><header>By Tribal Health
				Programs</header><text>A Tribal Health Program receiving payments pursuant to
				paragraph (1) may expend the payments to provide scholarships or recruit and
				employ, directly or by contract, health professionals to provide health care
				services.</text>
									</paragraph></subsection><subsection id="H9E01C853DF434F67AF3477EB4B727924"><enum>(c)</enum><header>Investment of
				funds</header><text>The Secretary of the Treasury shall invest such amounts of
				the LRRF as the Secretary of Health and Human Services determines are not
				required to meet current withdrawals from the LRRF. Such investments may be
				made only in interest bearing obligations of the United States. For such
				purpose, such obligations may be acquired on original issue at the issue price,
				or by purchase of outstanding obligations at the market price.</text>
								</subsection><subsection id="HB8F20FA282A440A09F271CBA5758FDB1"><enum>(d)</enum><header>Sale of
				obligations</header><text>Any obligation acquired by the LRRF may be sold by
				the Secretary of the Treasury at the market price.</text>
								</subsection></section><section id="H7A91189698AE44DDBA6DF0501EFAC324"><enum>112.</enum><header>Recruitment
				activities</header>
								<subsection id="H7D021189B8EA4F3A9677C9C5CFA6D6CE"><enum>(a)</enum><header>Reimbursement for
				travel</header><text>The Secretary, acting through the Service, may reimburse
				health professionals seeking positions with Indian Health Programs or Urban
				Indian Organizations, including individuals considering entering into a
				contract under section 110 and their spouses, for actual and reasonable
				expenses incurred in traveling to and from their places of residence to an area
				in which they may be assigned for the purpose of evaluating such area with
				respect to such assignment.</text>
								</subsection><subsection id="H19A0BCC7B19243079900C8A093AAC826"><enum>(b)</enum><header>Recruitment
				personnel</header><text>The Secretary, acting through the Service, shall assign
				1 individual in each Area Office to be responsible on a full-time basis for
				recruitment activities.</text>
								</subsection></section><section id="HF4EA795E03DE4779B1075DC9DD560000"><enum>113.</enum><header>Indian recruitment and
				retention program</header>
								<subsection id="H388BF36F6879481CA9DDF004DCB8BC08"><enum>(a)</enum><header>In
				general</header><text>The Secretary, acting through the Service, shall fund, on
				a competitive basis, innovative demonstration projects for a period not to
				exceed 3 years to enable Tribal Health Programs and Urban Indian Organizations
				to recruit, place, and retain health professionals to meet their staffing
				needs.</text>
								</subsection><subsection id="HB93DBE2A9EA64EC7BDBD876A4F65C7B"><enum>(b)</enum><header>Eligible entities;
				application</header><text>Any Tribal Health Program or Urban Indian
				Organization may submit an application for funding of a project pursuant to
				this section.</text>
								</subsection></section><section id="HF4817CC293194540883B83A46DD7C0FB"><enum>114.</enum><header>Advanced training and
				research</header>
								<subsection id="H44334B9D342D4C858341C8249C9FEBD1"><enum>(a)</enum><header>Demonstration
				program</header><text>The Secretary, acting through the Service, shall
				establish a demonstration project to enable health professionals who have
				worked in an Indian Health Program or Urban Indian Organization for a
				substantial period of time to pursue advanced training or research areas of
				study for which the Secretary determines a need exists.</text>
								</subsection><subsection id="H2EF3B517459A41A3AF06A4C1C2D218B"><enum>(b)</enum><header>Service
				obligation</header><text>An individual who participates in a program under
				subsection (a), where the educational costs are borne by the Service, shall
				incur an obligation to serve in an Indian Health Program or Urban Indian
				Organization for a period of obligated service equal to at least the period of
				time during which the individual participates in such program. In the event
				that the individual fails to complete such obligated service, the individual
				shall be liable to the United States for the period of service remaining. In
				such event, with respect to individuals entering the program after the date of
				enactment of the <short-title>Indian Health Care
				Improvement Act Amendments of 2007</short-title>, the United States shall be
				entitled to recover from such individual an amount to be determined in
				accordance with the formula specified in subsection (l) of section 110 in the
				manner provided for in such subsection.</text>
								</subsection><subsection id="HFF2F61CFAFA54545882FF206ED26F9C1"><enum>(c)</enum><header>Equal opportunity for
				participation</header><text>Health professionals from Tribal Health Programs
				and Urban Indian Organizations shall be given an equal opportunity to
				participate in the program under subsection (a).</text>
								</subsection></section><section id="H2AA7ACA5E3D842218FA10337AA9E13B4"><enum>115.</enum><header>Quentin N. Burdick
				American Indians Into Nursing Program</header>
								<subsection id="H0699B33AA0F349C59B60D25CA95BD218"><enum>(a)</enum><header>Grants
				authorized</header><text>For the purpose of increasing the number of nurses,
				nurse midwives, and nurse practitioners who deliver health care services to
				Indians, the Secretary, acting through the Service, shall provide grants to the
				following:</text>
									<paragraph id="HDE110429FECA451E889E47293E389C00"><enum>(1)</enum><text>Public or private schools
				of nursing.</text>
									</paragraph><paragraph id="H9C542C6189B64590A523ED00D557E6F1"><enum>(2)</enum><text>Tribal colleges or
				universities.</text>
									</paragraph><paragraph id="H7094D1EC78D64043A237FF00536176F"><enum>(3)</enum><text>Nurse midwife programs
				and advanced practice nurse programs that are provided by any tribal college or
				university accredited nursing program, or in the absence of such, any other
				public or private institutions.</text>
									</paragraph></subsection><subsection id="H2AF7DFD087704E1791924FF70072A297"><enum>(b)</enum><header>Use of
				grants</header><text>Grants provided under subsection (a) may be used for 1 or
				more of the following:</text>
									<paragraph id="H44A1D75B51664CD6B11DE275B7975F00"><enum>(1)</enum><text>To recruit individuals
				for programs which train individuals to be nurses, nurse midwives, or advanced
				practice nurses.</text>
									</paragraph><paragraph id="H4C0A92D168AE4552A461B3F94600D7C8"><enum>(2)</enum><text>To provide scholarships
				to Indians enrolled in such programs that may pay the tuition charged for such
				program and other expenses incurred in connection with such program, including
				books, fees, room and board, and stipends for living expenses.</text>
									</paragraph><paragraph id="H3C506AE2B0E24490A2E32C875B30BC2E"><enum>(3)</enum><text>To provide a program that
				encourages nurses, nurse midwives, and advanced practice nurses to provide, or
				continue to provide, health care services to Indians.</text>
									</paragraph><paragraph id="H952306BCD8DE4E9AA76B8209EB87D830"><enum>(4)</enum><text>To provide a program that
				increases the skills of, and provides continuing education to, nurses, nurse
				midwives, and advanced practice nurses.</text>
									</paragraph><paragraph id="HF74B41939BDD4E5E946EA04ED510811"><enum>(5)</enum><text>To provide any program
				that is designed to achieve the purpose described in subsection (a).</text>
									</paragraph></subsection><subsection id="H0D4ADD6CB43049239F47A2B4983B7441"><enum>(c)</enum><header>Applications</header><text>Each
				application for a grant under subsection (a) shall include such information as
				the Secretary may require to establish the connection between the program of
				the applicant and a health care facility that primarily serves Indians.</text>
								</subsection><subsection id="H0537C7651208450A0065F6F9C05FC3DF"><enum>(d)</enum><header>Preferences for grant
				recipients</header><text>In providing grants under subsection (a), the
				Secretary shall extend a preference to the following:</text>
									<paragraph id="H3C9F18132FEB4B6FBB54DFDC3A83B53"><enum>(1)</enum><text>Programs that provide a
				preference to Indians.</text>
									</paragraph><paragraph id="HEEB9E1A917474B9DBCB15FBEE7D91384"><enum>(2)</enum><text>Programs that train nurse
				midwives or advanced practice nurses.</text>
									</paragraph><paragraph id="H7B06BE4930344CB487ACEAF73CBF00D6"><enum>(3)</enum><text>Programs that are
				interdisciplinary.</text>
									</paragraph><paragraph id="H6F9E9391C60B4E52B0C4347F7BB7C00"><enum>(4)</enum><text>Programs that are
				conducted in cooperation with a program for gifted and talented Indian
				students.</text>
									</paragraph><paragraph id="H9E075BD1AACF4990AAEAE158D7B614CF"><enum>(5)</enum><text>Programs conducted by
				tribal colleges and universities.</text>
									</paragraph></subsection><subsection id="H31273BA4D2C344E1982073B5412CDE28"><enum>(e)</enum><header>Quentin N. Burdick
				program grant</header><text>The Secretary shall provide 1 of the grants
				authorized under subsection (a) to establish and maintain a program at the
				University of North Dakota to be known as the <quote>Quentin N. Burdick
				American Indians Into Nursing Program</quote>. Such program shall, to the
				maximum extent feasible, coordinate with the Quentin N. Burdick Indian Health
				Programs established under section 117(b) and the Quentin N. Burdick American
				Indians Into Psychology Program established under section 105(b).</text>
								</subsection><subsection id="H4A8DF3D49539456C922D869186406BD"><enum>(f)</enum><header>Active duty service
				obligation</header><text>The active duty service obligation prescribed under
				section 338C of the <act-name parsable-cite="PHSA">Public Health Service
				Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/254m">42 U.S.C. 254m</external-xref>) shall be met by each individual who receives
				training or assistance described in paragraph (1) or (2) of subsection (b) that
				is funded by a grant provided under subsection (a). Such obligation shall be
				met by service—</text>
									<paragraph id="HD8B303CE5CCA40208ED5A92FDEDAFB50"><enum>(1)</enum><text>in the Service;</text>
									</paragraph><paragraph id="H6637BA68B0A347E0A177F784B91253A4"><enum>(2)</enum><text>in a program of an Indian
				Tribe or Tribal Organization conducted under the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance Act (25
				U.S.C. 450 et seq.)</act-name> (including programs under agreements with the
				Bureau of Indian Affairs);</text>
									</paragraph><paragraph id="H4EA0638595174919BA00C8D8A403F51D"><enum>(3)</enum><text>in a program assisted
				under title V of this Act;</text>
									</paragraph><paragraph id="H53EAF7D9AEF3493B952798D7E35CF833"><enum>(4)</enum><text>in the private practice
				of nursing if, as determined by the Secretary, in accordance with guidelines
				promulgated by the Secretary, such practice is situated in a physician or other
				health shortage area and addresses the health care needs of a substantial
				number of Indians; or</text>
									</paragraph><paragraph id="H7AA2C10B740945FF87A8B6E61800251D"><enum>(5)</enum><text>in a teaching capacity in
				a tribal college or university nursing program (or a related health profession
				program) if, as determined by the Secretary, health services provided to
				Indians would not decrease.</text>
									</paragraph></subsection></section><section id="HB64430576CA44CECB3F381FA3EC616E8"><enum>116.</enum><header>Tribal cultural
				orientation</header>
								<subsection id="HCCEB8CC456EA4A899708692035E62465"><enum>(a)</enum><header>Cultural education of
				employees</header><text>The Secretary, acting through the Service, shall
				require that appropriate employees of the Service who serve Indian Tribes in
				each Service Area receive educational instruction in the history and culture of
				such Indian Tribes and their relationship to the Service.</text>
								</subsection><subsection id="H0FAFCC08762A43AEAA3879AFD9D0018D"><enum>(b)</enum><header>Program</header><text>In
				carrying out subsection (a), the Secretary shall establish a program which
				shall, to the extent feasible—</text>
									<paragraph id="HFB4D03A1F5974E18A929D4153B2035CC"><enum>(1)</enum><text>be developed in
				consultation with the affected Indian Tribes, Tribal Organizations, and Urban
				Indian Organizations;</text>
									</paragraph><paragraph id="HF8876948F4D547AC9477DB4D987180EB"><enum>(2)</enum><text>be carried out through
				tribal colleges or universities;</text>
									</paragraph><paragraph id="H5A3FE4B15DFD4BAA0091866D7CB6918E"><enum>(3)</enum><text>include instruction in
				American Indian studies; and</text>
									</paragraph><paragraph id="H77A7DE05908F415E80247034D59110A3"><enum>(4)</enum><text>describe the use and
				place of traditional health care practices of the Indian Tribes in the Service
				Area.</text>
									</paragraph></subsection></section><section id="HD331734C13564E3D98B0F06200586811"><enum>117.</enum><header>INMED Program</header>
								<subsection id="H24372A1B2AE54C8B88D164DE456B0009"><enum>(a)</enum><header>Grants
				authorized</header><text>The Secretary, acting through the Service, is
				authorized to provide grants to colleges and universities for the purpose of
				maintaining and expanding the Indian health careers recruitment program known
				as the <quote>Indians Into Medicine Program</quote> (hereinafter in this
				section referred to as <quote>INMED</quote>) as a means of encouraging Indians
				to enter the health professions.</text>
								</subsection><subsection id="H89E81E3C5E7843DE83288EE9EAB5414"><enum>(b)</enum><header>Quentin N. Burdick
				grant</header><text>The Secretary shall provide 1 of the grants authorized
				under subsection (a) to maintain the INMED program at the University of North
				Dakota, to be known as the <quote>Quentin N. Burdick Indian Health
				Programs</quote>, unless the Secretary makes a determination, based upon
				program reviews, that the program is not meeting the purposes of this section.
				Such program shall, to the maximum extent feasible, coordinate with the Quentin
				N. Burdick American Indians Into Psychology Program established under section
				105(b) and the Quentin N. Burdick American Indians Into Nursing Program
				established under section 115.</text>
								</subsection><subsection id="H55D7928BA076494BA9EDD625B3145183"><enum>(c)</enum><header>Regulations</header><text>The
				Secretary, pursuant to this Act, shall develop regulations to govern grants
				pursuant to this section.</text>
								</subsection><subsection id="HC69A9FCE9B124509BDD4001416891EA7"><enum>(d)</enum><header>Requirements</header><text>Applicants
				for grants provided under this section shall agree to provide a program
				which—</text>
									<paragraph id="H0A0CFFD77EF8433C902066AEA26CB731"><enum>(1)</enum><text>provides outreach and
				recruitment for health professions to Indian communities including elementary
				and secondary schools and community colleges located on reservations which will
				be served by the program;</text>
									</paragraph><paragraph id="H5499DB90D4F941578E1BE396832EDE2"><enum>(2)</enum><text>incorporates a program
				advisory board comprised of representatives from the Indian Tribes and Indian
				communities which will be served by the program;</text>
									</paragraph><paragraph id="H714E56CD3C49433883E21CB2EB91F9DD"><enum>(3)</enum><text>provides summer
				preparatory programs for Indian students who need enrichment in the subjects of
				math and science in order to pursue training in the health professions;</text>
									</paragraph><paragraph id="H55FF6BB4B01A45649F57A0877ED7B600"><enum>(4)</enum><text>provides tutoring,
				counseling, and support to students who are enrolled in a health career program
				of study at the respective college or university; and</text>
									</paragraph><paragraph id="H6EE3A5F99FEC4F179420F765A002F75"><enum>(5)</enum><text>to the maximum extent
				feasible, employs qualified Indians in the program.</text>
									</paragraph></subsection></section><section id="HCEA510788D2C4E2988A076A286DB4C53"><enum>118.</enum><header>Health training
				programs of community colleges</header>
								<subsection id="H6EF8E250772E4FD0A341EADBC1E439D8"><enum>(a)</enum><header>Grants To establish
				programs</header>
									<paragraph id="HF395771C0B5D4D8EA4BA9E48D6DC592E"><enum>(1)</enum><header>In
				general</header><text>The Secretary, acting through the Service, shall award
				grants to accredited and accessible community colleges for the purpose of
				assisting such community colleges in the establishment of programs which
				provide education in a health profession leading to a degree or diploma in a
				health profession for individuals who desire to practice such profession on or
				near a reservation or in an Indian Health Program.</text>
									</paragraph><paragraph id="HA44AE4E1556547BE8255C6B84FBA2C28"><enum>(2)</enum><header>Amount of
				grants</header><text>The amount of any grant awarded to a community college
				under paragraph (1) for the first year in which such a grant is provided to the
				community college shall not exceed $250,000.</text>
									</paragraph></subsection><subsection id="H4F371D22F5084FE090D49C89D733EA2F"><enum>(b)</enum><header>Grants for maintenance
				and recruiting</header>
									<paragraph id="H45FBDC2E7C344034B9A4FF3E3C5515F0"><enum>(1)</enum><header>In
				general</header><text>The Secretary, acting through the Service, shall award
				grants to accredited and accessible community colleges that have established a
				program described in subsection (a)(1) for the purpose of maintaining the
				program and recruiting students for the program.</text>
									</paragraph><paragraph id="H20A0AA7A7BD44FF280B300E0BFDE1D61"><enum>(2)</enum><header>Requirements</header><text>Grants
				may only be made under this section to a community college which—</text>
										<subparagraph id="HF410359F5DD84ACEB61EF0ADD9793621"><enum>(A)</enum><text>is accredited;</text>
										</subparagraph><subparagraph id="H4AEC9A5943BF41C68EEC822BF8EC5A4"><enum>(B)</enum><text>has a relationship with a
				hospital facility, Service facility, or hospital that could provide training of
				nurses or health professionals;</text>
										</subparagraph><subparagraph id="H68EBC628C37147E997B75CBEE1409941"><enum>(C)</enum><text>has entered into an
				agreement with an accredited college or university medical school, the terms of
				which—</text>
											<clause id="H73C52F9ABA4F4912A1DA3CF51EDDA052"><enum>(i)</enum><text>provide a program that
				enhances the transition and recruitment of students into advanced baccalaureate
				or graduate programs that train health professionals; and</text>
											</clause><clause id="H2F56E38C19614010B9C9005ED5C9D873"><enum>(ii)</enum><text>stipulate certifications
				necessary to approve internship and field placement opportunities at Indian
				Health Programs;</text>
											</clause></subparagraph><subparagraph id="H50B8C3BD51FA4204BCDA8E64CAADCBA8"><enum>(D)</enum><text>has a qualified staff
				which has the appropriate certifications;</text>
										</subparagraph><subparagraph id="HDD8320DF00F845348000E063DC3D911D"><enum>(E)</enum><text>is capable of obtaining
				State or regional accreditation of the program described in subsection (a)(1);
				and</text>
										</subparagraph><subparagraph id="H7591410A6AC4470D8137EA4D1805B7FA"><enum>(F)</enum><text>agrees to provide for
				Indian preference for applicants for programs under this section.</text>
										</subparagraph></paragraph></subsection><subsection id="HCBF18EF530734A6E8C272CA379998B14"><enum>(c)</enum><header>Technical
				assistance</header><text>The Secretary shall encourage community colleges
				described in subsection (b)(2) to establish and maintain programs described in
				subsection (a)(1) by—</text>
									<paragraph id="H42F3DB1B7CA44E74993B634F5EF71FE"><enum>(1)</enum><text>entering into agreements
				with such colleges for the provision of qualified personnel of the Service to
				teach courses of study in such programs; and</text>
									</paragraph><paragraph id="H18A397DA18DA44F3BF6289EC4975271D"><enum>(2)</enum><text>providing technical
				assistance and support to such colleges.</text>
									</paragraph></subsection><subsection id="HA94246CBADC9471899CEFFE68CDD6B59"><enum>(d)</enum><header>Advanced
				training</header>
									<paragraph id="H28251B452B584463AA70F000A8D2F66F"><enum>(1)</enum><header>Required</header><text>Any
				program receiving assistance under this section that is conducted with respect
				to a health profession shall also offer courses of study which provide advanced
				training for any health professional who—</text>
										<subparagraph id="HE073CD6BA78A4B8BB2A126D9A508D65B"><enum>(A)</enum><text>has already received a
				degree or diploma in such health profession; and</text>
										</subparagraph><subparagraph id="HC9B27D452CDB4318B8EB8F5C3DC54667"><enum>(B)</enum><text>provides clinical
				services on or near a reservation or for an Indian Health Program.</text>
										</subparagraph></paragraph><paragraph id="HA4E55120DEAA4E29AE5EE59D404F752B"><enum>(2)</enum><header>May be offered at
				alternate site</header><text>Such courses of study may be offered in
				conjunction with the college or university with which the community college has
				entered into the agreement required under subsection (b)(2)(C).</text>
									</paragraph></subsection><subsection id="H6CACB17DF8ED4FA3B2C686721549D7D9"><enum>(e)</enum><header>Priority</header><text>Where
				the requirements of subsection (b) are met, grant award priority shall be
				provided to tribal colleges and universities in Service Areas where they
				exist.</text>
								</subsection></section><section id="HD7B6A0A87573482C9269E05BFC005F4B"><enum>119.</enum><header>Retention
				bonus</header>
								<subsection id="H4D52E2236D9D49A1A7D5C2C2907754E1"><enum>(a)</enum><header>Bonus
				authorized</header><text>The Secretary may pay a retention bonus to any health
				professional employed by, or assigned to, and serving in, an Indian Health
				Program or Urban Indian Organization either as a civilian employee or as a
				commissioned officer in the Regular or Reserve Corps of the Public Health
				Service who—</text>
									<paragraph id="H9C9D2004CCE74359AEFEB7F471ED5882"><enum>(1)</enum><text>is assigned to, and
				serving in, a position for which recruitment or retention of personnel is
				difficult;</text>
									</paragraph><paragraph id="HE313EFEB968F4A95A0DBBF7736AC3B94"><enum>(2)</enum><text>the Secretary determines
				is needed by Indian Health Programs and Urban Indian Organizations;</text>
									</paragraph><paragraph id="H4DCF5FA30EF442629387B5CC8FA9C104"><enum>(3)</enum><text>has—</text>
										<subparagraph id="H8987EB6C7E6C413EBD94C8A1A44BB36C"><enum>(A)</enum><text>completed 2 years of
				employment with an Indian Health Program or Urban Indian Organization;
				or</text>
										</subparagraph><subparagraph id="H9ED3C1F6035049D2912DE54CEF02C09F"><enum>(B)</enum><text>completed any service
				obligations incurred as a requirement of—</text>
											<clause id="H7F7FAF3420A64B2EA3D2886955DA888F"><enum>(i)</enum><text>any Federal scholarship
				program; or</text>
											</clause><clause id="HA04E97168B9E46E0BEF0D9CB57B05186"><enum>(ii)</enum><text>any Federal education
				loan repayment program; and</text>
											</clause></subparagraph></paragraph><paragraph id="HC9A3FB1FC66048EEBC269DCC33FA4FBE"><enum>(4)</enum><text>enters into an agreement
				with an Indian Health Program or Urban Indian Organization for continued
				employment for a period of not less than 1 year.</text>
									</paragraph></subsection><subsection id="H1952C07ACE584D4F995BDC17DEDDBA"><enum>(b)</enum><header>Rates</header><text>The
				Secretary may establish rates for the retention bonus which shall provide for a
				higher annual rate for multiyear agreements than for single year agreements
				referred to in subsection (a)(4), but in no event shall the annual rate be more
				than $25,000 per annum.</text>
								</subsection><subsection id="HD5CE6141AEC64CEE976220FD3C08008C"><enum>(c)</enum><header>Default of retention
				agreement</header><text>Any health professional failing to complete the agreed
				upon term of service, except where such failure is through no fault of the
				individual, shall be obligated to refund to the Government the full amount of
				the retention bonus for the period covered by the agreement, plus interest as
				determined by the Secretary in accordance with section 110(l)(2)(B).</text>
								</subsection><subsection id="H15621951AF1F409DBD51FE592E3BAD26"><enum>(d)</enum><header>Other retention
				bonus</header><text>The Secretary may pay a retention bonus to any health
				professional employed by a Tribal Health Program if such health professional is
				serving in a position which the Secretary determines is—</text>
									<paragraph id="H913DEA15B4F544EC8DA26967682B8524"><enum>(1)</enum><text>a position for which
				recruitment or retention is difficult; and</text>
									</paragraph><paragraph id="HDCA01119AD9E4EC9BE234000CD1216A4"><enum>(2)</enum><text>necessary for providing
				health care services to Indians.</text>
									</paragraph></subsection></section><section id="H7FBB09F3229B44B38930F64415292DC7"><enum>120.</enum><header>Nursing residency
				program</header>
								<subsection id="H86B82DEAA5C54278A932001D9EC56805"><enum>(a)</enum><header>Establishment of
				program</header><text>The Secretary, acting through the Service, shall
				establish a program to enable Indians who are licensed practical nurses,
				licensed vocational nurses, and registered nurses who are working in an Indian
				Health Program or Urban Indian Organization, and have done so for a period of
				not less than 1 year, to pursue advanced training. Such program shall include a
				combination of education and work study in an Indian Health Program or Urban
				Indian Organization leading to an associate or bachelor’s degree (in the case
				of a licensed practical nurse or licensed vocational nurse), a bachelor’s
				degree (in the case of a registered nurse), or advanced degrees or
				certifications in nursing and public health.</text>
								</subsection><subsection id="H2D049544C13A4603A5A7B4675CBD44E5"><enum>(b)</enum><header>Service
				obligation</header><text>An individual who participates in a program under
				subsection (a), where the educational costs are paid by the Service, shall
				incur an obligation to serve in an Indian Health Program or Urban Indian
				Organization for a period of obligated service equal to 1 year for every year
				that nonprofessional employee (licensed practical nurses, licensed vocational
				nurses, nursing assistants, and various health care technicals), or 2 years for
				every year that professional nurse (associate degree and bachelor-prepared
				registered nurses), participates in such program. In the event that the
				individual fails to complete such obligated service, the United States shall be
				entitled to recover from such individual an amount determined in accordance
				with the formula specified in subsection (l) of section 110 in the manner
				provided for in such subsection.</text>
								</subsection></section><section id="H84FD0D55F3F14767B8867518CF1C2F31"><enum>121.</enum><header>Community Health Aide
				Program</header>
								<subsection id="HE4C062AE83B344C58203521500A64134"><enum>(a)</enum><header>General purposes of
				program</header><text>Under the authority of the Act of November 2, 1921 (25
				U.S.C. 13) (commonly known as the <quote>Snyder Act</quote>), the Secretary,
				acting through the Service, shall develop and operate a Community Health Aide
				Program in Alaska under which the Service—</text>
									<paragraph id="HB43846A2CB754F90AC884EB50201DDA"><enum>(1)</enum><text>provides for the training
				of Alaska Natives as health aides or community health practitioners;</text>
									</paragraph><paragraph id="HD1F312F2F45844E6B600007B81E81BE0"><enum>(2)</enum><text>uses such aides or
				practitioners in the provision of health care, health promotion, and disease
				prevention services to Alaska Natives living in villages in rural Alaska;
				and</text>
									</paragraph><paragraph id="H556AA7E0BC5D485F81CE81BC97675234"><enum>(3)</enum><text>provides for the
				establishment of teleconferencing capacity in health clinics located in or near
				such villages for use by community health aides or community health
				practitioners.</text>
									</paragraph></subsection><subsection id="HD3CB8266D774457BB300E9C9ABC3C1F5"><enum>(b)</enum><header>Specific program
				requirements</header><text>The Secretary, acting through the Community Health
				Aide Program of the Service, shall—</text>
									<paragraph id="HDEF64E4E1C9B4251B884A6463BB5FB00"><enum>(1)</enum><text>using trainers accredited
				by the Program, provide a high standard of training to community health aides
				and community health practitioners to ensure that such aides and practitioners
				provide quality health care, health promotion, and disease prevention services
				to the villages served by the Program;</text>
									</paragraph><paragraph id="H1FED9105708448DFAC8BB2676ACDB67"><enum>(2)</enum><text>in order to provide such
				training, develop a curriculum that—</text>
										<subparagraph id="H1D6F2C1A0D6A46AC824914BD6E67D5E6"><enum>(A)</enum><text>combines education in the
				theory of health care with supervised practical experience in the provision of
				health care;</text>
										</subparagraph><subparagraph id="H67C41211FB724B61994E5F88CF02F543"><enum>(B)</enum><text>provides instruction and
				practical experience in the provision of acute care, emergency care, health
				promotion, disease prevention, and the efficient and effective management of
				clinic pharmacies, supplies, equipment, and facilities; and</text>
										</subparagraph><subparagraph id="HF35075730E7942F5ACB8EC65ACD243B"><enum>(C)</enum><text>promotes the achievement
				of the health status objectives specified in section 3(2);</text>
										</subparagraph></paragraph><paragraph id="H07550F0B8D38424BAAD6E07117FF1DC8"><enum>(3)</enum><text>establish and maintain a
				Community Health Aide Certification Board to certify as community health aides
				or community health practitioners individuals who have successfully completed
				the training described in paragraph (1) or can demonstrate equivalent
				experience;</text>
									</paragraph><paragraph id="H4A763EA940E9482A8DD19B06A84D00BE"><enum>(4)</enum><text>develop and maintain a
				system which identifies the needs of community health aides and community
				health practitioners for continuing education in the provision of health care,
				including the areas described in paragraph (2)(B), and develop programs that
				meet the needs for such continuing education;</text>
									</paragraph><paragraph id="HD0791F10F38949B1A4C55EB85325944C"><enum>(5)</enum><text>develop and maintain a
				system that provides close supervision of community health aides and community
				health practitioners;</text>
									</paragraph><paragraph id="H6A6FFAAB45414A78A3FDA0AA64AB9212"><enum>(6)</enum><text>develop a system under
				which the work of community health aides and community health practitioners is
				reviewed and evaluated to assure the provision of quality health care, health
				promotion, and disease prevention services; and</text>
									</paragraph><paragraph id="H9C728F35FAE7467CADEE00E45EAD8217"><enum>(7)</enum><text>ensure that pulpal
				therapy (not including pulpotomies on deciduous teeth) or extraction of adult
				teeth can be performed by a dental health aide therapist only after
				consultation with a licensed dentist who determines that the procedure is a
				medical emergency that cannot be resolved with palliative treatment, and
				further that dental health aide therapists are strictly prohibited from
				performing all other oral or jaw surgeries, provided that uncomplicated
				extractions shall not be considered oral surgery under this section.</text>
									</paragraph></subsection><subsection id="H15BD438BA62D4B21A9B35EE60AD0015"><enum>(c)</enum><header>Program review</header>
									<paragraph id="H239DA58C12474DB292366969E252F5FF"><enum>(1)</enum><header>Neutral panel</header>
										<subparagraph id="H4365BD638C094E7F9D8D4378D88C700"><enum>(A)</enum><header>Establishment</header><text>The
				Secretary, acting through the Service, shall establish a neutral panel to carry
				out the study under paragraph (2).</text>
										</subparagraph><subparagraph id="H539D0FD63C8F4D5DAF59C32DE6CD2604"><enum>(B)</enum><header>Membership</header><text>Members
				of the neutral panel shall be appointed by the Secretary from among clinicians,
				economists, community practitioners, oral epidemiologists, and Alaska
				Natives.</text>
										</subparagraph></paragraph><paragraph id="H227F85BAB8CA4EB8BB13037384D39D90"><enum>(2)</enum><header>Study</header>
										<subparagraph id="H76097DD80BB84F99B46800355CBCCD27"><enum>(A)</enum><header>In
				general</header><text>The neutral panel established under paragraph (1) shall
				conduct a study of the dental health aide therapist services provided by the
				Community Health Aide Program under this section to ensure that the quality of
				care provided through those services is adequate and appropriate.</text>
										</subparagraph><subparagraph id="H4ED1C400C3D34EC39766E7B4446C74C3"><enum>(B)</enum><header>Parameters of
				study</header><text>The Secretary, in consultation with interested parties,
				including professional dental organizations, shall develop the parameters of
				the study.</text>
										</subparagraph><subparagraph id="H87BDDC53EE2A436100F8CBEED77DB179"><enum>(C)</enum><header>Inclusions</header><text>The
				study shall include a determination by the neutral panel with respect
				to—</text>
											<clause id="HC9904E2C98E44F4787601382FB7FF86B"><enum>(i)</enum><text>the ability of the dental
				health aide therapist services under this section to address the dental care
				needs of Alaska Natives;</text>
											</clause><clause id="H694CEE9851F04C5A00A495FEF1554B"><enum>(ii)</enum><text>the quality of care
				provided through those services, including any training, improvement, or
				additional oversight required to improve the quality of care; and</text>
											</clause><clause id="H26201E8B162A49B48F536483968E3D05"><enum>(iii)</enum><text>whether safer and less
				costly alternatives to the dental health aide therapist services exist.</text>
											</clause></subparagraph><subparagraph id="H53C4E608C2F44C7F8E00162FDEC12723"><enum>(D)</enum><header>Consultation</header><text>In
				carrying out the study under this paragraph, the neutral panel shall consult
				with Alaska Tribal Organizations with respect to the adequacy and accuracy of
				the study.</text>
										</subparagraph></paragraph><paragraph id="H1D33A3AADE514C91AAF1ECFC5DAD93BA"><enum>(3)</enum><header>Report</header><text>The
				neutral panel shall submit to the Secretary, the Committee on Indian Affairs of
				the Senate, and the Committee on Natural Resources of the House of
				Representatives a report describing the results of the study under paragraph
				(2), including a description of—</text>
										<subparagraph id="HED0E234864A94A5B9C1F4CDCE939B700"><enum>(A)</enum><text>any determination of the
				neutral panel under paragraph (2)(C); and</text>
										</subparagraph><subparagraph id="H364EBD08D8684764B28717C0E7709F50"><enum>(B)</enum><text>any comments received
				from an Alaska Tribal Organization under paragraph (2)(D).</text>
										</subparagraph></paragraph></subsection><subsection id="H442CABBBD42145B485444794B806F948"><enum>(d)</enum><header>Nationalization of
				program</header>
									<paragraph id="HDA7173CB16194DD5AE7FC3D99275928C"><enum>(1)</enum><header>In
				general</header><text>Except as provided in paragraph (2), the Secretary,
				acting through the Service, may establish a national Community Health Aide
				Program in accordance with the program under this section, as the Secretary
				determines to be appropriate.</text>
									</paragraph><paragraph id="HC92B98D4D3FF43D3BC9000E6A6437294"><enum>(2)</enum><header>Exception</header><text>The
				national Community Health Aide Program under paragraph (1) shall not include
				dental health aide therapist services.</text>
									</paragraph><paragraph id="H8794752E9D81427798918072E469F5E7"><enum>(3)</enum><header>Requirement</header><text>In
				establishing a national program under paragraph (1), the Secretary shall not
				reduce the amount of funds provided for the Community Health Aide Program
				described in subsections (a) and (b).</text>
									</paragraph></subsection></section><section id="HDE0D1B82BF2F4D9C838B3C3276D45507"><enum>122.</enum><header>Tribal Health Program
				administration</header><text display-inline="no-display-inline">The Secretary,
				acting through the Service, shall, by contract or otherwise, provide training
				for Indians in the administration and planning of Tribal Health
				Programs.</text>
							</section><section id="HA1FE737A18B14904B0C1315BDA108203"><enum>123.</enum><header>Health professional
				chronic shortage demonstration programs</header>
								<subsection id="H6710E9DE19F74A0E9B55A2E599E41F20"><enum>(a)</enum><header>Demonstration programs
				authorized</header><text>The Secretary, acting through the Service, may fund
				demonstration programs for Tribal Health Programs to address the chronic
				shortages of health professionals.</text>
								</subsection><subsection id="H214B19685C5F492FA4E500D2F3A9B300"><enum>(b)</enum><header>Purposes of
				programs</header><text>The purposes of demonstration programs funded under
				subsection (a) shall be—</text>
									<paragraph id="H69FB667EA6A24A6F98A1B886B2D7E486"><enum>(1)</enum><text>to provide direct
				clinical and practical experience at a Service Unit to health profession
				students and residents from medical schools;</text>
									</paragraph><paragraph id="H34847379D065441A8600A1E139DC179E"><enum>(2)</enum><text>to improve the quality of
				health care for Indians by assuring access to qualified health care
				professionals; and</text>
									</paragraph><paragraph id="H9B17AC34B5F54755AEDF12EEF8CBE78"><enum>(3)</enum><text>to provide academic and
				scholarly opportunities for health professionals serving Indians by identifying
				all academic and scholarly resources of the region.</text>
									</paragraph></subsection><subsection id="H9981E9552DC942C9A71EBC3B787F011E"><enum>(c)</enum><header>Advisory
				board</header><text>The demonstration programs established pursuant to
				subsection (a) shall incorporate a program advisory board composed of
				representatives from the Indian Tribes and Indian communities in the area which
				will be served by the program.</text>
								</subsection></section><section id="HAE97E4C7A7744015B2B323F9F93FD42"><enum>124.</enum><header>National Health
				Service Corps</header>
								<subsection id="HA127F2C9089B4C4B993178DA86C3E9B"><enum>(a)</enum><header>No reduction in
				services</header><text display-inline="yes-display-inline">The Secretary shall
				not—</text>
									<paragraph id="H08CCE73DFE0D46EBBF88A4E1D733F6B"><enum>(1)</enum><text>remove a member of the
				National Health Service Corps from an Indian Health Program or Urban Indian
				Organization; or</text>
									</paragraph><paragraph id="H9E15BDD733FE4108AB4DFF763CA6EFE1"><enum>(2)</enum><text>withdraw funding used to
				support such member, unless the Secretary, acting through the Service, has
				ensured that the Indians receiving services from such member will experience no
				reduction in services.</text>
									</paragraph></subsection><subsection id="H19D06D86F59D485390102EDFE2297DDA"><enum>(b)</enum><header>Exemption from
				limitations</header><text>National Health Service Corps scholars qualifying for
				the Commissioned Corps in the Public Health Service shall be exempt from the
				full-time equivalent limitations of the National Health Service Corps and the
				Service when serving as a commissioned corps officer in a Tribal Health Program
				or an Urban Indian Organization.</text>
								</subsection></section><section id="H2DFC74098FE2441ABAA6197D9CDA35F9"><enum>125.</enum><header>Substance abuse
				counselor educational curricula demonstration programs</header>
								<subsection id="H5A0DDB0C2E894176A33F04BD67CBC08B"><enum>(a)</enum><header>Contracts and
				grants</header><text>The Secretary, acting through the Service, may enter into
				contracts with, or make grants to, accredited tribal colleges and universities
				and eligible accredited and accessible community colleges to establish
				demonstration programs to develop educational curricula for substance abuse
				counseling.</text>
								</subsection><subsection id="H9D43FDAF2DFD45FAB8DFB9EDBACDF9F3"><enum>(b)</enum><header>Use of
				funds</header><text>Funds provided under this section shall be used only for
				developing and providing educational curriculum for substance abuse counseling
				(including paying salaries for instructors). Such curricula may be provided
				through satellite campus programs.</text>
								</subsection><subsection id="H8B350D7FDB644381BD1CEB67C49F23A3"><enum>(c)</enum><header>Time period of
				assistance; renewal</header><text>A contract entered into or a grant provided
				under this section shall be for a period of 3 years. Such contract or grant may
				be renewed for an additional 2-year period upon the approval of the
				Secretary.</text>
								</subsection><subsection id="H03B46D22ACB2457DA05DD500FCEC2C9D"><enum>(d)</enum><header>Criteria for review and
				approval of applications</header><text>Not later than 180 days after the date
				of enactment of the <short-title>Indian Health Care
				Improvement Act Amendments of 2007</short-title>, the Secretary, after
				consultation with Indian Tribes and administrators of tribal colleges and
				universities and eligible accredited and accessible community colleges, shall
				develop and issue criteria for the review and approval of applications for
				funding (including applications for renewals of funding) under this section.
				Such criteria shall ensure that demonstration programs established under this
				section promote the development of the capacity of such entities to educate
				substance abuse counselors.</text>
								</subsection><subsection id="HFCF06F4B8D864B04969DCC00DA0A1AD"><enum>(e)</enum><header>Assistance</header><text>The
				Secretary shall provide such technical and other assistance as may be necessary
				to enable grant recipients to comply with the provisions of this
				section.</text>
								</subsection><subsection id="H37337032B4964210AAAAF058DF34A1C0"><enum>(f)</enum><header>Report</header><text>Each
				fiscal year, the Secretary shall submit to the President, for inclusion in the
				report which is required to be submitted under section 801 for that fiscal
				year, a report on the findings and conclusions derived from the demonstration
				programs conducted under this section during that fiscal year.</text>
								</subsection><subsection id="HD7329DB009EB498590CE5B38B9E9556E"><enum>(g)</enum><header>Definition</header><text>For
				the purposes of this section, the term <term>educational curriculum</term>
				means 1 or more of the following:</text>
									<paragraph id="H2EC5B233A7C14FE5B29EC6C41D067FF2"><enum>(1)</enum><text>Classroom
				education.</text>
									</paragraph><paragraph id="HD4EE797EE08B43BC8C027EB425F77DA5"><enum>(2)</enum><text>Clinical work
				experience.</text>
									</paragraph><paragraph id="H906069FCEE934D04A3153554E15488BF"><enum>(3)</enum><text>Continuing education
				workshops.</text>
									</paragraph></subsection></section><section id="HA4AF960FE56647C1A9DE45E6C7B183FB"><enum>126.</enum><header>Behavioral health
				training and community education programs</header>
								<subsection id="H2AD55B67FB2B403587C2F189A7F9C407"><enum>(a)</enum><header>Study;
				list</header><text>The Secretary, acting through the Service, and the Secretary
				of the Interior, in consultation with Indian Tribes and Tribal Organizations,
				shall conduct a study and compile a list of the types of staff positions
				specified in subsection (b) whose qualifications include, or should include,
				training in the identification, prevention, education, referral, or treatment
				of mental illness, or dysfunctional and self destructive behavior.</text>
								</subsection><subsection id="H235DEDF95A9149AB9DFB3F8B007D4535"><enum>(b)</enum><header>Positions</header><text>The
				positions referred to in subsection (a) are—</text>
									<paragraph id="H781001A09DA941D69FCD4C32E8001659"><enum>(1)</enum><text>staff positions within
				the Bureau of Indian Affairs, including existing positions, in the fields
				of—</text>
										<subparagraph id="HD345678880EC4E1D91F5AE74BDB5279E"><enum>(A)</enum><text>elementary and secondary
				education;</text>
										</subparagraph><subparagraph id="H79DF83B3C687416B845F00A9B9AA5901"><enum>(B)</enum><text>social services and
				family and child welfare;</text>
										</subparagraph><subparagraph id="HFA48BD2921F34769AD93A2E3E0E8EDE8"><enum>(C)</enum><text>law enforcement and
				judicial services; and</text>
										</subparagraph><subparagraph id="HB6F418A247EC4BD8A341FC54AAC1FB85"><enum>(D)</enum><text>alcohol and substance
				abuse;</text>
										</subparagraph></paragraph><paragraph id="HF83FDF4F410C4E3E8EBDCB069CCA1BD"><enum>(2)</enum><text>staff positions within
				the Service; and</text>
									</paragraph><paragraph id="HE704BB580D5647EA95D969CC2833085"><enum>(3)</enum><text>staff positions similar
				to those identified in paragraphs (1) and (2) established and maintained by
				Indian Tribes, Tribal Organizations (without regard to the funding source), and
				Urban Indian Organizations.</text>
									</paragraph></subsection><subsection id="HDF71459C8D85419D96CADE56EB9C9261"><enum>(c)</enum><header>Training
				criteria</header>
									<paragraph id="H93DBFEBFA3E047C299CD97B565E368E6"><enum>(1)</enum><header>In
				general</header><text>The appropriate Secretary shall provide training criteria
				appropriate to each type of position identified in subsection (b)(1) and (b)(2)
				and ensure that appropriate training has been, or shall be provided to any
				individual in any such position. With respect to any such individual in a
				position identified pursuant to subsection (b)(3), the respective Secretaries
				shall provide appropriate training to, or provide funds to, an Indian Tribe,
				Tribal Organization, or Urban Indian Organization for training of appropriate
				individuals. In the case of positions funded under a contract or compact under
				the <act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>), the appropriate Secretary
				shall ensure that such training costs are included in the contract or compact,
				as the Secretary determines necessary.</text>
									</paragraph><paragraph id="H1FD36B9E37B44D3D825BD31DD31582C6"><enum>(2)</enum><header>Position specific
				training criteria</header><text>Position specific training criteria shall be
				culturally relevant to Indians and Indian Tribes and shall ensure that
				appropriate information regarding traditional health care practices is
				provided.</text>
									</paragraph></subsection><subsection id="H4472DB98405843E79B688FBE3D1ECFD8"><enum>(d)</enum><header>Community education on
				mental illness</header><text>The Service shall develop and implement, on
				request of an Indian Tribe, Tribal Organization, or Urban Indian Organization,
				or assist the Indian Tribe, Tribal Organization, or Urban Indian Organization
				to develop and implement, a program of community education on mental illness.
				In carrying out this subsection, the Service shall, upon request of an Indian
				Tribe, Tribal Organization, or Urban Indian Organization, provide technical
				assistance to the Indian Tribe, Tribal Organization, or Urban Indian
				Organization to obtain and develop community educational materials on the
				identification, prevention, referral, and treatment of mental illness and
				dysfunctional and self-destructive behavior.</text>
								</subsection><subsection id="H8DF9D9424D2E4B61892BD27181F7D21D"><enum>(e)</enum><header>Plan</header><text>Not
				later than 90 days after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, the Secretary shall develop a plan under which the
				Service will increase the health care staff providing behavioral health
				services by at least 500 positions within 5 years after the date of enactment
				of this section, with at least 200 of such positions devoted to child,
				adolescent, and family services. The plan developed under this subsection shall
				be implemented under the Act of November 2, 1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>) (commonly known
				as the <quote>Snyder Act</quote>).</text>
								</subsection></section><section id="H29EE90EE5B6D4A5B96328FD1B0E4E2E9"><enum>127.</enum><header>Authorization of
				appropriations</header><text display-inline="no-display-inline">There are
				authorized to be appropriated such sums as may be necessary for each fiscal
				year through fiscal year 2017 to carry out this title.</text>
							</section></title><title id="H38AC93D4232046329CB17CE18200805C"><enum>II</enum><header>Health Services</header>
							<section id="H12CEDF6BBEAF4450B9A9302D00261377"><enum>201.</enum><header>Indian Health Care
				Improvement Fund</header>
								<subsection id="HE3FF4E28684943A8A8123271A497F549"><enum>(a)</enum><header>Use of
				funds</header><text>The Secretary, acting through the Service, is authorized to
				expend funds, directly or under the authority of the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>), which are appropriated under
				the authority of this section, for the purposes of—</text>
									<paragraph id="HEF633EC04D3143D39138C96F0524A2FF"><enum>(1)</enum><text>eliminating the
				deficiencies in health status and health resources of all Indian Tribes;</text>
									</paragraph><paragraph id="H1BF49BBA2F134C54B6038D821764D6D1"><enum>(2)</enum><text>eliminating backlogs in
				the provision of health care services to Indians;</text>
									</paragraph><paragraph id="H02495217A3364845A54F4D8E936F9066"><enum>(3)</enum><text>meeting the health needs
				of Indians in an efficient and equitable manner, including the use of
				telehealth and telemedicine when appropriate;</text>
									</paragraph><paragraph id="H22FE93D659E34F4FAAB2EDDA286DB345"><enum>(4)</enum><text>eliminating inequities in
				funding for both direct care and contract health service programs; and</text>
									</paragraph><paragraph id="HA73D6400DD8D460F8FC8559ED1E679D2"><enum>(5)</enum><text>augmenting the ability of
				the Service to meet the following health service responsibilities with respect
				to those Indian Tribes with the highest levels of health status deficiencies
				and resource deficiencies:</text>
										<subparagraph id="H95355782247E4236854E2DDF0000C219"><enum>(A)</enum><text>Clinical care, including
				inpatient care, outpatient care (including audiology, clinical eye, and vision
				care), primary care, secondary and tertiary care, and long-term care.</text>
										</subparagraph><subparagraph id="H6A4A789E9BB54A1F8409F98E636CA6C4"><enum>(B)</enum><text>Preventive health,
				including mammography and other cancer screening in accordance with section
				207.</text>
										</subparagraph><subparagraph id="H51D897E94F424C3FAAD3FF24FD6990D2"><enum>(C)</enum><text>Dental care.</text>
										</subparagraph><subparagraph id="H2E4F08FA7D67418E951C38D3F21E811D"><enum>(D)</enum><text>Mental health, including
				community mental health services, inpatient mental health services, dormitory
				mental health services, therapeutic and residential treatment centers, and
				training of traditional health care practitioners.</text>
										</subparagraph><subparagraph id="H21A8E973EDDE4D26BD6C4C3FA0E3BDA7"><enum>(E)</enum><text>Emergency medical
				services.</text>
										</subparagraph><subparagraph id="H929EF103EC96494CAEC18C1FA27737D7"><enum>(F)</enum><text>Treatment and control of,
				and rehabilitative care related to, alcoholism and drug abuse (including fetal
				alcohol syndrome) among Indians.</text>
										</subparagraph><subparagraph id="H68F051966EF6420AADC749F0351D8B64"><enum>(G)</enum><text>Injury prevention
				programs, including data collection and evaluation, demonstration projects,
				training, and capacity building.</text>
										</subparagraph><subparagraph id="H71EF7C6EF8B6418483697506000000D8"><enum>(H)</enum><text>Home health care.</text>
										</subparagraph><subparagraph id="H0D89659CD41249078F38B7F1CD9320A5"><enum>(I)</enum><text>Community health
				representatives.</text>
										</subparagraph><subparagraph id="H7C00DEFFF39A4C8CB3E94DB6B791FF18"><enum>(J)</enum><text>Maintenance and
				improvement.</text>
										</subparagraph></paragraph></subsection><subsection id="H617D7EAA21864C91ACAFFE7C403F25AC"><enum>(b)</enum><header>No offset or
				limitation</header><text>Any funds appropriated under the authority of this
				section shall not be used to offset or limit any other appropriations made to
				the Service under this Act or the Act of November 2, 1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>)
				(commonly known as the <quote>Snyder Act</quote>), or any other provision of
				law.</text>
								</subsection><subsection id="H9F4417529F1F4761AD513543EA0700EC"><enum>(c)</enum><header>Allocation;
				use</header>
									<paragraph id="HFB21E58FE0E24E0FA288E31ECBE87958"><enum>(1)</enum><header>In
				general</header><text>Funds appropriated under the authority of this section
				shall be allocated to Service Units, Indian Tribes, or Tribal Organizations.
				The funds allocated to each Indian Tribe, Tribal Organization, or Service Unit
				under this paragraph shall be used by the Indian Tribe, Tribal Organization, or
				Service Unit under this paragraph to improve the health status and reduce the
				resource deficiency of each Indian Tribe served by such Service Unit, Indian
				Tribe, or Tribal Organization.</text>
									</paragraph><paragraph id="H17171F2D290A4D17BC8B21A0EC7FD1E6"><enum>(2)</enum><header>Apportionment of
				allocated funds</header><text>The apportionment of funds allocated to a Service
				Unit, Indian Tribe, or Tribal Organization under paragraph (1) among the health
				service responsibilities described in subsection (a)(5) shall be determined by
				the Service in consultation with, and with the active participation of, the
				affected Indian Tribes and Tribal Organizations.</text>
									</paragraph></subsection><subsection id="H7E78A962C59E493D98497BE5EB2931EE"><enum>(d)</enum><header>Provisions relating to
				health status and resource deficiencies</header><text>For the purposes of this
				section, the following definitions apply:</text>
									<paragraph id="H5F2CC3D716C949CDB81D3F34E0CE089F"><enum>(1)</enum><header>Definition</header><text>The
				term <term>health status and resource deficiency</term> means the extent to
				which—</text>
										<subparagraph id="HB5A9DCE546F542AE8D9F1B4D17549CAE"><enum>(A)</enum><text>the health status
				objectives set forth in section 3(2) are not being achieved; and</text>
										</subparagraph><subparagraph id="H15BD6D8EFBDD4115A4EC9C0293D50856"><enum>(B)</enum><text>the Indian Tribe or
				Tribal Organization does not have available to it the health resources it
				needs, taking into account the actual cost of providing health care services
				given local geographic, climatic, rural, or other circumstances.</text>
										</subparagraph></paragraph><paragraph id="HAFE463C7F6B945D5BF2C759EC52BFAE8"><enum>(2)</enum><header>Available
				resources</header><text>The health resources available to an Indian Tribe or
				Tribal Organization include health resources provided by the Service as well as
				health resources used by the Indian Tribe or Tribal Organization, including
				services and financing systems provided by any Federal programs, private
				insurance, and programs of State or local governments.</text>
									</paragraph><paragraph id="H97D89870F03C430289E6E4AC4E946F8C"><enum>(3)</enum><header>Process for review of
				determinations</header><text>The Secretary shall establish procedures which
				allow any Indian Tribe or Tribal Organization to petition the Secretary for a
				review of any determination of the extent of the health status and resource
				deficiency of such Indian Tribe or Tribal Organization.</text>
									</paragraph></subsection><subsection id="HABDCEABBF5D34DDF9317F5D7FEE99BE5"><enum>(e)</enum><header>Eligibility for
				funds</header><text>Tribal Health Programs shall be eligible for funds
				appropriated under the authority of this section on an equal basis with
				programs that are administered directly by the Service.</text>
								</subsection><subsection id="H2E9D1F97678C488386A476F6ED361C9C"><enum>(f)</enum><header>Report</header><text>By
				no later than the date that is 3 years after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, the Secretary shall submit to Congress the current
				health status and resource deficiency report of the Service for each Service
				Unit, including newly recognized or acknowledged Indian Tribes. Such report
				shall set out—</text>
									<paragraph id="H6A007AD33E9F4D6A8F50007E37989691"><enum>(1)</enum><text>the methodology then in
				use by the Service for determining Tribal health status and resource
				deficiencies, as well as the most recent application of that
				methodology;</text>
									</paragraph><paragraph id="HC111936F47924612B4D213B3356CFD9"><enum>(2)</enum><text>the extent of the health
				status and resource deficiency of each Indian Tribe served by the Service or a
				Tribal Health Program;</text>
									</paragraph><paragraph id="H03638C1027624D2692D694F288579E59"><enum>(3)</enum><text>the amount of funds
				necessary to eliminate the health status and resource deficiencies of all
				Indian Tribes served by the Service or a Tribal Health Program; and</text>
									</paragraph><paragraph id="HE4A6D14069C44B37A789E3E200BBA97F"><enum>(4)</enum><text>an estimate of—</text>
										<subparagraph id="H8269B9B47AE44589A643C34FD380FB2"><enum>(A)</enum><text>the amount of health
				service funds appropriated under the authority of this Act, or any other Act,
				including the amount of any funds transferred to the Service for the preceding
				fiscal year which is allocated to each Service Unit, Indian Tribe, or Tribal
				Organization;</text>
										</subparagraph><subparagraph id="HE6785C1A53FD4946A22C440338E867F7"><enum>(B)</enum><text>the number of Indians
				eligible for health services in each Service Unit or Indian Tribe or Tribal
				Organization; and</text>
										</subparagraph><subparagraph id="H93C09C16171941BDA8007BACF9FB328E"><enum>(C)</enum><text>the number of Indians
				using the Service resources made available to each Service Unit, Indian Tribe
				or Tribal Organization, and, to the extent available, information on the
				waiting lists and number of Indians turned away for services due to lack of
				resources.</text>
										</subparagraph></paragraph></subsection><subsection id="H3928D395C4B24D47003000A0C3991362"><enum>(g)</enum><header>Inclusion in base
				budget</header><text>Funds appropriated under this section for any fiscal year
				shall be included in the base budget of the Service for the purpose of
				determining appropriations under this section in subsequent fiscal
				years.</text>
								</subsection><subsection id="HB2B75055190C45F59F59E80250D900AD"><enum>(h)</enum><header>Clarification</header><text>Nothing
				in this section is intended to diminish the primary responsibility of the
				Service to eliminate existing backlogs in unmet health care needs, nor are the
				provisions of this section intended to discourage the Service from undertaking
				additional efforts to achieve equity among Indian Tribes and Tribal
				Organizations.</text>
								</subsection><subsection id="H873CBFBE6A354012A72826AF382F4477"><enum>(i)</enum><header>Funding
				designation</header><text>Any funds appropriated under the authority of this
				section shall be designated as the <quote>Indian Health Care Improvement
				Fund</quote>.</text>
								</subsection></section><section id="HA9C6523618C443A29E740053C589F203"><enum>202.</enum><header>Catastrophic Health
				Emergency Fund</header>
								<subsection id="H74820F5E904C422992003C53EFB7B942"><enum>(a)</enum><header>Establishment</header><text>There
				is established an Indian Catastrophic Health Emergency Fund (hereafter in this
				section referred to as the <quote>CHEF</quote>) consisting of—</text>
									<paragraph id="H36044C732F3C45049C8E8300F0715B86"><enum>(1)</enum><text>the amounts deposited
				under subsection (f); and</text>
									</paragraph><paragraph id="H769E1A97ABEB417FBAEAB473B002DF2"><enum>(2)</enum><text>the amounts appropriated
				to CHEF under this section.</text>
									</paragraph></subsection><subsection id="HB3B6B43D06A24F9BA41270F4B2AA0042"><enum>(b)</enum><header>Administration</header><text>CHEF
				shall be administered by the Secretary, acting through the headquarters of the
				Service, solely for the purpose of meeting the extraordinary medical costs
				associated with the treatment of victims of disasters or catastrophic illnesses
				who are within the responsibility of the Service.</text>
								</subsection><subsection id="H73EEC772896F4C2FBFA932441696FBBA"><enum>(c)</enum><header>Conditions on use of
				fund</header><text>No part of CHEF or its administration shall be subject to
				contract or grant under any law, including the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance
				Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>), nor shall CHEF funds be allocated,
				apportioned, or delegated on an Area Office, Service Unit, or other similar
				basis.</text>
								</subsection><subsection id="H1D3520C928D645E9A11ED98482937EC4"><enum>(d)</enum><header>Regulations</header><text>The
				Secretary shall promulgate regulations consistent with the provisions of this
				section to—</text>
									<paragraph id="H23F8D1EB139C421A94B6B2FB800BC92"><enum>(1)</enum><text>establish a definition of
				disasters and catastrophic illnesses for which the cost of the treatment
				provided under contract would qualify for payment from CHEF;</text>
									</paragraph><paragraph id="H2EAC3DCFE07A4C879C1027D336B834BE"><enum>(2)</enum><text>provide that a Service
				Unit shall not be eligible for reimbursement for the cost of treatment from
				CHEF until its cost of treating any victim of such catastrophic illness or
				disaster has reached a certain threshold cost which the Secretary shall
				establish at—</text>
										<subparagraph id="H7926413F77FA42AE8398FB2FDABA2B59"><enum>(A)</enum><text>the 2000 level of
				$19,000; and</text>
										</subparagraph><subparagraph id="H762CB5349104406A832047953C8B02E9"><enum>(B)</enum><text>for any subsequent year,
				not less than the threshold cost of the previous year increased by the
				percentage increase in the medical care expenditure category of the consumer
				price index for all urban consumers (United States city average) for the
				12-month period ending with December of the previous year;</text>
										</subparagraph></paragraph><paragraph id="HCDA8D10AC5644515A2DEC100777C6BBF"><enum>(3)</enum><text>establish a procedure for
				the reimbursement of the portion of the costs that exceeds such threshold cost
				incurred by—</text>
										<subparagraph id="H97FA2A5F23B244D6A972FCEEDF20032"><enum>(A)</enum><text>Service Units; or</text>
										</subparagraph><subparagraph id="H26030C949C034734A27847C2FE477031"><enum>(B)</enum><text>whenever otherwise
				authorized by the Service, non-Service facilities or providers;</text>
										</subparagraph></paragraph><paragraph id="HDF597CBF9CA84FB4A8C6E4B7604256F6"><enum>(4)</enum><text>establish a procedure for
				payment from CHEF in cases in which the exigencies of the medical circumstances
				warrant treatment prior to the authorization of such treatment by the Service;
				and</text>
									</paragraph><paragraph id="H04133A0562EE489D81BD3B35C492F200"><enum>(5)</enum><text>establish a procedure
				that will ensure that no payment shall be made from CHEF to any provider of
				treatment to the extent that such provider is eligible to receive payment for
				the treatment from any other Federal, State, local, or private source of
				reimbursement for which the patient is eligible.</text>
									</paragraph></subsection><subsection id="H73F6CC55CD864307A4D8DE2100AF97EE"><enum>(e)</enum><header>No offset or
				limitation</header><text>Amounts appropriated to CHEF under this section shall
				not be used to offset or limit appropriations made to the Service under the
				authority of the Act of November 2, 1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>) (commonly known as the
				<quote>Snyder Act</quote>), or any other law.</text>
								</subsection><subsection id="H21CBACB74C014E9E9740158BA640037"><enum>(f)</enum><header>Deposit of
				reimbursement funds</header><text>There shall be deposited into CHEF all
				reimbursements to which the Service is entitled from any Federal, State, local,
				or private source (including third party insurance) by reason of treatment
				rendered to any victim of a disaster or catastrophic illness the cost of which
				was paid from CHEF.</text>
								</subsection></section><section id="HB92C041A376E442EBE7DF3B803B67ED"><enum>203.</enum><header>Health promotion and
				disease prevention services</header>
								<subsection id="H95326A04045E4A0788D6E76369005306"><enum>(a)</enum><header>Findings</header><text>Congress
				finds that health promotion and disease prevention activities—</text>
									<paragraph id="H367E7C0F367641A4BA467E50898100D9"><enum>(1)</enum><text>improve the health and
				well-being of Indians; and</text>
									</paragraph><paragraph id="H14F51D931FB646ADB286A67B1500BBB"><enum>(2)</enum><text>reduce the expenses for
				health care of Indians.</text>
									</paragraph></subsection><subsection id="H6DDE3428B9054274849FAA5559C4099D"><enum>(b)</enum><header>Provision of
				services</header><text>The Secretary, acting through the Service and Tribal
				Health Programs, shall provide health promotion and disease prevention services
				to Indians to achieve the health status objectives set forth in section
				3(2).</text>
								</subsection><subsection id="H49AAE50E4D294B9880DF597D247FECE5"><enum>(c)</enum><header>Evaluation</header><text>The
				Secretary, after obtaining input from the affected Tribal Health Programs,
				shall submit to the President for inclusion in the report which is required to
				be submitted to Congress under section 801 an evaluation of—</text>
									<paragraph id="H1DBA812BF8814AFC888692795EDF1E80"><enum>(1)</enum><text>the health promotion and
				disease prevention needs of Indians;</text>
									</paragraph><paragraph id="H87A9C6E680B348D79BBA2FBFB229B362"><enum>(2)</enum><text>the health promotion and
				disease prevention activities which would best meet such needs;</text>
									</paragraph><paragraph id="HC87E8CB434534E0F8F308CED435339F3"><enum>(3)</enum><text>the internal capacity of
				the Service and Tribal Health Programs to meet such needs; and</text>
									</paragraph><paragraph id="H5172E38D7A9E400B8BF6EB613359CAA"><enum>(4)</enum><text>the resources which would
				be required to enable the Service and Tribal Health Programs to undertake the
				health promotion and disease prevention activities necessary to meet such
				needs.</text>
									</paragraph></subsection></section><section id="HC717747DDB3546D9B2FBA2EC4F99A7F1"><enum>204.</enum><header>Diabetes prevention,
				treatment, and control</header>
								<subsection id="H33D4C635E881481A8F208D566800A58F"><enum>(a)</enum><header>Determinations
				regarding diabetes</header><text>The Secretary, acting through the Service, and
				in consultation with Indian Tribes and Tribal Organizations, shall
				determine—</text>
									<paragraph id="HB9CC2001DE714567ACA90425314D70E8"><enum>(1)</enum><text>by Indian Tribe and by
				Service Unit, the incidence of, and the types of complications resulting from,
				diabetes among Indians; and</text>
									</paragraph><paragraph id="H0FE4891BA56643539FF123893DD4D16"><enum>(2)</enum><text>based on the
				determinations made pursuant to paragraph (1), the measures (including patient
				education and effective ongoing monitoring of disease indicators) each Service
				Unit should take to reduce the incidence of, and prevent, treat, and control
				the complications resulting from, diabetes among Indian Tribes within that
				Service Unit.</text>
									</paragraph></subsection><subsection id="HC09BAFAC9FC64BA3A3496FB0DE10461B"><enum>(b)</enum><header>Diabetes
				screening</header><text>To the extent medically indicated and with informed
				consent, the Secretary shall screen each Indian who receives services from the
				Service for diabetes and for conditions which indicate a high risk that the
				individual will become diabetic and establish a cost-effective approach to
				ensure ongoing monitoring of disease indicators. Such screening and monitoring
				may be conducted by a Tribal Health Program and may be conducted through
				appropriate Internet-based health care management programs.</text>
								</subsection><subsection id="H9EF9028A372A40C58956324B1704C74F"><enum>(c)</enum><header>Diabetes
				projects</header><text>The Secretary shall continue to maintain each model
				diabetes project in existence on the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, any such other diabetes programs operated by the Service
				or Tribal Health Programs, and any additional diabetes projects, such as the
				Medical Vanguard program provided for in title IV of <external-xref legal-doc="public-law" parsable-cite="pl/108/87">Public Law 108–87</external-xref>, as
				implemented to serve Indian Tribes. Tribal Health Programs shall receive
				recurring funding for the diabetes projects that they operate pursuant to this
				section, both at the date of enactment of the <short-title>Indian Health Care Improvement Act Amendments of
				2007</short-title> and for projects which are added and funded
				thereafter.</text>
								</subsection><subsection id="H81A553A0338F4CB69CEE527BFC2D26E4"><enum>(d)</enum><header>Dialysis
				programs</header><text>The Secretary is authorized to provide, through the
				Service, Indian Tribes, and Tribal Organizations, dialysis programs, including
				the purchase of dialysis equipment and the provision of necessary
				staffing.</text>
								</subsection><subsection id="H1CBBB4CF43004F7199CEE1F2EF143F89"><enum>(e)</enum><header>Other duties of the
				Secretary</header>
									<paragraph id="H00013F1829214AEE95FE642200F62253"><enum>(1)</enum><header>In
				general</header><text>The Secretary shall, to the extent funding is
				available—</text>
										<subparagraph id="HFD67D3F231A84FC4BAECA0C8F43D659"><enum>(A)</enum><text>in each Area Office,
				consult with Indian Tribes and Tribal Organizations regarding programs for the
				prevention, treatment, and control of diabetes;</text>
										</subparagraph><subparagraph id="H0E85BAF4AECD4624B8151906D9BB00AF"><enum>(B)</enum><text>establish in each Area
				Office a registry of patients with diabetes to track the incidence of diabetes
				and the complications from diabetes in that area; and</text>
										</subparagraph><subparagraph id="H1E2CD7B5AF5147D89694C3FC87FFBF3B"><enum>(C)</enum><text>ensure that data
				collected in each Area Office regarding diabetes and related complications
				among Indians are disseminated to all other Area Offices, subject to applicable
				patient privacy laws.</text>
										</subparagraph></paragraph><paragraph id="H4370E0BBD0B340C098D3E24E89A0BC74"><enum>(2)</enum><header>Diabetes control
				officers</header>
										<subparagraph id="HA47438A45477406A8FD59E4BA0BC6F03"><enum>(A)</enum><header>In
				general</header><text>The Secretary may establish and maintain in each Area
				Office a position of diabetes control officer to coordinate and manage any
				activity of that Area Office relating to the prevention, treatment, or control
				of diabetes to assist the Secretary in carrying out a program under this
				section or section 330C of the Public Health Service Act (42 U.S.C.
				254c–3).</text>
										</subparagraph><subparagraph id="H01BCD49612CB45C3A46959BB15B994EE"><enum>(B)</enum><header>Certain
				activities</header><text>Any activity carried out by a diabetes control officer
				under subparagraph (A) that is the subject of a contract or compact under the
				Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>),
				and any funds made available to carry out such an activity, shall not be
				divisible for purposes of that Act.</text>
										</subparagraph></paragraph></subsection></section><section id="H5B15558FF0F34CF8AD2DA959BBE032A6"><enum>205.</enum><header>Shared services for
				long-term care</header>
								<subsection id="H55C98B271F0242D0996642683E7599E9"><enum>(a)</enum><header>Long-term
				care</header><text>Notwithstanding any other provision of law, the Secretary,
				acting through the Service, is authorized to provide directly, or enter into
				contracts or compacts under the <act-name parsable-cite="ISDA">Indian
				Self-Determination and Education Assistance Act</act-name> (25 U.S.C. 450 et
				seq.) with Indian Tribes or Tribal Organizations for, the delivery of long-term
				care (including health care services associated with long-term care) provided
				in a facility to Indians. Such agreements shall provide for the sharing of
				staff or other services between the Service or a Tribal Health Program and a
				long-term care or related facility owned and operated (directly or through a
				contract or compact under the <act-name parsable-cite="ISDA">Indian
				Self-Determination and Education Assistance Act</act-name> (25 U.S.C. 450 et
				seq.)) by such Indian Tribe or Tribal Organization.</text>
								</subsection><subsection id="HCCDE0F0AE917449D869F453DBE4BCFCC"><enum>(b)</enum><header>Contents of
				agreements</header><text>An agreement entered into pursuant to subsection
				(a)—</text>
									<paragraph id="H364E965CC4FC4F5A91BEE8A478CDE3FF"><enum>(1)</enum><text>may, at the request of
				the Indian Tribe or Tribal Organization, delegate to such Indian Tribe or
				Tribal Organization such powers of supervision and control over Service
				employees as the Secretary deems necessary to carry out the purposes of this
				section;</text>
									</paragraph><paragraph id="HBFD3B083949B44FD9F10D653F58FBBF9"><enum>(2)</enum><text>shall provide that
				expenses (including salaries) relating to services that are shared between the
				Service and the Tribal Health Program be allocated proportionately between the
				Service and the Indian Tribe or Tribal Organization; and</text>
									</paragraph><paragraph id="H515869E7A738458B9500E6F25231D969"><enum>(3)</enum><text>may authorize such Indian
				Tribe or Tribal Organization to construct, renovate, or expand a long-term care
				or other similar facility (including the construction of a facility attached to
				a Service facility).</text>
									</paragraph></subsection><subsection id="H70142A3191F942089EBB4394902D5684"><enum>(c)</enum><header>Minimum
				requirement</header><text>Any nursing facility provided for under this section
				shall meet the requirements for nursing facilities under section 1919 of the
				<act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
								</subsection><subsection id="HE06C4C8471B145BCB9796FDCE1E750E2"><enum>(d)</enum><header>Other
				assistance</header><text>The Secretary shall provide such technical and other
				assistance as may be necessary to enable applicants to comply with the
				provisions of this section.</text>
								</subsection><subsection id="H8F556313F28841259432B5BF71F2A697"><enum>(e)</enum><header>Use of existing or
				underused facilities</header><text>The Secretary shall encourage the use of
				existing facilities that are underused or allow the use of swing beds for
				long-term or similar care.</text>
								</subsection></section><section id="H43FB13082C5E4693B7FF04FEBAF5BD8"><enum>206.</enum><header>Health services
				research</header>
								<subsection id="HCE40E1C41F4441189BAB9F6937EB4328"><enum>(a)</enum><header>In
				general</header><text display-inline="yes-display-inline">The Secretary, acting
				through the Service, shall make funding available for research to further the
				performance of the health service responsibilities of Indian Health
				Programs.</text>
								</subsection><subsection id="HDCC45A09A8664F9281B643223FE97E37"><enum>(b)</enum><header>Coordination of
				resources and activities</header><text display-inline="yes-display-inline">The
				Secretary shall also, to the maximum extent practicable, coordinate
				departmental research resources and activities to address relevant Indian
				Health Program research needs.</text>
								</subsection><subsection id="H01891EA9E0C1490B897E213109C8BAD2"><enum>(c)</enum><header>Availability</header><text display-inline="yes-display-inline">Tribal Health Programs shall be given an
				equal opportunity to compete for, and receive, research funds under this
				section.</text>
								</subsection><subsection id="H7921F09D8BB84FF89D28339C7DA12FD"><enum>(d)</enum><header>Use of
				funds</header><text display-inline="yes-display-inline">This funding may be
				used for both clinical and nonclinical research.</text>
								</subsection><subsection id="HA195EE62394A456FB208236F138E9C14"><enum>(e)</enum><header>Evaluation and
				dissemination</header><text>The Secretary shall periodically—</text>
									<paragraph id="H5B0205E5AC5A46EAADCA76699D1DB019"><enum>(1)</enum><text>evaluate the impact of
				research conducted under this section; and</text>
									</paragraph><paragraph id="HE932E2AEF07748478B003CD9D7539CFC"><enum>(2)</enum><text>disseminate to Tribal
				Health Programs information regarding that research as the Secretary determines
				to be appropriate.</text>
									</paragraph></subsection></section><section id="H08B6D4E367D04AF79B2683D6656E3959"><enum>207.</enum><header>Mammography and other
				cancer screening</header><text display-inline="no-display-inline">The
				Secretary, acting through the Service or Tribal Health Programs, shall provide
				for screening as follows:</text>
								<paragraph id="H904F400FB0A14D16AFEDB90972CED3EB"><enum>(1)</enum><text>Screening mammography (as
				defined in section 1861(jj) of the <act-name parsable-cite="SSA">Social
				Security Act</act-name>) for Indian women at a frequency appropriate to such
				women under accepted and appropriate national standards, and under such terms
				and conditions as are consistent with standards established by the Secretary to
				ensure the safety and accuracy of screening mammography under part B of title
				XVIII of such Act.</text>
								</paragraph><paragraph id="H8ACBFAE87B9141F384A560A0E8F7E46"><enum>(2)</enum><text>Other cancer screening
				that receives an A or B rating as recommended by the United States Preventive
				Services Task Force established under section 915(a)(1) of the Public Health
				Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/299b-4">42 U.S.C. 299b–4(a)(1)</external-xref>). The Secretary shall ensure that screening
				provided for under this paragraph complies with the recommendations of the Task
				Force with respect to—</text>
									<subparagraph id="H079D5B887A3A47C3BC43BD36C0602E76"><enum>(A)</enum><text>frequency;</text>
									</subparagraph><subparagraph id="H49B4E43FF2B84AA5BDD8D307EEF9BA23"><enum>(B)</enum><text>the population to be
				served;</text>
									</subparagraph><subparagraph id="HCAE53854A5DC4FF983CDE5802E2B9408"><enum>(C)</enum><text>the procedure or
				technology to be used;</text>
									</subparagraph><subparagraph id="H6B6CCC9CD8AA4952A2BAD12257DC362"><enum>(D)</enum><text>evidence of
				effectiveness; and</text>
									</subparagraph><subparagraph id="HD36E8420FCDF482C92E5E9A72C8F3D16"><enum>(E)</enum><text>other matters that the
				Secretary determines appropriate.</text>
									</subparagraph></paragraph></section><section id="H1600DA2C726940F792604C49360695D2"><enum>208.</enum><header>Patient travel
				costs</header>
								<subsection id="HB8468787214F42258882F200CFF70548"><enum>(a)</enum><header>Definition of qualified
				escort</header><text>In this section, the term <term>qualified escort</term>
				means—</text>
									<paragraph id="HBC3A637B5A9F496E9EE5A642913F85F7"><enum>(1)</enum><text>an adult escort
				(including a parent, guardian, or other family member) who is required because
				of the physical or mental condition, or age, of the applicable patient;</text>
									</paragraph><paragraph id="H6BAF686202C749FA90ECBB5759A43CF"><enum>(2)</enum><text>a health professional for
				the purpose of providing necessary medical care during travel by the applicable
				patient; or</text>
									</paragraph><paragraph id="HFE482D3930AC48F5B8A519F0C5A8E978"><enum>(3)</enum><text>other escorts, as the
				Secretary or applicable Indian Health Program determines to be
				appropriate.</text>
									</paragraph></subsection><subsection id="HE7862FD21C724FB3BD1E88A3221CE9C"><enum>(b)</enum><header>Provision of
				funds</header><text display-inline="yes-display-inline">The Secretary, acting
				through the Service and Tribal Health Programs, is authorized to provide funds
				for the following patient travel costs, including qualified escorts, associated
				with receiving health care services provided (either through direct or contract
				care or through a contract or compact under the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance
				Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>)) under this Act—</text>
									<paragraph id="HBA638BEFCED248D18BC9CFBCAB5DC723"><enum>(1)</enum><text>emergency air
				transportation and non-emergency air transportation where ground transportation
				is infeasible;</text>
									</paragraph><paragraph id="HEACD4B7E166D48B29C844B001D01D358"><enum>(2)</enum><text>transportation by private
				vehicle (where no other means of transportation is available), specially
				equipped vehicle, and ambulance; and</text>
									</paragraph><paragraph id="HF58BFDF0A14841E3968037F3D5A8CFFF"><enum>(3)</enum><text>transportation by such
				other means as may be available and required when air or motor vehicle
				transportation is not available.</text>
									</paragraph></subsection></section><section id="H6EF8DBAAF67B414982E6FE0518BF983B"><enum>209.</enum><header>Epidemiology
				centers</header>
								<subsection display-inline="no-display-inline" id="H06ADE8A7273546BCBA004991ACB797AD"><enum>(a)</enum><header>Establishment of
				centers</header><text>The Secretary shall establish an epidemiology center in
				each Service Area to carry out the functions described in subsection (b). Any
				new center established after the date of the enactment of the Indian Health
				Care Improvement Act Amendments of 2007 may be operated under a grant
				authorized by subsection (d), but funding under such a grant shall not be
				divisible.</text>
								</subsection><subsection id="HF7B2864436E84552A347AAA5D776DB4F"><enum>(b)</enum><header>Functions of
				centers</header><text>In consultation with and upon the request of Indian
				Tribes, Tribal Organizations, and Urban Indian Organizations, each Service Area
				epidemiology center established under this subsection shall, with respect to
				such Service Area—</text>
									<paragraph id="H7646BECE129C4E74B5598B8F9E41BCC1"><enum>(1)</enum><text>collect data relating to,
				and monitor progress made toward meeting, each of the health status objectives
				of the Service, the Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations in the Service Area;</text>
									</paragraph><paragraph id="HB39B2C2AAE004A56B6B699F3BB2B7344"><enum>(2)</enum><text>evaluate existing
				delivery systems, data systems, and other systems that impact the improvement
				of Indian health;</text>
									</paragraph><paragraph id="HD3AC1B3554C746A689E20854D30561B5"><enum>(3)</enum><text>assist Indian Tribes,
				Tribal Organizations, and Urban Indian Organizations in identifying their
				highest priority health status objectives and the services needed to achieve
				such objectives, based on epidemiological data;</text>
									</paragraph><paragraph id="H257CB105DC044C378BB6439482A8C697"><enum>(4)</enum><text>make recommendations for
				the targeting of services needed by the populations served;</text>
									</paragraph><paragraph id="HFCB93C00B19046FBAFF25DE380F84B78"><enum>(5)</enum><text>make recommendations to
				improve health care delivery systems for Indians and Urban Indians;</text>
									</paragraph><paragraph id="HF53C10C33E304E84AE587EA71F90EF65"><enum>(6)</enum><text>provide requested
				technical assistance to Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations in the development of local health service priorities and
				incidence and prevalence rates of disease and other illness in the community;
				and</text>
									</paragraph><paragraph id="HCB945B880A45484C9E28EC027DAB48F7"><enum>(7)</enum><text>provide disease
				surveillance and assist Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations to promote public health.</text>
									</paragraph></subsection><subsection id="H62B38B84A5564351AC88456ED4000317"><enum>(c)</enum><header>Technical
				assistance</header><text>The Director of the Centers for Disease Control and
				Prevention shall provide technical assistance to the centers in carrying out
				the requirements of this subsection.</text>
								</subsection><subsection id="H1B347D45C900493FBE41BD665E72D5B4"><enum>(d)</enum><header>Grants for
				studies</header>
									<paragraph id="HF9B35460F2C24D00AC8E624D91BCD200"><enum>(1)</enum><header>In
				general</header><text>The Secretary may make grants to Indian Tribes, Tribal
				Organizations, Urban Indian Organizations, and eligible intertribal consortia
				to conduct epidemiological studies of Indian communities.</text>
									</paragraph><paragraph id="HD7EF6C8754B6425C9307522D671EEAAF"><enum>(2)</enum><header>Eligible intertribal
				consortia</header><text>An intertribal consortium is eligible to receive a
				grant under this subsection if—</text>
										<subparagraph id="HA88ABC7802DC486F9DCB91980000DC6"><enum>(A)</enum><text>the intertribal
				consortium is incorporated for the primary purpose of improving Indian health;
				and</text>
										</subparagraph><subparagraph id="H688AA3B2458740D7BC2DD704EFAF2EE"><enum>(B)</enum><text>the intertribal
				consortium is representative of the Indian Tribes or urban Indian communities
				in which the intertribal consortium is located.</text>
										</subparagraph></paragraph><paragraph id="H7D4F1F9DC6AD44299979B71EA6A7EC3B"><enum>(3)</enum><header>Applications</header><text>An
				application for a grant under this subsection shall be submitted in such manner
				and at such time as the Secretary shall prescribe.</text>
									</paragraph><paragraph id="H4676EF5047084EADBDDA2703465DF01"><enum>(4)</enum><header>Requirements</header><text>An
				applicant for a grant under this subsection shall—</text>
										<subparagraph id="HE4269D39908C470A826BCCBEDF96A05D"><enum>(A)</enum><text>demonstrate the
				technical, administrative, and financial expertise necessary to carry out the
				functions described in paragraph (5);</text>
										</subparagraph><subparagraph id="H22A41CE184F1458C00A4DF518734CDA9"><enum>(B)</enum><text>consult and cooperate
				with providers of related health and social services in order to avoid
				duplication of existing services; and</text>
										</subparagraph><subparagraph id="HB0049FD4E9A449E59039EADE8EE6285"><enum>(C)</enum><text>demonstrate cooperation
				from Indian tribes or Urban Indian Organizations in the area to be
				served.</text>
										</subparagraph></paragraph><paragraph id="HB2E684A7EF8D4E8FAFD34FFBB6FE5B22"><enum>(5)</enum><header>Use of
				funds</header><text>A grant awarded under paragraph (1) may be used—</text>
										<subparagraph id="H7CE2E465E0A4462893CCAA8BC3C27B5D"><enum>(A)</enum><text>to carry out the
				functions described in subsection (b);</text>
										</subparagraph><subparagraph id="H897EA9A5A305477DB670FE004CDBA7D"><enum>(B)</enum><text>to provide information to
				and consult with tribal leaders, urban Indian community leaders, and related
				health staff on health care and health service management issues; and</text>
										</subparagraph><subparagraph id="HE791057BDF024FBB8CA6AC454800BBB3"><enum>(C)</enum><text>in collaboration with
				Indian Tribes, Tribal Organizations, and urban Indian communities, to provide
				the Service with information regarding ways to improve the health status of
				Indians.</text>
										</subparagraph></paragraph></subsection><subsection id="HACEEA6E99B33452EA4FCADB188E0CF83"><enum>(e)</enum><header>Access to
				information</header><text>An epidemiology center operated by a grantee pursuant
				to a grant awarded under subsection (d) shall be treated as a public health
				authority for purposes of the Health Insurance Portability and Accountability
				Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/191">Public Law 104–191</external-xref>; 110 Stat. 2033), as such entities are defined
				in part 164.501 of title 45, Code of Federal Regulations (or a successor
				regulation). The Secretary shall grant such grantees access to and use of data,
				data sets, monitoring systems, delivery systems, and other protected health
				information in the possession of the Secretary.</text>
								</subsection></section><section id="H2F0241D4894E489CACA9A7D8E57DC814"><enum>210.</enum><header>Comprehensive school
				health education programs</header>
								<subsection id="H499A4BCA43544CB7BA91D8DE45B89051"><enum>(a)</enum><header>Funding for development
				of programs</header><text>In addition to carrying out any other program for
				health promotion or disease prevention, the Secretary, acting through the
				Service, is authorized to award grants to Indian Tribes, Tribal Organizations,
				and Urban Indian Organizations to develop comprehensive school health education
				programs for children from pre-school through grade 12 in schools for the
				benefit of Indian and Urban Indian children.</text>
								</subsection><subsection id="HFB2E28CDBCC24C298476442C05FF1904"><enum>(b)</enum><header>Use of grant
				funds</header><text>A grant awarded under this section may be used for purposes
				which may include, but are not limited to, the following:</text>
									<paragraph id="H2A7D97AA96A14BA38EC21AE679D463"><enum>(1)</enum><text>Developing health
				education materials both for regular school programs and afterschool
				programs.</text>
									</paragraph><paragraph id="H727154A7BAB040FBB4B62BC8451953C"><enum>(2)</enum><text>Training teachers in
				comprehensive school health education materials.</text>
									</paragraph><paragraph id="HE3C8D44D808644B0807922882034B7E2"><enum>(3)</enum><text>Integrating school-based,
				community-based, and other public and private health promotion efforts.</text>
									</paragraph><paragraph id="H90636EED113D4FD487B1741BC9123648"><enum>(4)</enum><text>Encouraging healthy,
				tobacco-free school environments.</text>
									</paragraph><paragraph id="H0308668535064649A3073418B3CBB7B6"><enum>(5)</enum><text>Coordinating school-based
				health programs with existing services and programs available in the
				community.</text>
									</paragraph><paragraph id="H778AFC6BE43647DD9F3D760220E0FFEE"><enum>(6)</enum><text>Developing school
				programs on nutrition education, personal health, oral health, and
				fitness.</text>
									</paragraph><paragraph id="HB119246E04494D58B930385BA6609806"><enum>(7)</enum><text>Developing behavioral
				health wellness programs.</text>
									</paragraph><paragraph id="HC3A25FA3132949A5BA4D96B9D718000"><enum>(8)</enum><text>Developing chronic
				disease prevention programs.</text>
									</paragraph><paragraph id="H6DEB9703CF744D3294B12600359B0019"><enum>(9)</enum><text>Developing substance
				abuse prevention programs.</text>
									</paragraph><paragraph id="H665A652127654F2395587B6DEF6FAC3E"><enum>(10)</enum><text>Developing injury
				prevention and safety education programs.</text>
									</paragraph><paragraph id="H623992989CBA4FC7B2AE86736EFFD70"><enum>(11)</enum><text>Developing activities
				for the prevention and control of communicable diseases.</text>
									</paragraph><paragraph id="H4363F9BE99A247479300E6CD4878035"><enum>(12)</enum><text>Developing community and
				environmental health education programs that include traditional health care
				practitioners.</text>
									</paragraph><paragraph id="H6E7E55B5D9014288B238501E632CF3AF"><enum>(13)</enum><text>Violence
				prevention.</text>
									</paragraph><paragraph id="H8F0FBF249ADE434380003E61B25327E"><enum>(14)</enum><text>Such other health issues
				as are appropriate.</text>
									</paragraph></subsection><subsection id="HBB6BC10107BA4D45BF73F73C11FDF951"><enum>(c)</enum><header>Technical
				assistance</header><text>Upon request, the Secretary, acting through the
				Service, shall provide technical assistance to Indian Tribes, Tribal
				Organizations, and Urban Indian Organizations in the development of
				comprehensive health education plans and the dissemination of comprehensive
				health education materials and information on existing health programs and
				resources.</text>
								</subsection><subsection id="HF0A5CE43BB2D440DB17ECE55B13E445"><enum>(d)</enum><header>Criteria for review and
				approval of applications</header><text>The Secretary, acting through the
				Service, and in consultation with Indian Tribes, Tribal Organizations, and
				Urban Indian Organizations, shall establish criteria for the review and
				approval of applications for grants awarded under this section.</text>
								</subsection><subsection id="H792C1963221E45DFAD68CAD2BB7F6CC7"><enum>(e)</enum><header>Development of program
				for BIA-funded schools</header>
									<paragraph id="H9FF8C6F134B24203AA04A678DD9DF2AF"><enum>(1)</enum><header>In
				general</header><text>The Secretary of the Interior, acting through the Bureau
				of Indian Affairs and in cooperation with the Secretary, acting through the
				Service, and affected Indian Tribes and Tribal Organizations, shall develop a
				comprehensive school health education program for children from preschool
				through grade 12 in schools for which support is provided by the Bureau of
				Indian Affairs.</text>
									</paragraph><paragraph id="H0602534E194F40F9ABF1165E94B96B98"><enum>(2)</enum><header>Requirements for
				programs</header><text>Such programs shall include—</text>
										<subparagraph id="HF1C6578AE73E4A88AC03FCF73E828098"><enum>(A)</enum><text>school programs on
				nutrition education, personal health, oral health, and fitness;</text>
										</subparagraph><subparagraph id="H6DA1B834680E4EE9B6DCABFBCC477C10"><enum>(B)</enum><text>behavioral health
				wellness programs;</text>
										</subparagraph><subparagraph id="HF858E63F032C450D84B3BB3D60F948E6"><enum>(C)</enum><text>chronic disease
				prevention programs;</text>
										</subparagraph><subparagraph id="H26AFC2B98AE5437A8CA8C3DA401ADB6"><enum>(D)</enum><text>substance abuse
				prevention programs;</text>
										</subparagraph><subparagraph id="HC774CF129DB34C548106D55393F11E58"><enum>(E)</enum><text>injury prevention and
				safety education programs; and</text>
										</subparagraph><subparagraph id="H70801AC306094D54A89ECFBE70BC7719"><enum>(F)</enum><text>activities for the
				prevention and control of communicable diseases.</text>
										</subparagraph></paragraph><paragraph id="HC101A723DA544E81965F00682828A0B3"><enum>(3)</enum><header>Duties of the
				Secretary</header><text>The Secretary of the Interior shall—</text>
										<subparagraph id="H0697E9FA9BF141DF8B8BEF9C711E303B"><enum>(A)</enum><text>provide training to
				teachers in comprehensive school health education materials;</text>
										</subparagraph><subparagraph id="H0076A600CF944011A818B0B9768372C3"><enum>(B)</enum><text>ensure the integration
				and coordination of school-based programs with existing services and health
				programs available in the community; and</text>
										</subparagraph><subparagraph id="H9A72E6F8218E4669A975006C2729EA4"><enum>(C)</enum><text>encourage healthy,
				tobacco-free school environments.</text>
										</subparagraph></paragraph></subsection></section><section id="HA1BFAD0F940246DEB6F8F852D6A922B3"><enum>211.</enum><header>Indian youth
				program</header>
								<subsection id="H62B3DEA2C84745E6808DF2100043F072"><enum>(a)</enum><header>Program
				authorized</header><text>The Secretary, acting through the Service, is
				authorized to establish and administer a program to provide grants to Indian
				Tribes, Tribal Organizations, and Urban Indian Organizations for innovative
				mental and physical disease prevention and health promotion and treatment
				programs for Indian and Urban Indian preadolescent and adolescent
				youths.</text>
								</subsection><subsection id="H5CF3D23914C74D239090B031BEAE4BBB"><enum>(b)</enum><header>Use of funds</header>
									<paragraph id="HFCBF284F79E047A9997D57D2B99042CD"><enum>(1)</enum><header>Allowable
				uses</header><text>Funds made available under this section may be used
				to—</text>
										<subparagraph id="H8979E5D30BF84E14B000003762BEEC5C"><enum>(A)</enum><text>develop prevention and
				treatment programs for Indian youth which promote mental and physical health
				and incorporate cultural values, community and family involvement, and
				traditional health care practitioners; and</text>
										</subparagraph><subparagraph id="H8B3FEB278594429600325DC5E9942CD6"><enum>(B)</enum><text>develop and provide
				community training and education.</text>
										</subparagraph></paragraph><paragraph id="HC7DB248779EC48A29CC891097D6530A5"><enum>(2)</enum><header>Prohibited
				use</header><text>Funds made available under this section may not be used to
				provide services described in section 707(c).</text>
									</paragraph></subsection><subsection id="H9F8379E70D4B417980361404CCE1A007"><enum>(c)</enum><header>Duties of the
				Secretary</header><text>The Secretary shall—</text>
									<paragraph id="H325EBFC1E7274003BF9EC90045B001E0"><enum>(1)</enum><text>disseminate to Indian
				Tribes, Tribal Organizations, and Urban Indian Organizations information
				regarding models for the delivery of comprehensive health care services to
				Indian and Urban Indian adolescents;</text>
									</paragraph><paragraph id="H0C27CD29BBA04451AE9FB040687D81E9"><enum>(2)</enum><text>encourage the
				implementation of such models; and</text>
									</paragraph><paragraph id="H8F455FCDA5B14EF0AB5C48FCE778AEF"><enum>(3)</enum><text>at the request of an
				Indian Tribe, Tribal Organization, or Urban Indian Organization, provide
				technical assistance in the implementation of such models.</text>
									</paragraph></subsection><subsection id="H8F54914DCAAB4A03ABE63D230018FBBC"><enum>(d)</enum><header>Criteria for review and
				approval of applications</header><text>The Secretary, in consultation with
				Indian Tribes, Tribal Organizations, and Urban Indian Organizations, shall
				establish criteria for the review and approval of applications or proposals
				under this section.</text>
								</subsection></section><section id="H5593F7B8578D4AAB9C5BDCB3CFBE395"><enum>212.</enum><header>Prevention, control,
				and elimination of communicable and infectious diseases</header>
								<subsection id="H864540759C5240EF934BDA318D4F5592"><enum>(a)</enum><header>Grants
				authorized</header><text>The Secretary, acting through the Service, and after
				consultation with the Centers for Disease Control and Prevention, may make
				grants available to Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations for the following:</text>
									<paragraph id="H5976AA0426CE4E8688AB44B0793D00FA"><enum>(1)</enum><text>Projects for the
				prevention, control, and elimination of communicable and infectious diseases,
				including tuberculosis, hepatitis, HIV, respiratory syncytial virus, hanta
				virus, sexually transmitted diseases, and H. Pylori.</text>
									</paragraph><paragraph id="H2051FDF7D6C249DDB21C50B45FDF4D1E"><enum>(2)</enum><text>Public information and
				education programs for the prevention, control, and elimination of communicable
				and infectious diseases.</text>
									</paragraph><paragraph id="H1BF533B9AB784960B6CFE2B9002A427"><enum>(3)</enum><text>Education, training, and
				clinical skills improvement activities in the prevention, control, and
				elimination of communicable and infectious diseases for health professionals,
				including allied health professionals.</text>
									</paragraph><paragraph id="HEBF2350276E544E0A491E222E2CA98A8"><enum>(4)</enum><text>Demonstration projects
				for the screening, treatment, and prevention of hepatitis C virus (HCV).</text>
									</paragraph></subsection><subsection id="H1AC4971262F44C9086DE053EA8F242B5"><enum>(b)</enum><header>Application
				required</header><text>The Secretary may provide funding under subsection (a)
				only if an application or proposal for funding is submitted to the
				Secretary.</text>
								</subsection><subsection id="H2BF76680263049FCB7C8FEAA500642C"><enum>(c)</enum><header>Coordination with
				health agencies</header><text>Indian Tribes, Tribal Organizations, and Urban
				Indian Organizations receiving funding under this section are encouraged to
				coordinate their activities with the Centers for Disease Control and Prevention
				and State and local health agencies.</text>
								</subsection><subsection id="H81E2D7022DA6427D8B34FBF62FF05C38"><enum>(d)</enum><header>Technical assistance;
				report</header><text>In carrying out this section, the Secretary—</text>
									<paragraph id="HE1579AE53CEB41528510D012AFE9D26E"><enum>(1)</enum><text>may, at the request of an
				Indian Tribe, Tribal Organization, or Urban Indian Organization, provide
				technical assistance; and</text>
									</paragraph><paragraph id="HD623EBABDE8742F0A5FC03B4A52B2EBD"><enum>(2)</enum><text>shall prepare and submit
				a report to Congress biennially on the use of funds under this section and on
				the progress made toward the prevention, control, and elimination of
				communicable and infectious diseases among Indians and Urban Indians.</text>
									</paragraph></subsection></section><section id="H202B53E05E2D4AC79C6B5C3D00708CFA"><enum>213.</enum><header>Authority for
				provision of other services</header>
								<subsection id="HEA437EE5FCB640119EECC39D7C5717B1"><enum>(a)</enum><header>Funding
				authorized</header><text>The Secretary, acting through the Service, Indian
				Tribes, and Tribal Organizations, may provide funding under this Act to meet
				the objectives set forth in section 3 through health care-related services and
				programs not otherwise described in this Act, including—</text>
									<paragraph id="HECB73BDA82CA4D89AB0153AD4656F6E3"><enum>(1)</enum><text>hospice care;</text>
									</paragraph><paragraph id="H04472D690D514E31A670398F014B3B80"><enum>(2)</enum><text>assisted living;</text>
									</paragraph><paragraph id="H84D6EA4444EE4BF2ACF00E5B59B8D8B"><enum>(3)</enum><text>long-term care;
				and</text>
									</paragraph><paragraph id="H059D71734FEB44AAA69FA5BBA7809E59"><enum>(4)</enum><text>home- and community-based
				services.</text>
									</paragraph></subsection><subsection id="H0AF22A1AFB834423BB4508C8A2F8EB78"><enum>(b)</enum><header>Terms and
				conditions</header>
									<paragraph id="HA52334D81A1046CE8C474DBAB7EF5193"><enum>(1)</enum><header>In
				general</header><text>Any service provided under this section shall be in
				accordance with such terms and conditions as are consistent with accepted and
				appropriate standards relating to the service, including any licensing term or
				condition under this Act.</text>
									</paragraph><paragraph id="H018EFFDBE6564B65B491D3B7D0BA0665"><enum>(2)</enum><header>Standards</header>
										<subparagraph id="HB65C1E9C93C047939146D5DF2D0940A5"><enum>(A)</enum><header>In
				general</header><text>The Secretary may establish, by regulation, the standards
				for a service provided under this section, provided that such standards shall
				not be more stringent than the standards required by the State in which the
				service is provided.</text>
										</subparagraph><subparagraph id="H061A0EC51163475D9E1F5618B3963F3D"><enum>(B)</enum><header>Use of State
				Standards</header><text>If the Secretary does not, by regulation, establish
				standards for a service provided under this section, the standards required by
				the State in which the service is or will be provided shall apply to such
				service.</text>
										</subparagraph><subparagraph id="H03761A00C32842A684E4A3B9B978D54E"><enum>(C)</enum><header>Indian
				tribes</header><text>If a service under this section is provided by an Indian
				Tribe or Tribal Organization pursuant to the Indian Self-Determination and
				Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>), the verification by the
				Secretary that the service meets any standards required by the State in which
				the service is or will be provided shall be considered to meet the terms and
				conditions required under this subsection.</text>
										</subparagraph></paragraph><paragraph id="HA466DD73F0A14540A9392F6D93629526"><enum>(3)</enum><header>Eligibility</header><text>The
				following individuals shall be eligible to receive long-term care under this
				section:</text>
										<subparagraph id="H2A0BB3C178CF477DAB8304F892E40079"><enum>(A)</enum><text>Individuals who are
				unable to perform a certain number of activities of daily living without
				assistance.</text>
										</subparagraph><subparagraph id="HCF6D8FC73956492FBC1257269D9DFF05"><enum>(B)</enum><text>Individuals with a mental
				impairment, such as dementia, Alzheimer's disease, or another disabling mental
				illness, who may be able to perform activities of daily living under
				supervision.</text>
										</subparagraph><subparagraph id="HE4A1D7255BDB4D6482A2111440C1B151"><enum>(C)</enum><text>Such other individuals as
				an applicable Indian Health Program determines to be appropriate.</text>
										</subparagraph></paragraph></subsection><subsection id="HF02406F0D6C441EE8EEFCA54CFBA36F0"><enum>(c)</enum><header>Definitions</header><text>For
				the purposes of this section, the following definitions shall apply:</text>
									<paragraph id="H319F2E7DBBA5471D836CCE00F5A26649"><enum>(1)</enum><text>The term <term>home- and
				community-based services</term> means 1 or more of the services specified in
				paragraphs (1) through (9) of section 1929(a) of the Social Security Act (42
				U.S.C. 1396t(a)) (whether provided by the Service or by an Indian Tribe or
				Tribal Organization pursuant to the Indian Self-Determination and Education
				Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>)) that are or will be provided in
				accordance with the standards described in subsection (b).</text>
									</paragraph><paragraph id="H2265BC3CE96D4D5E9514D1D55C36637D"><enum>(2)</enum><text>The term <term>hospice
				care</term> means the items and services specified in subparagraphs (A) through
				(H) of section 1861(dd)(1) of the <act-name parsable-cite="SSA">Social Security
				Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(dd)(1)</external-xref>), and such other services which an
				Indian Tribe or Tribal Organization determines are necessary and appropriate to
				provide in furtherance of this care.</text>
									</paragraph></subsection></section><section id="HDF21A1B9F9B8461CADAA8D8B001D7CEE"><enum>214.</enum><header>Indian women’s health
				care</header><text display-inline="no-display-inline">The Secretary, acting
				through the Service and Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations, shall monitor and improve the quality of health care for Indian
				women of all ages through the planning and delivery of programs administered by
				the Service, in order to improve and enhance the treatment models of care for
				Indian women.</text>
							</section><section id="H8147151810F54475A6FE37714F71E848"><enum>215.</enum><header>Environmental and
				nuclear health hazards</header>
								<subsection id="H3628F44DF80749E8BF0040FA18ABEFAF"><enum>(a)</enum><header>Studies and
				monitoring</header><text>The Secretary and the Service shall conduct, in
				conjunction with other appropriate Federal agencies and in consultation with
				concerned Indian Tribes and Tribal Organizations, studies and ongoing
				monitoring programs to determine trends in the health hazards to Indian miners
				and to Indians on or near reservations and Indian communities as a result of
				environmental hazards which may result in chronic or life threatening health
				problems, such as nuclear resource development, petroleum contamination, and
				contamination of water source and of the food chain. Such studies shall
				include—</text>
									<paragraph id="H7670649BA97448FFA2566FC7C5400A6"><enum>(1)</enum><text>an evaluation of the
				nature and extent of health problems caused by environmental hazards currently
				exhibited among Indians and the causes of such health problems;</text>
									</paragraph><paragraph id="H0F086199040849D6B1DBC258ADFBF0B3"><enum>(2)</enum><text>an analysis of the
				potential effect of ongoing and future environmental resource development on or
				near reservations and Indian communities, including the cumulative effect over
				time on health;</text>
									</paragraph><paragraph id="H96110168D1AB47EDBA2B4B6D803D5426"><enum>(3)</enum><text>an evaluation of the
				types and nature of activities, practices, and conditions causing or affecting
				such health problems, including uranium mining and milling, uranium mine
				tailing deposits, nuclear power plant operation and construction, and nuclear
				waste disposal; oil and gas production or transportation on or near
				reservations or Indian communities; and other development that could affect the
				health of Indians and their water supply and food chain;</text>
									</paragraph><paragraph id="H3E460B0D428B4719AAF11FDACA35806F"><enum>(4)</enum><text>a summary of any findings
				and recommendations provided in Federal and State studies, reports,
				investigations, and inspections during the 5 years prior to the date of
				enactment of the <short-title>Indian Health Care
				Improvement Act Amendments of 2007</short-title> that directly or indirectly
				relate to the activities, practices, and conditions affecting the health or
				safety of such Indians; and</text>
									</paragraph><paragraph id="H5158DF0DC08E45B794E5106FB04CF603"><enum>(5)</enum><text>the efforts that have
				been made by Federal and State agencies and resource and economic development
				companies to effectively carry out an education program for such Indians
				regarding the health and safety hazards of such development.</text>
									</paragraph></subsection><subsection id="H42850919BC9D4F3188A4C9CE43C11463"><enum>(b)</enum><header>Health care
				plans</header><text>Upon completion of such studies, the Secretary and the
				Service shall take into account the results of such studies and develop health
				care plans to address the health problems studied under subsection (a). The
				plans shall include—</text>
									<paragraph id="H2DDB1ADDFD254B7DB4212D7DCAB055BB"><enum>(1)</enum><text>methods for diagnosing
				and treating Indians currently exhibiting such health problems;</text>
									</paragraph><paragraph id="HC81C22EF7B564018BB3E3F6DCBAEA380"><enum>(2)</enum><text>preventive care and
				testing for Indians who may be exposed to such health hazards, including the
				monitoring of the health of individuals who have or may have been exposed to
				excessive amounts of radiation or affected by other activities that have had or
				could have a serious impact upon the health of such individuals; and</text>
									</paragraph><paragraph id="HF2206D628D4646A288B3E7D294A36B59"><enum>(3)</enum><text>a program of education
				for Indians who, by reason of their work or geographic proximity to such
				nuclear or other development activities, may experience health problems.</text>
									</paragraph></subsection><subsection id="HEA2FF4B46E7240E08B2CCAC7C5475432"><enum>(c)</enum><header>Submission of report
				and plan to Congress</header><text>The Secretary and the Service shall submit
				to Congress the study prepared under subsection (a) no later than 18 months
				after the date of enactment of the <short-title>Indian
				Health Care Improvement Act Amendments of 2007</short-title>. The health care
				plan prepared under subsection (b) shall be submitted in a report no later than
				1 year after the study prepared under subsection (a) is submitted to Congress.
				Such report shall include recommended activities for the implementation of the
				plan, as well as an evaluation of any activities previously undertaken by the
				Service to address such health problems.</text>
								</subsection><subsection id="HDBDB90329387459891564422FFD6C76F"><enum>(d)</enum><header>Intergovernmental task
				force</header>
									<paragraph id="H0699ED9F574F42A7BA008333BBED7E63"><enum>(1)</enum><header>Establishment;
				members</header><text>There is established an Intergovernmental Task Force to
				be composed of the following individuals (or their designees):</text>
										<subparagraph id="H4D102E4115D245F988C8DDEF5E2D3D95"><enum>(A)</enum><text>The Secretary of
				Energy.</text>
										</subparagraph><subparagraph id="HA48E1BE3E36A4AE7AA6C50004F88A34B"><enum>(B)</enum><text>The Secretary of the
				Environmental Protection Agency.</text>
										</subparagraph><subparagraph id="H9691ADFFA9D24D00B1D3EBA4E5A96BC9"><enum>(C)</enum><text>The Director of the
				Bureau of Mines.</text>
										</subparagraph><subparagraph id="H30A30C77FCAA462A931E32123E326721"><enum>(D)</enum><text>The Assistant Secretary
				for Occupational Safety and Health.</text>
										</subparagraph><subparagraph id="HBC7CD24F2C8B4DDEA400E9D98F618F22"><enum>(E)</enum><text>The Secretary of the
				Interior.</text>
										</subparagraph><subparagraph id="H0CE454D7B5C541E486CCCA32FA00243C"><enum>(F)</enum><text>The Secretary of Health
				and Human Services.</text>
										</subparagraph><subparagraph id="H33B06422587B46D08EFD90F964D80000"><enum>(G)</enum><text>The Director of the
				Indian Health Service.</text>
										</subparagraph></paragraph><paragraph id="HC59AAAE012404608B25E1FADB3D47EF"><enum>(2)</enum><header>Duties</header><text>The
				Task Force shall—</text>
										<subparagraph id="H4692F471DC8043CA00CDA717C09E9C61"><enum>(A)</enum><text>identify existing and
				potential operations related to nuclear resource development or other
				environmental hazards that affect or may affect the health of Indians on or
				near a reservation or in an Indian community; and</text>
										</subparagraph><subparagraph id="H38742E6BB5754CECA93D815711CD5B9B"><enum>(B)</enum><text>enter into activities to
				correct existing health hazards and ensure that current and future health
				problems resulting from nuclear resource or other development activities are
				minimized or reduced.</text>
										</subparagraph></paragraph><paragraph id="H272C6E783D734013B8E48371C794BF4B"><enum>(3)</enum><header>Chairman;
				meetings</header><text>The Secretary of Health and Human Services shall be the
				Chairman of the Task Force. The Task Force shall meet at least twice each
				year.</text>
									</paragraph></subsection><subsection id="H38B7183E30FA4448B1E6E70061FD8B6"><enum>(e)</enum><header>Health services to
				certain employees</header><text>In the case of any Indian who—</text>
									<paragraph id="HF73C4F5732C54DDDA2C370BB1CEC2882"><enum>(1)</enum><text>as a result of employment
				in or near a uranium mine or mill or near any other environmental hazard,
				suffers from a work-related illness or condition;</text>
									</paragraph><paragraph id="HC59A4359215041168038DFBCA83197D6"><enum>(2)</enum><text>is eligible to receive
				diagnosis and treatment services from an Indian Health Program; and</text>
									</paragraph><paragraph id="H497435EA79E9412380A300BB62F3B7E9"><enum>(3)</enum><text>by reason of such
				Indian’s employment, is entitled to medical care at the expense of such mine or
				mill operator or entity responsible for the environmental hazard, the Indian
				Health Program shall, at the request of such Indian, render appropriate medical
				care to such Indian for such illness or condition and may be reimbursed for any
				medical care so rendered to which such Indian is entitled at the expense of
				such operator or entity from such operator or entity. Nothing in this
				subsection shall affect the rights of such Indian to recover damages other than
				such amounts paid to the Indian Health Program from the employer for providing
				medical care for such illness or condition.</text>
									</paragraph></subsection></section><section id="HCC09D43FDAD44C1AA7CA4DEE98E6B53"><enum>216.</enum><header>Arizona as a contract
				health service delivery area</header>
								<subsection id="H13CD961F2D2B4C65BC8BB63B8587BD08"><enum>(a)</enum><header>In
				general</header><text>For fiscal years beginning with the fiscal year ending
				September 30, 1983, and ending with the fiscal year ending September 30, 2016,
				the State of Arizona shall be designated as a contract health service delivery
				area by the Service for the purpose of providing contract health care services
				to members of federally recognized Indian Tribes of Arizona.</text>
								</subsection><subsection id="HEBE9F3B7A8674102B01EBCCE4033A3A7"><enum>(b)</enum><header>Maintenance of
				services</header><text>The Service shall not curtail any health care services
				provided to Indians residing on reservations in the State of Arizona if such
				curtailment is due to the provision of contract services in such State pursuant
				to the designation of such State as a contract health service delivery area
				pursuant to subsection (a).</text>
								</subsection></section><section id="HB89FF10683ED4C1DAB05906D00358C76"><enum>217.</enum><header>North Dakota and South
				Dakota as contract health service delivery area</header>
								<subsection id="HC580B70E784B458F86BA29AA49722CA5"><enum>(a)</enum><header>In
				general</header><text>Beginning in fiscal year 2003, the States of North Dakota
				and South Dakota shall be designated as a contract health service delivery area
				by the Service for the purpose of providing contract health care services to
				members of federally recognized Indian Tribes of North Dakota and South
				Dakota.</text>
								</subsection><subsection id="H86147B4E55A54A5F947CEB8E692C3324"><enum>(b)</enum><header>Limitation</header><text>The
				Service shall not curtail any health care services provided to Indians residing
				on any reservation, or in any county that has a common boundary with any
				reservation, in the State of North Dakota or South Dakota if such curtailment
				is due to the provision of contract services in such States pursuant to the
				designation of such States as a contract health service delivery area pursuant
				to subsection (a).</text>
								</subsection></section><section id="H3DF49AF3E950494BB6027EAC1BD7105B"><enum>218.</enum><header>California contract
				health services program</header>
								<subsection id="H470067A3B0E74B68AC4CE4FE3D508B8"><enum>(a)</enum><header>Funding
				authorized</header><text>The Secretary is authorized to fund a program using
				the California Rural Indian Health Board (hereafter in this section referred to
				as the <quote>CRIHB</quote>) as a contract care intermediary to improve the
				accessibility of health services to California Indians.</text>
								</subsection><subsection id="H49DE400F893D4A1B9DC08002736A21C"><enum>(b)</enum><header>Reimbursement
				contract</header><text>The Secretary shall enter into an agreement with the
				CRIHB to reimburse the CRIHB for costs (including reasonable administrative
				costs) incurred pursuant to this section, in providing medical treatment under
				contract to California Indians described in section 806(a) throughout the
				California contract health services delivery area described in section 218 with
				respect to high cost contract care cases.</text>
								</subsection><subsection id="H3806DD2754494C7B813D5343DE9FBA80"><enum>(c)</enum><header>Administrative
				expenses</header><text>Not more than 5 percent of the amounts provided to the
				CRIHB under this section for any fiscal year may be for reimbursement for
				administrative expenses incurred by the CRIHB during such fiscal year.</text>
								</subsection><subsection id="H7EB964CE20A04D8EAB3B4F6E18C113E7"><enum>(d)</enum><header>Limitation on
				payment</header><text>No payment may be made for treatment provided hereunder
				to the extent payment may be made for such treatment under the Indian
				Catastrophic Health Emergency Fund described in section 202 or from amounts
				appropriated or otherwise made available to the California contract health
				service delivery area for a fiscal year.</text>
								</subsection><subsection id="HC7F46BBF821843C08783AA5338BBF60"><enum>(e)</enum><header>Advisory
				board</header><text>There is established an advisory board which shall advise
				the CRIHB in carrying out this section. The advisory board shall be composed of
				representatives, selected by the CRIHB, from not less than 8 Tribal Health
				Programs serving California Indians covered under this section at least
				<fraction>1/2</fraction> of whom of whom are not affiliated with the
				CRIHB.</text>
								</subsection></section><section id="HA0DDD20212BB46E7BC6E88A57357B301"><enum>219.</enum><header>California as a
				contract health service delivery area</header><text display-inline="no-display-inline">The State of California, excluding the
				counties of Alameda, Contra Costa, Los Angeles, Marin, Orange, Sacramento, San
				Francisco, San Mateo, Santa Clara, Kern, Merced, Monterey, Napa, San Benito,
				San Joaquin, San Luis Obispo, Santa Cruz, Solano, Stanislaus, and Ventura,
				shall be designated as a contract health service delivery area by the Service
				for the purpose of providing contract health services to California Indians.
				However, any of the counties listed herein may only be included in the contract
				health services delivery area if funding is specifically provided by the
				Service for such services in those counties.</text>
							</section><section id="H6F09705A273149C8BFAAD708E717889F"><enum>220.</enum><header>Contract health
				services for the Trenton Service Area</header>
								<subsection id="H40A0A3755B3746E200AEB588001F8F1E"><enum>(a)</enum><header>Authorization for
				services</header><text>The Secretary, acting through the Service, is directed
				to provide contract health services to members of the Turtle Mountain Band of
				Chippewa Indians that reside in the Trenton Service Area of Divide, McKenzie,
				and Williams counties in the State of North Dakota and the adjoining counties
				of Richland, Roosevelt, and Sheridan in the State of Montana.</text>
								</subsection><subsection id="H8AF10274D08F41A0AD3F59FECA5D4272"><enum>(b)</enum><header>No expansion of
				eligibility</header><text>Nothing in this section may be construed as expanding
				the eligibility of members of the Turtle Mountain Band of Chippewa Indians for
				health services provided by the Service beyond the scope of eligibility for
				such health services that applied on May 1, 1986.</text>
								</subsection></section><section id="H674CB5EE45B74EA39D047F6EB5502132"><enum>221.</enum><header>Programs operated by
				Indian Tribes and Tribal Organizations</header><text display-inline="no-display-inline">The Service shall provide funds for health
				care programs and facilities operated by Tribal Health Programs on the same
				basis as such funds are provided to programs and facilities operated directly
				by the Service.</text>
							</section><section id="H3C43D16888FB4E4696D5EDD574581140"><enum>222.</enum><header>Licensing</header><text display-inline="no-display-inline">Health care professionals employed by a
				Tribal Health Program shall, if licensed in any State, be exempt from the
				licensing requirements of the State in which the Tribal Health Program performs
				the services described in its contract or compact under the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>).</text>
							</section><section id="HB1D9F17B05144522B56B948EB3D673FA"><enum>223.</enum><header>Notification of
				provision of emergency contract health services</header><text display-inline="no-display-inline">With respect to an elderly Indian or an
				Indian with a disability receiving emergency medical care or services from a
				non-Service provider or in a non-Service facility under the authority of this
				Act, the time limitation (as a condition of payment) for notifying the Service
				of such treatment or admission shall be 30 days.</text>
							</section><section id="H9962CC84099A48E19F1155080092AFFD"><enum>224.</enum><header>Prompt action on
				payment of claims</header>
								<subsection id="HC097DE7D642A4CC70018A844D82E1B96"><enum>(a)</enum><header>Deadline for
				response</header><text>The Service shall respond to a notification of a claim
				by a provider of a contract care service with either an individual purchase
				order or a denial of the claim within 5 working days after the receipt of such
				notification.</text>
								</subsection><subsection id="HA7D96FEB3AE1425197A07445B254CBF6"><enum>(b)</enum><header>Effect of untimely
				response</header><text>If the Service fails to respond to a notification of a
				claim in accordance with subsection (a), the Service shall accept as valid the
				claim submitted by the provider of a contract care service.</text>
								</subsection><subsection id="H795D5F638DCB4E78BB344F9E4376709C"><enum>(c)</enum><header>Deadline for payment of
				valid claim</header><text>The Service shall pay a valid contract care service
				claim within 30 days after the completion of the claim.</text>
								</subsection></section><section id="H155793156F3A45B59700A3FE09C70915"><enum>225.</enum><header>Liability for
				payment</header>
								<subsection id="H83DD5C10DC1245F79619E6007E63488F"><enum>(a)</enum><header>No patient
				liability</header><text>A patient who receives contract health care services
				that are authorized by the Service shall not be liable for the payment of any
				charges or costs associated with the provision of such services.</text>
								</subsection><subsection id="HC1AF8C98DA0C4CFEA7C53D6E8100F73"><enum>(b)</enum><header>Notification</header><text>The
				Secretary shall notify a contract care provider and any patient who receives
				contract health care services authorized by the Service that such patient is
				not liable for the payment of any charges or costs associated with the
				provision of such services not later than 5 business days after receipt of a
				notification of a claim by a provider of contract care services.</text>
								</subsection><subsection id="HD9971DE849854C63AAADC0FFEDE0F6F8"><enum>(c)</enum><header>No
				recourse</header><text>Following receipt of the notice provided under
				subsection (b), or, if a claim has been deemed accepted under section 223(b),
				the provider shall have no further recourse against the patient who received
				the services.</text>
								</subsection></section><section id="H8A9728AFCA5840519694473BAFB3F325"><enum>226.</enum><header>Office of Indian Men's
				Health</header>
								<subsection id="H41835F1D77284E06B367F93C6773E443"><enum>(a)</enum><header>Establishment</header><text>The
				Secretary may establish within the Service an office to be known as the
				<quote>Office of Indian Men's Health</quote> (referred to in this section as
				the <quote>Office</quote>).</text>
								</subsection><subsection id="H654613E8BAA24C78B1C3AA4FE3509BD6"><enum>(b)</enum><header>Director</header>
									<paragraph id="H1BB65AAEC30846F7AE00134D38E07879"><enum>(1)</enum><header>In
				general</header><text>The Office shall be headed by a director, to be appointed
				by the Secretary.</text>
									</paragraph><paragraph id="H0A181029E0684744883DDB00883E69C8"><enum>(2)</enum><header>Duties</header><text>The
				director shall coordinate and promote the status of the health of Indian men in
				the United States.</text>
									</paragraph></subsection><subsection id="H856E3A3E5C234111B48851B32715E09"><enum>(c)</enum><header>Report</header><text>Not
				later than 2 years after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, the Secretary, acting through the director of the
				Office, shall submit to Congress a report describing—</text>
									<paragraph id="H11716644A233497D8871AD6C1DC4DFD5"><enum>(1)</enum><text>any activity carried out
				by the director as of the date on which the report is prepared; and</text>
									</paragraph><paragraph id="H4E2C2A2B4D2E4294BD39001732BBD64"><enum>(2)</enum><text>any finding of the
				director with respect to the health of Indian men.</text>
									</paragraph></subsection></section><section id="HEF340CB60E8649449ED7FC5780C6C6F1"><enum>227.</enum><header>Authorization of
				appropriations</header><text display-inline="no-display-inline">There are
				authorized to be appropriated such sums as may be necessary for each fiscal
				year through fiscal year 2017 to carry out this title.</text>
							</section></title><title id="H8B46CE8C42224601A4CC1BA709B3DEDC"><enum>III</enum><header>Facilities</header>
							<section id="HEEF36B8D59E0495A8EF88CD49D457C6"><enum>301.</enum><header>Consultation;
				construction and renovation of facilities; reports</header>
								<subsection id="H4B59F7A75EFF4544AE02B115334483FA"><enum>(a)</enum><header>Prerequisites for
				expenditure of funds</header><text>Prior to the expenditure of, or the making
				of any binding commitment to expend, any funds appropriated for the planning,
				design, construction, or renovation of facilities pursuant to the Act of
				November 2, 1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>) (commonly known as the <quote>Snyder
				Act</quote>), the Secretary, acting through the Service, shall—</text>
									<paragraph id="H06B56550E411425F9C308ED92FB400DA"><enum>(1)</enum><text>consult with any Indian
				Tribe that would be significantly affected by such expenditure for the purpose
				of determining and, whenever practicable, honoring tribal preferences
				concerning size, location, type, and other characteristics of any facility on
				which such expenditure is to be made; and</text>
									</paragraph><paragraph id="H16F69150BC15404C8C55652BB58CCEF"><enum>(2)</enum><text>ensure, whenever
				practicable and applicable, that such facility meets the construction standards
				of any accrediting body recognized by the Secretary for the purposes of the
				Medicare, Medicaid, and SCHIP programs under titles XVIII, XIX, and XXI of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> by not later than
				1 year after the date on which the construction or renovation of such facility
				is completed.</text>
									</paragraph></subsection><subsection id="H3A9B1F79F040482FA77BE8D9C16FB534"><enum>(b)</enum><header>Closures</header>
									<paragraph id="H7D55B62D70494FE1A5BF99DC10D90603"><enum>(1)</enum><header>Evaluation
				required</header><text>Notwithstanding any other provision of law, no facility
				operated by the Service, or any portion of such facility, may be closed if the
				Secretary has not submitted to Congress, not less than 1 year and not more than
				2 years before the date of the proposed closure, an evaluation, completed not
				more than 2 years before such submission, of the impact of the proposed closure
				that specifies, in addition to other considerations—</text>
										<subparagraph id="H1790D3B8114C4A56B47466946B9DF28"><enum>(A)</enum><text>the accessibility of
				alternative health care resources for the population served by such
				facility;</text>
										</subparagraph><subparagraph id="H42F6A03E767B4D8AB1B71B9993757630"><enum>(B)</enum><text>the cost-effectiveness of
				such closure;</text>
										</subparagraph><subparagraph id="H3BD5CC5EFB5B4AC69EAD00BBEE2C800"><enum>(C)</enum><text>the quality of health
				care to be provided to the population served by such facility after such
				closure;</text>
										</subparagraph><subparagraph id="H2C681C22528F4F1F8FFAB1F413620072"><enum>(D)</enum><text>the availability of
				contract health care funds to maintain existing levels of service;</text>
										</subparagraph><subparagraph id="H81FA179FB28740AA9332B4A964FBCB6"><enum>(E)</enum><text>the views of the Indian
				Tribes served by such facility concerning such closure;</text>
										</subparagraph><subparagraph id="HAAB2F73FDFEF4742B65BF3617873856E"><enum>(F)</enum><text>the level of use of such
				facility by all eligible Indians; and</text>
										</subparagraph><subparagraph id="HA8F30DD10ED94C45849842F13910BAC8"><enum>(G)</enum><text>the distance between such
				facility and the nearest operating Service hospital.</text>
										</subparagraph></paragraph><paragraph id="H8A19A0E852E24099B534E1BD41175CFE"><enum>(2)</enum><header>Exception for certain
				temporary closures</header><text>Paragraph (1) shall not apply to any temporary
				closure of a facility or any portion of a facility if such closure is necessary
				for medical, environmental, or construction safety reasons.</text>
									</paragraph></subsection><subsection id="HF4902FE2DEAB489186B32BEEC715296"><enum>(c)</enum><header>Health care facility
				priority system</header>
									<paragraph id="H4E31243EFBD545ACB825C8CB0183EEB"><enum>(1)</enum><header>In general</header>
										<subparagraph id="H7E8500B992204CA48EA94D11382792EC"><enum>(A)</enum><header>Priority
				system</header><text>The Secretary, acting through the Service, shall maintain
				a health care facility priority system, which—</text>
											<clause id="H65B2F904E8734C9C83485200CEDAB3E9"><enum>(i)</enum><text>shall be developed in
				consultation with Indian Tribes and Tribal Organizations;</text>
											</clause><clause id="HBC0B88AF14CE43F7B4F76D42F321CFC1"><enum>(ii)</enum><text>shall give Indian
				Tribes’ needs the highest priority;</text>
											</clause><clause id="H705DAD4D189A493084B3F75BD244AD29"><enum>(iii)</enum><subclause commented="no" display-inline="yes-display-inline" id="HBAA768A440764BCF84C8AB9990ABFC8"><enum>(I)</enum><text>may include the lists
				required in paragraph (2)(B)(ii); and</text>
												</subclause><subclause changed="added" committee-id="HII00" id="H4071C3FD927F4C728BBAE7B76033A21F" indent="up1" reported-display-style="italic"><enum>(II)</enum><text>shall include the
				methodology required in paragraph (2)(B)(v); and</text>
												</subclause><subclause changed="added" committee-id="HII00" id="HC680CC79C05F43AC00877957D6FEB24E" indent="up1" reported-display-style="italic"><enum>(III)</enum><text>may include such other
				facilities, and such renovation or expansion needs of any health care facility,
				as the Service, Indian Tribes, and Tribal Organizations may identify;
				and</text>
												</subclause></clause><clause id="HC00FA8C6DEE74E4EA8F46120FBFBA4B"><enum>(iv)</enum><text>shall provide an
				opportunity for the nomination of planning, design, and construction projects
				by the Service, Indian Tribes, and Tribal Organizations for consideration under
				the priority system at least once every 3 years, or more frequently as the
				Secretary determines to be appropriate.</text>
											</clause></subparagraph><subparagraph id="HDD837013A1EB42078FE4128495767FAD"><enum>(B)</enum><header>Needs of facilities
				under ISDEAA agreements</header><text>The Secretary shall ensure that the
				planning, design, construction, renovation, and expansion needs of Service and
				non-Service facilities operated under contracts or compacts in accordance with
				the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et
				seq.) are fully and equitably integrated into the health care facility priority
				system.</text>
										</subparagraph><subparagraph id="H9054E0DE44D548B2BF4EE837BBFF6D93"><enum>(C)</enum><header>Criteria for evaluating
				needs</header><text>For purposes of this subsection, the Secretary, in
				evaluating the needs of facilities operated under a contract or compact under
				the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et
				seq.), shall use the criteria used by the Secretary in evaluating the needs of
				facilities operated directly by the Service.</text>
										</subparagraph><subparagraph id="HD87E8B2FC8264E559B17A55C049FC700"><enum>(D)</enum><header>Priority of certain
				projects protected</header><text>The priority of any project established under
				the construction priority system in effect on the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title> shall not be affected by any change in the construction
				priority system taking place after that date if the project—</text>
											<clause id="H749A3563F96344C8AE00B44D10005300"><enum>(i)</enum><text>was identified in the
				fiscal year 2008 Service budget justification as—</text>
												<subclause id="HCA4200CE1A6F49B18543677093F2737"><enum>(I)</enum><text>1 of the 10 top-priority
				inpatient projects;</text>
												</subclause><subclause id="H4F30F33FBB044C15B8DC87E978FFD1D6"><enum>(II)</enum><text>1 of the 10 top-priority
				outpatient projects;</text>
												</subclause><subclause id="HC95803F290C54689B3A0C93FCAA4DA8C"><enum>(III)</enum><text>1 of the 10
				top-priority staff quarters developments; or</text>
												</subclause><subclause id="H01947271E9C746FA87F3558301C0E29B"><enum>(IV)</enum><text>1 of the 10 top-priority
				Youth Regional Treatment Centers;</text>
												</subclause></clause><clause id="HABCA41836E8743D48DB0242B009EF0FF"><enum>(ii)</enum><text>had completed both Phase
				I and Phase II of the construction priority system in effect on the date of
				enactment of such Act; or</text>
											</clause><clause id="H26052998B2394494B238C60836477B08"><enum>(iii)</enum><text>is not included in
				clause (i) or (ii) and is selected, as determined by the Secretary—</text>
												<subclause id="H3A1AC0DD71E8416EB7168789E521AEEA"><enum>(I)</enum><text>on the initiative of the
				Secretary; or</text>
												</subclause><subclause id="H55967FFF3DEB43D894F63E7BA6B48749"><enum>(II)</enum><text>pursuant to a request of
				an Indian Tribe or Tribal Organization.</text>
												</subclause></clause></subparagraph></paragraph><paragraph id="H4CA868A404DB4E8F008F4C761F20EE4F"><enum>(2)</enum><header>Report;
				contents</header>
										<subparagraph id="HC71A52D30A01469C91A4005600B48100"><enum>(A)</enum><header>Initial comprehensive
				report</header>
											<clause id="HF7AFF0D6CC5B484684BE73FB5E0747D8"><enum>(i)</enum><header>Definitions</header><text>In
				this subparagraph:</text>
												<subclause id="H80AB1628935347509C8ED0EC31EB600"><enum>(I)</enum><header>Facilities
				Appropriation Advisory Board</header><text>The term <term>Facilities
				Appropriation Advisory Board</term> means the advisory board, comprised of 12
				members representing Indian tribes and 2 members representing the Service,
				established at the discretion of the Assistant Secretary—</text>
													<item id="H65F2B2C4AF5441DFAAE6AEB3D227EBF6"><enum>(aa)</enum><text>to provide advice and
				recommendations for policies and procedures of the programs funded pursuant to
				facilities appropriations; and</text>
													</item><item id="H1B420500E79544EB84E80397A4E292CE"><enum>(bb)</enum><text>to address other
				facilities issues.</text>
													</item></subclause><subclause id="HA801FE5FFEC94DAAADE6B3344D70976F"><enum>(II)</enum><header>Facilities Needs
				Assessment Workgroup</header><text>The term <term>Facilities Needs Assessment
				Workgroup</term> means the workgroup established at the discretion of the
				Assistant Secretary—</text>
													<item id="HB76193EE7B6549B58F1227FEE179A6E2"><enum>(aa)</enum><text>to review the health
				care facilities construction priority system; and</text>
													</item><item id="H19CA00DBBA0C46E9B353E5384501E43B"><enum>(bb)</enum><text>to make recommendations
				to the Facilities Appropriation Advisory Board for revising the priority
				system.</text>
													</item></subclause></clause><clause id="H02F2537488544017A7FE313E18BFC204"><enum>(ii)</enum><header>Initial
				report</header>
												<subclause id="H4BCFDBFEC9D84A71ACA3E731BE4DB13C"><enum>(I)</enum><header>In
				general</header><text>Not later than 1 year after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, the Secretary shall submit to the Committee on Indian
				Affairs of the Senate and the Committee on Natural Resources of the House of
				Representatives a report that describes the comprehensive, national, ranked
				list of all health care facilities needs for the Service, Indian Tribes, and
				Tribal Organizations (including inpatient health care facilities, outpatient
				health care facilities, specialized health care facilities (such as for
				long-term care and alcohol and drug abuse treatment), wellness centers, staff
				quarters and hostels associated with health care facilities, and the renovation
				and expansion needs, if any, of such facilities) developed by the Service,
				Indian Tribes, and Tribal Organizations for the Facilities Needs Assessment
				Workgroup and the Facilities Appropriation Advisory Board.</text>
												</subclause><subclause id="H0DB1D4D214FB421FBA4782CF437DDCA"><enum>(II)</enum><header>Inclusions</header><text>The
				initial report shall include—</text>
													<item id="HDE77F26A91F841B48633525488E5582D"><enum>(aa)</enum><text>the methodology and
				criteria used by the Service in determining the needs and establishing the
				ranking of the facilities needs; and</text>
													</item><item id="HD6E92B8713F64802B8CE70ED5EA0636B"><enum>(bb)</enum><text>such other information
				as the Secretary determines to be appropriate.</text>
													</item></subclause></clause><clause id="H2156E257B8D343F8954293AE485507E9"><enum>(iii)</enum><header>Updates of
				report</header><text>Beginning in calendar year 2011, the Secretary
				shall—</text>
												<subclause id="H53DF98815F464C108CC955037819579D"><enum>(I)</enum><text>update the report under
				clause (ii) not less frequently that once every 5 years; and</text>
												</subclause><subclause id="H26B47F954DD04453B3D79500AD5FA00"><enum>(II)</enum><text>include the updated
				report in the appropriate annual report under subparagraph (B) for submission
				to Congress under section 801.</text>
												</subclause></clause></subparagraph><subparagraph id="H526442E85EB649309EF1895EAC00AE8F"><enum>(B)</enum><header>Annual
				reports</header><text>The Secretary shall submit to the President, for
				inclusion in the report required to be transmitted to Congress under section
				801, a report which sets forth the following:</text>
											<clause id="HE58C3E9679394FBEB1D6022809BBDAC0"><enum>(i)</enum><text>A description of the
				health care facility priority system of the Service established under paragraph
				(1).</text>
											</clause><clause id="HEAB3FB1C7BFF46EDBF96EB55043F3048"><enum>(ii)</enum><text>Health care facilities
				lists, which may include—</text>
												<subclause id="H07A5976089994E9BAF322954E055C5D3"><enum>(I)</enum><text>the 10 top-priority
				inpatient health care facilities;</text>
												</subclause><subclause id="H1B4CAF0844834722A413B7F2B7DCDE5C"><enum>(II)</enum><text>the 10 top-priority
				outpatient health care facilities;</text>
												</subclause><subclause id="H1C04B5334B234D8389F943DB460AD00"><enum>(III)</enum><text>the 10 top-priority
				specialized health care facilities (such as long-term care and alcohol and drug
				abuse treatment);</text>
												</subclause><subclause id="H97CA348479CA4D80AADFA722492E2B6F"><enum>(IV)</enum><text>the 10 top-priority
				staff quarters developments associated with health care facilities; and</text>
												</subclause><subclause id="H7BCAC0D0F4214A31A502346D3581DE17"><enum>(V)</enum><text>the 10 top-priority
				hostels associated with health care facilities.</text>
												</subclause></clause><clause id="H0213F9F5BBEA404D8549BD96F7004631"><enum>(iii)</enum><text>The justification for
				such order of priority.</text>
											</clause><clause id="HE00195C05C014260BE255EEC8B47435B"><enum>(iv)</enum><text>The projected cost of
				such projects.</text>
											</clause><clause id="H1AA665211263436DA97EEB4BC075674F"><enum>(v)</enum><text>The methodology adopted
				by the Service in establishing priorities under its health care facility
				priority system.</text>
											</clause></subparagraph></paragraph><paragraph id="HDF8092693C984B4FB6C7E9E294ACF0DC"><enum>(3)</enum><header>Requirements for
				preparation of reports</header><text>In preparing the report required under
				paragraph (2), the Secretary shall—</text>
										<subparagraph id="H9EF5690A2AFF47B59F48762111762945"><enum>(A)</enum><text>consult with and obtain
				information on all health care facilities needs from Indian Tribes, Tribal
				Organizations, and Urban Indian Organizations; and</text>
										</subparagraph><subparagraph id="HB8EF2BE378A244A39D17A15319A0A1C5"><enum>(B)</enum><text>review the total unmet
				needs of all Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations for health care facilities (including hostels and staff
				quarters), including needs for renovation and expansion of existing
				facilities.</text>
										</subparagraph></paragraph></subsection><subsection id="H075BADF25A8A442B9E007716FEFFC409"><enum>(d)</enum><header>Review of methodology
				used for health facilities construction priority system</header>
									<paragraph id="H7DF6A1680E7946AE96C6251BC1848669"><enum>(1)</enum><header>In
				general</header><text>Not later than 1 year after the establishment of the
				priority system under subsection (c)(1)(A), the Comptroller General of the
				United States shall prepare and finalize a report reviewing the methodologies
				applied, and the processes followed, by the Service in making each assessment
				of needs for the list under subsection (c)(2)(A)(ii) and developing the
				priority system under subsection (c)(1), including a review of—</text>
										<subparagraph id="H88BC70D15057443599952EA16F00A1A4"><enum>(A)</enum><text>the recommendations of
				the Facilities Appropriation Advisory Board and the Facilities Needs Assessment
				Workgroup (as those terms are defined in subsection (c)(2)(A)(i)); and</text>
										</subparagraph><subparagraph id="H3E5C786714FC4C4ABE9875339D77A14D"><enum>(B)</enum><text>the relevant criteria
				used in ranking or prioritizing facilities other than hospitals or
				clinics.</text>
										</subparagraph></paragraph><paragraph id="HBC3980BF455541F4002081C860225F37"><enum>(2)</enum><header>Submission to
				Congress</header><text>The Comptroller General of the United States shall
				submit the report under paragraph (1) to—</text>
										<subparagraph id="HFFAD2C82820543ABBEA1227ED05B65A9"><enum>(A)</enum><text>the Committees on Indian
				Affairs and Appropriations of the Senate;</text>
										</subparagraph><subparagraph id="H762CBA5950CA42938CA1AFBB8205139E"><enum>(B)</enum><text>the Committees on Natural
				Resources and Appropriations of the House of Representatives; and</text>
										</subparagraph><subparagraph id="H06B182778CAE4CE7889B36F33EB6C12D"><enum>(C)</enum><text>the Secretary.</text>
										</subparagraph></paragraph></subsection><subsection id="H9095486022A448E6A987AC989F84354B"><enum>(e)</enum><header>Funding
				condition</header><text>All funds appropriated under the Act of November 2,
				1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>) (commonly known as the <quote>Snyder Act</quote>), for the
				planning, design, construction, or renovation of health facilities for the
				benefit of 1 or more Indian Tribes shall be subject to the provisions of the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>).</text>
								</subsection><subsection id="H0327BFD6B3B54E4DB50560D343F649BF"><enum>(f)</enum><header>Development of
				innovative approaches</header><text>The Secretary shall consult and cooperate
				with Indian Tribes, Tribal Organizations, and Urban Indian Organizations in
				developing innovative approaches to address all or part of the total unmet need
				for construction of health facilities, including those provided for in other
				sections of this title and other approaches.</text>
								</subsection></section><section id="H915998DD62AA40D4B9039CDA07F41D1E"><enum>302.</enum><header>Sanitation
				facilities</header>
								<subsection id="H24FD15CDDE3C4EDFA0CDAFB017E0BC70"><enum>(a)</enum><header>Findings</header><text>Congress
				finds the following:</text>
									<paragraph id="HF1849A8C9BC748738B91D38667F21F2C"><enum>(1)</enum><text>The provision of
				sanitation facilities is primarily a health consideration and function.</text>
									</paragraph><paragraph id="H7455830C311F4A78B82F443318C3F01D"><enum>(2)</enum><text>Indian people suffer an
				inordinately high incidence of disease, injury, and illness directly
				attributable to the absence or inadequacy of sanitation facilities.</text>
									</paragraph><paragraph id="H63268BCB20E94F67ABD93F940749285D"><enum>(3)</enum><text>The long-term cost to the
				United States of treating and curing such disease, injury, and illness is
				substantially greater than the short-term cost of providing sanitation
				facilities and other preventive health measures.</text>
									</paragraph><paragraph id="HA83BBBD4C81241F0A01F436200C9B0B2"><enum>(4)</enum><text>Many Indian homes and
				Indian communities still lack sanitation facilities.</text>
									</paragraph><paragraph id="H038662266F18409B9BE811C069D031E3"><enum>(5)</enum><text>It is in the interest of
				the United States, and it is the policy of the United States, that all Indian
				communities and Indian homes, new and existing, be provided with sanitation
				facilities.</text>
									</paragraph></subsection><subsection id="H4712D10F6BA840009318A5C5B6267CBF"><enum>(b)</enum><header>Facilities and
				services</header><text>In furtherance of the findings made in subsection (a),
				Congress reaffirms the primary responsibility and authority of the Service to
				provide the necessary sanitation facilities and services as provided in section
				7 of the Act of August 5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2004a">42 U.S.C. 2004a</external-xref>). Under such authority, the
				Secretary, acting through the Service, is authorized to provide the
				following:</text>
									<paragraph id="H22F19420BEAB4F65BB73C4052B223841"><enum>(1)</enum><text>Financial and technical
				assistance to Indian Tribes, Tribal Organizations, and Indian communities in
				the establishment, training, and equipping of utility organizations to operate
				and maintain sanitation facilities, including the provision of existing plans,
				standard details, and specifications available in the Department, to be used at
				the option of the Indian Tribe, Tribal Organization, or Indian
				community.</text>
									</paragraph><paragraph id="H1629FA8EC83A4334A76E02145CC2FE63"><enum>(2)</enum><text>Ongoing technical
				assistance and training to Indian Tribes, Tribal Organizations, and Indian
				communities in the management of utility organizations which operate and
				maintain sanitation facilities.</text>
									</paragraph><paragraph id="HE0F5E15DA2D14E319183206BC8E19528"><enum>(3)</enum><text>Priority funding for
				operation and maintenance assistance for, and emergency repairs to, sanitation
				facilities operated by an Indian Tribe, Tribal Organization or Indian community
				when necessary to avoid an imminent health threat or to protect the investment
				in sanitation facilities and the investment in the health benefits gained
				through the provision of sanitation facilities.</text>
									</paragraph></subsection><subsection id="H5E48562825E14ED38297B5F0C03598E"><enum>(c)</enum><header>Funding</header><text>Notwithstanding
				any other provision of law—</text>
									<paragraph id="HC085A040FBA543AB80384DB73972F77D"><enum>(1)</enum><text>the Secretary of Housing
				and Urban Development is authorized to transfer funds appropriated under the
				Native American Housing Assistance and Self-Determination Act of 1996 (25
				U.S.C. 4101 et seq.) to the Secretary of Health and Human Services;</text>
									</paragraph><paragraph id="H4E3B07FE8F7449B18520AFA25A76CE1"><enum>(2)</enum><text>the Secretary of Health
				and Human Services is authorized to accept and use such funds for the purpose
				of providing sanitation facilities and services for Indians under section 7 of
				the Act of August 5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2004a">42 U.S.C. 2004a</external-xref>);</text>
									</paragraph><paragraph id="H29B583ED5CB545BDA12507E360C900CD"><enum>(3)</enum><text>unless specifically
				authorized when funds are appropriated, the Secretary shall not use funds
				appropriated under section 7 of the Act of August 5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2004a">42 U.S.C. 2004a</external-xref>), to
				provide sanitation facilities to new homes constructed using funds provided by
				the Department of Housing and Urban Development;</text>
									</paragraph><paragraph id="HDA14BEBE46F44F3881B228BFA558DF85"><enum>(4)</enum><text>the Secretary of Health
				and Human Services is authorized to accept from any source, including Federal
				and State agencies, funds for the purpose of providing sanitation facilities
				and services and place these funds into contracts or compacts under the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>);</text>
									</paragraph><paragraph id="H328BC87AF7F3415AA0ACC18017252574"><enum>(5)</enum><text>except as otherwise
				prohibited by this section, the Secretary may use funds appropriated under the
				authority of section 7 of the Act of August 5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2004a">42 U.S.C. 2004a</external-xref>), to fund
				up to 100 percent of the amount of an Indian Tribe's loan obtained under any
				Federal program for new projects to construct eligible sanitation facilities to
				serve Indian homes;</text>
									</paragraph><paragraph id="H1CA511758A244F0F90C847DF568CA89F"><enum>(6)</enum><text>except as otherwise
				prohibited by this section, the Secretary may use funds appropriated under the
				authority of section 7 of the Act of August 5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2004a">42 U.S.C. 2004a</external-xref>) to meet
				matching or cost participation requirements under other Federal and non-Federal
				programs for new projects to construct eligible sanitation facilities;</text>
									</paragraph><paragraph id="HD59796C75A204C3EA4E3D78E38ACC1B"><enum>(7)</enum><text>all Federal agencies are
				authorized to transfer to the Secretary funds identified, granted, loaned, or
				appropriated whereby the Department’s applicable policies, rules, and
				regulations shall apply in the implementation of such projects;</text>
									</paragraph><paragraph id="H88AC8E36B3BA472CA1B0C54B221F58C2"><enum>(8)</enum><text>the Secretary of Health
				and Human Services shall enter into interagency agreements with Federal and
				State agencies for the purpose of providing financial assistance for sanitation
				facilities and services under this Act;</text>
									</paragraph><paragraph id="H77F7039E0EDA4D05B6460033CF796510"><enum>(9)</enum><text>the Secretary of Health
				and Human Services shall, by regulation, establish standards applicable to the
				planning, design, and construction of sanitation facilities funded under this
				Act; and</text>
									</paragraph><paragraph id="HAE98785FADD645638E6D2D56A1124211"><enum>(10)</enum><text>the Secretary of Health
				and Human Services is authorized to accept payments for goods and services
				furnished by the Service from appropriate public authorities, nonprofit
				organizations or agencies, or Indian Tribes, as contributions by that
				authority, organization, agency, or tribe to agreements made under section 7 of
				the Act of August 5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2004a">42 U.S.C. 2004a</external-xref>), and such payments shall be
				credited to the same or subsequent appropriation account as funds appropriated
				under the authority of section 7 of the Act of August 5, 1954 (42 U.S.C.
				2004a).</text>
									</paragraph></subsection><subsection id="HEF9BBB8D110546F98182D3B12C88B8F"><enum>(d)</enum><header>Certain capabilities
				not prerequisite</header><text>The financial and technical capability of an
				Indian Tribe, Tribal Organization, or Indian community to safely operate,
				manage, and maintain a sanitation facility shall not be a prerequisite to the
				provision or construction of sanitation facilities by the Secretary.</text>
								</subsection><subsection id="H8171C9652492455BA91823C88F47862C"><enum>(e)</enum><header>Financial
				assistance</header><text>The Secretary is authorized to provide financial
				assistance to Indian Tribes, Tribal Organizations, and Indian communities for
				operation, management, and maintenance of their sanitation facilities.</text>
								</subsection><subsection id="HC95DDC71A21F4DDC837E5EB7A1D14CF5"><enum>(f)</enum><header>Operation, management,
				and maintenance of facilities</header><text>The Indian Tribe has the primary
				responsibility to establish, collect, and use reasonable user fees, or
				otherwise set aside funding, for the purpose of operating, managing, and
				maintaining sanitation facilities. If a sanitation facility serving a community
				that is operated by an Indian Tribe or Tribal Organization is threatened with
				imminent failure and such operator lacks capacity to maintain the integrity or
				the health benefits of the sanitation facility, then the Secretary is
				authorized to assist the Indian Tribe, Tribal Organization, or Indian community
				in the resolution of the problem on a short-term basis through cooperation with
				the emergency coordinator or by providing operation, management, and
				maintenance service.</text>
								</subsection><subsection id="H05EF56CA76E44982836884D0133763A1"><enum>(g)</enum><header>ISDEAA program funded
				on equal basis</header><text>Tribal Health Programs shall be eligible (on an
				equal basis with programs that are administered directly by the Service)
				for—</text>
									<paragraph id="H7938A0159A3A4569A3AF93DFB87D78B3"><enum>(1)</enum><text>any funds appropriated
				pursuant to this section; and</text>
									</paragraph><paragraph id="HF86784F974DF449EB5013DFBC281E823"><enum>(2)</enum><text>any funds appropriated
				for the purpose of providing sanitation facilities.</text>
									</paragraph></subsection><subsection id="H54D3E01200974201B212B34C77683600"><enum>(h)</enum><header>Report</header>
									<paragraph id="HA9E9DBDD50824A40A2267C8741976CB7"><enum>(1)</enum><header>Required;
				contents</header><text>The Secretary, in consultation with the Secretary of
				Housing and Urban Development, Indian Tribes, Tribal Organizations, and
				tribally designated housing entities (as defined in section 4 of the Native
				American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C.
				4103)) shall submit to the President, for inclusion in the report required to
				be transmitted to Congress under section 801, a report which sets forth—</text>
										<subparagraph id="H50A180E9E8A948F28371338B4F845F3E"><enum>(A)</enum><text>the current Indian
				sanitation facility priority system of the Service;</text>
										</subparagraph><subparagraph id="HC84E841969CE491AB847C72EA67B79CF"><enum>(B)</enum><text>the methodology for
				determining sanitation deficiencies and needs;</text>
										</subparagraph><subparagraph id="H282B6FEEBB774305BAC8618B395500DD"><enum>(C)</enum><text>the criteria on which the
				deficiencies and needs will be evaluated;</text>
										</subparagraph><subparagraph id="HDCEB3CC74D594F818E37050863C14C30"><enum>(D)</enum><text>the level of initial and
				final sanitation deficiency for each type of sanitation facility for each
				project of each Indian Tribe or Indian community;</text>
										</subparagraph><subparagraph id="H9D2BCA4F25D648EF8F8262907820215D"><enum>(E)</enum><text>the amount and most
				effective use of funds, derived from whatever source, necessary to accommodate
				the sanitation facilities needs of new homes assisted with funds under the
				Native American Housing Assistance and Self-Determination Act (25 U.S.C. 4101
				et seq.), and to reduce the identified sanitation deficiency levels of all
				Indian Tribes and Indian communities to level I sanitation deficiency as
				defined in paragraph (3)(A); and</text>
										</subparagraph><subparagraph id="H644A655D29E2448B84FEC9327D40BAA"><enum>(F)</enum><text>a 10-year plan to provide
				sanitation facilities to serve existing Indian homes and Indian communities and
				new and renovated Indian homes.</text>
										</subparagraph></paragraph><paragraph id="H3D721E32887644FBB9E8FCE3C4D37DFF"><enum>(2)</enum><header>Uniform
				methodology</header><text>The methodology used by the Secretary in determining,
				preparing cost estimates for, and reporting sanitation deficiencies for
				purposes of paragraph (1) shall be applied uniformly to all Indian Tribes and
				Indian communities.</text>
									</paragraph><paragraph id="H2A6695EA9A384253B5A8485F59004337"><enum>(3)</enum><header>Sanitation deficiency
				levels</header><text>For purposes of this subsection, the sanitation deficiency
				levels for an individual, Indian Tribe, or Indian community sanitation facility
				to serve Indian homes are determined as follows:</text>
										<subparagraph id="H0609A53612FD45DBA6D4EA57383E6DF"><enum>(A)</enum><text>A level I deficiency
				exists if a sanitation facility serving an individual, Indian Tribe, or Indian
				community—</text>
											<clause id="HEE2D6205EF4445A3A58E22598068D404"><enum>(i)</enum><text>complies with all
				applicable water supply, pollution control, and solid waste disposal laws;
				and</text>
											</clause><clause id="H31C38C75FA394EB598E13F8BDB047D10"><enum>(ii)</enum><text>deficiencies relate to
				routine replacement, repair, or maintenance needs.</text>
											</clause></subparagraph><subparagraph id="H77C6741A07D8492F99163E5DD2408B00"><enum>(B)</enum><text>A level II deficiency
				exists if a sanitation facility serving an individual, Indian Tribe, or Indian
				community substantially or recently complied with all applicable water supply,
				pollution control, and solid waste laws and any deficiencies relate to—</text>
											<clause id="H613020FE83444DD6B17BB1F3FFA1744"><enum>(i)</enum><text>small or minor capital
				improvements needed to bring the facility back into compliance;</text>
											</clause><clause id="HDB6C66C4501A496A805B6170A0D3BCE8"><enum>(ii)</enum><text>capital improvements
				that are necessary to enlarge or improve the facilities in order to meet the
				current needs for domestic sanitation facilities; or</text>
											</clause><clause id="H95098AED134841FBB5931385C4536790"><enum>(iii)</enum><text>the lack of equipment
				or training by an Indian Tribe, Tribal Organization, or an Indian community to
				properly operate and maintain the sanitation facilities.</text>
											</clause></subparagraph><subparagraph id="HE5E79AEBF54F4929965EE540D1237FE8"><enum>(C)</enum><text>A level III deficiency
				exists if a sanitation facility serving an individual, Indian Tribe or Indian
				community meets 1 or more of the following conditions—</text>
											<clause id="H709DB58D11C448FA9F4F77B850479841"><enum>(i)</enum><text>water or sewer service in
				the home is provided by a haul system with holding tanks and interior
				plumbing;</text>
											</clause><clause id="H8B464BDF12FE4EDFBFA68798331CDA22"><enum>(ii)</enum><text>major significant
				interruptions to water supply or sewage disposal occur frequently, requiring
				major capital improvements to correct the deficiencies; or</text>
											</clause><clause id="H5C6DC7068F0B40739812B92B569004BE"><enum>(iii)</enum><text>there is no access to
				or no approved or permitted solid waste facility available.</text>
											</clause></subparagraph><subparagraph id="H26A3303D9A4D4EE1B4CF5BA9DAEF45E8"><enum>(D)</enum><text>A level IV deficiency
				exists—</text>
											<clause id="HF8D4D540113C48F585D3B828C2539C6"><enum>(i)</enum><text>if a sanitation facility
				for an individual home, an Indian Tribe, or an Indian community exists
				but—</text>
												<subclause id="H110F4CB8BDD64EBE83C1DB5D004332B6"><enum>(I)</enum><text>lacks—</text>
													<item id="H832AD939EA3F46F1A8523491A8BA17B4"><enum>(aa)</enum><text>a safe water supply
				system; or</text>
													</item><item id="HD2E2758BF9154EE9A290FA0086DD5207"><enum>(bb)</enum><text>a waste disposal
				system;</text>
													</item></subclause><subclause id="H4CB87B22CEBD409CBE251BF490D9436C"><enum>(II)</enum><text>contains no piped water
				or sewer facilities; or</text>
												</subclause><subclause id="HF7C81AA4A55443EEAB0887905F8C4BBF"><enum>(III)</enum><text>has become inoperable
				due to a major component failure; or</text>
												</subclause></clause><clause id="HB3E5A54A9BAA4B42943B26F657718811"><enum>(ii)</enum><text>if only a washeteria or
				central facility exists in the community.</text>
											</clause></subparagraph><subparagraph id="H4E8D272B07844B2DB187878539AACAFC"><enum>(E)</enum><text>A level V deficiency
				exists in the absence of a sanitation facility, where individual homes do not
				have access to safe drinking water or adequate wastewater (including sewage)
				disposal.</text>
										</subparagraph></paragraph></subsection><subsection id="H8D5CBAF1E7D54A8992399900A5E879A6"><enum>(i)</enum><header>Definitions</header><text>For
				purposes of this section, the following terms apply:</text>
									<paragraph id="H49A8D3A7C2F94F09A3D6BA061BE58CCD"><enum>(1)</enum><header>Indian
				community</header><text>The term <term>Indian community</term> means a
				geographic area, a significant proportion of whose inhabitants are Indians and
				which is served by or capable of being served by a facility described in this
				section.</text>
									</paragraph><paragraph id="H116AD14C7EE249DFA51EA7D443DA3FEE"><enum>(2)</enum><header>Sanitation
				facilities</header><text>The terms <term>sanitation facility</term> and
				<term>sanitation facilities</term> mean safe and adequate water supply systems,
				sanitary sewage disposal systems, and sanitary solid waste systems (and all
				related equipment and support infrastructure).</text>
									</paragraph></subsection></section><section id="H50AB5BD98F964AA58983A1DE302076FC"><enum>303.</enum><header>Preference to Indians
				and Indian firms</header>
								<subsection id="HC70BDD4896D5406BBE4C4D1D1939D8FA"><enum>(a)</enum><header>Buy Indian
				Act</header><text>The Secretary, acting through the Service, may use the
				negotiating authority of section 23 of the Act of June 25, 1910 (<external-xref legal-doc="usc" parsable-cite="usc/25/47">25 U.S.C. 47</external-xref>,
				commonly known as the <quote>Buy Indian Act</quote>), to give preference to any
				Indian or any enterprise, partnership, corporation, or other type of business
				organization owned and controlled by an Indian or Indians including former or
				currently federally recognized Indian Tribes in the State of New York
				(hereinafter referred to as an <quote>Indian firm</quote>) in the construction
				and renovation of Service facilities pursuant to section 301 and in the
				construction of sanitation facilities pursuant to section 302. Such preference
				may be accorded by the Secretary unless the Secretary finds, pursuant to
				regulations, that the project or function to be contracted for will not be
				satisfactory or such project or function cannot be properly completed or
				maintained under the proposed contract. The Secretary, in arriving at such a
				finding, shall consider whether the Indian or Indian firm will be deficient
				with respect to—</text>
									<paragraph id="HC5025306B7754CCF8E80F98B8EE7AFDF"><enum>(1)</enum><text>ownership and control by
				Indians;</text>
									</paragraph><paragraph id="H2AD36F71B912477AB4081FFB902225A1"><enum>(2)</enum><text>equipment;</text>
									</paragraph><paragraph id="H34EDBD869E2E47D98E047800E428ED92"><enum>(3)</enum><text>bookkeeping and
				accounting procedures;</text>
									</paragraph><paragraph id="HD4A1300958D743418F7342F450E6FC2E"><enum>(4)</enum><text>substantive knowledge of
				the project or function to be contracted for;</text>
									</paragraph><paragraph id="HF89090B3359743BFB02570CEC2E582A5"><enum>(5)</enum><text>adequately trained
				personnel; or</text>
									</paragraph><paragraph id="HC664BB95A3B14CA7982100008B2802FE"><enum>(6)</enum><text>other necessary
				components of contract performance.</text>
									</paragraph></subsection><subsection id="H45DBEE11BBFF4AEEA69498C9E1D23D98"><enum>(b)</enum><header>Labor
				standards</header><text>For the purposes of implementing the provisions of this
				title, contracts for the construction or renovation of health care facilities,
				staff quarters, and sanitation facilities, and related support infrastructure,
				funded in whole or in part with funds made available pursuant to this title,
				shall contain a provision requiring compliance with subchapter IV of chapter 31
				of title 40, United States Code (commonly known as the <quote><act-name parsable-cite="DBA">Davis-Bacon Act</act-name></quote>).</text>
								</subsection></section><section id="HBC84B9C517C0446DB6B19560627E58E4"><enum>304.</enum><header>Expenditure of
				non-Service funds for renovation</header>
								<subsection id="H06B014929F4F4946BDEF39C76200BE64"><enum>(a)</enum><header>In
				general</header><text>Notwithstanding any other provision of law, if the
				requirements of subsection (c) are met, the Secretary, acting through the
				Service, is authorized to accept any major expansion, renovation, or
				modernization by any Indian Tribe or Tribal Organization of any Service
				facility or of any other Indian health facility operated pursuant to a contract
				or compact under the <act-name parsable-cite="ISDA">Indian Self-Determination
				and Education Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>),
				including—</text>
									<paragraph id="H9C3A012923E64198BDCF4DDAF128ABA8"><enum>(1)</enum><text>any plans or designs for
				such expansion, renovation, or modernization; and</text>
									</paragraph><paragraph id="H533B4892F563426AB953F1E100B8B2F9"><enum>(2)</enum><text>any expansion,
				renovation, or modernization for which funds appropriated under any Federal law
				were lawfully expended.</text>
									</paragraph></subsection><subsection id="H7A96C38882754FA39585ED34839206E3"><enum>(b)</enum><header>Priority list</header>
									<paragraph id="H009ADB0B6E9A48B9BA918485DC2260FE"><enum>(1)</enum><header>In
				general</header><text>The Secretary shall maintain a separate priority list to
				address the needs for increased operating expenses, personnel, or equipment for
				such facilities. The methodology for establishing priorities shall be developed
				through regulations. The list of priority facilities will be revised annually
				in consultation with Indian Tribes and Tribal Organizations.</text>
									</paragraph><paragraph id="H78696BE1901E46B4A7EE701D1C22E560"><enum>(2)</enum><header>Report</header><text>The
				Secretary shall submit to the President, for inclusion in the report required
				to be transmitted to Congress under section 801, the priority list maintained
				pursuant to paragraph (1).</text>
									</paragraph></subsection><subsection id="H9DDE71DD24C6499EAF304EB5DFCA6D00"><enum>(c)</enum><header>Requirements</header><text>The
				requirements of this subsection are met with respect to any expansion,
				renovation, or modernization if—</text>
									<paragraph id="H149DFA50D39046D18B22E182D1464EEC"><enum>(1)</enum><text>the Indian Tribe or
				Tribal Organization—</text>
										<subparagraph id="H12DE5D55B4144149AFCCA3C72C9FF354"><enum>(A)</enum><text>provides notice to the
				Secretary of its intent to expand, renovate, or modernize; and</text>
										</subparagraph><subparagraph id="HE4CD44D43EC340A991928EF26ECDEA5F"><enum>(B)</enum><text>applies to the Secretary
				to be placed on a separate priority list to address the needs of such new
				facilities for increased operating expenses, personnel, or equipment;
				and</text>
										</subparagraph></paragraph><paragraph id="H67C7A55FBDE44429B5B1C1782246ED84"><enum>(2)</enum><text>the expansion,
				renovation, or modernization—</text>
										<subparagraph id="HC6AEFF52CA17457894EF00B35F659FAE"><enum>(A)</enum><text>is approved by the
				appropriate area director of the Service for Federal facilities; and</text>
										</subparagraph><subparagraph id="HCE7481A8178D438890B84DBBAC1B4901"><enum>(B)</enum><text>is administered by the
				Indian Tribe or Tribal Organization in accordance with any applicable
				regulations prescribed by the Secretary with respect to construction or
				renovation of Service facilities.</text>
										</subparagraph></paragraph></subsection><subsection id="H3B7BD1372B904DCCA8DE90000750FADE"><enum>(d)</enum><header>Additional requirement
				for expansion</header><text>In addition to the requirements under subsection
				(c), for any expansion, the Indian Tribe or Tribal Organization shall provide
				to the Secretary additional information pursuant to regulations, including
				additional staffing, equipment, and other costs associated with the
				expansion.</text>
								</subsection><subsection id="H3586CFEE42B54D0A81294545D3ABDC7E"><enum>(e)</enum><header>Closure or conversion
				of facilities</header><text>If any Service facility which has been expanded,
				renovated, or modernized by an Indian Tribe or Tribal Organization under this
				section ceases to be used as a Service facility during the 20-year period
				beginning on the date such expansion, renovation, or modernization is
				completed, such Indian Tribe or Tribal Organization shall be entitled to
				recover from the United States an amount which bears the same ratio to the
				value of such facility at the time of such cessation as the value of such
				expansion, renovation, or modernization (less the total amount of any funds
				provided specifically for such facility under any Federal program that were
				expended for such expansion, renovation, or modernization) bore to the value of
				such facility at the time of the completion of such expansion, renovation, or
				modernization.</text>
								</subsection></section><section id="HF9B9FD4262D94F19B5E0E300B4AAE7E4"><enum>305.</enum><header>Funding for the
				construction, expansion, and modernization of small ambulatory care
				facilities</header>
								<subsection id="H95E9AC7FDC914E0083B159C3F3ACA603"><enum>(a)</enum><header>Grants</header>
									<paragraph id="H45ADE05284924201BC66A2EF8799291"><enum>(1)</enum><header>In
				general</header><text>The Secretary, acting through the Service, shall make
				grants to Indian Tribes and Tribal Organizations for the construction,
				expansion, or modernization of facilities for the provision of ambulatory care
				services to eligible Indians (and noneligible persons pursuant to subsections
				(b)(2) and (c)(1)(C)). A grant made under this section may cover up to 100
				percent of the costs of such construction, expansion, or modernization. For the
				purposes of this section, the term <term>construction</term> includes the
				replacement of an existing facility.</text>
									</paragraph><paragraph id="H451C4E5B095F435F98ED79D30075427F"><enum>(2)</enum><header>Grant agreement
				required</header><text>A grant under paragraph (1) may only be made available
				to a Tribal Health Program operating an Indian health facility (other than a
				facility owned or constructed by the Service, including a facility originally
				owned or constructed by the Service and transferred to an Indian Tribe or
				Tribal Organization).</text>
									</paragraph></subsection><subsection id="H5177B3AB0FC14D8EB1FD00B9003F0866"><enum>(b)</enum><header>Use of grant
				funds</header>
									<paragraph id="HFCFC8990E53441CEA496CA78F34EFFF0"><enum>(1)</enum><header>Allowable
				uses</header><text>A grant awarded under this section may be used for the
				construction, expansion, or modernization (including the planning and design of
				such construction, expansion, or modernization) of an ambulatory care
				facility—</text>
										<subparagraph id="HAC6CAD8FB00346C5AB82C70226ADB173"><enum>(A)</enum><text>located apart from a
				hospital;</text>
										</subparagraph><subparagraph id="HFB2440D717164DA5BA35CE62A6E88C29"><enum>(B)</enum><text>not funded under section
				301 or section 306; and</text>
										</subparagraph><subparagraph id="HD0D7BABFB0224A5D8F97D714B1D95B1B"><enum>(C)</enum><text>which, upon completion of
				such construction or modernization will—</text>
											<clause id="HC5077FF2759C41A184DD22FEAC5D07B"><enum>(i)</enum><text>have a total capacity
				appropriate to its projected service population;</text>
											</clause><clause id="H3FB2A94E4F894424BD27DFAEE08CE2A4"><enum>(ii)</enum><text>provide annually no
				fewer than 150 patient visits by eligible Indians and other users who are
				eligible for services in such facility in accordance with section 807(c)(2);
				and</text>
											</clause><clause id="HA054FF9406FE4A47815226ACCCE30002"><enum>(iii)</enum><text>provide ambulatory care
				in a Service Area (specified in the contract or compact under the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>)) with a population of no
				fewer than 1,500 eligible Indians and other users who are eligible for services
				in such facility in accordance with section 807(c)(2).</text>
											</clause></subparagraph></paragraph><paragraph id="H73B9A1F658CE4A47B849D389EE86D69D"><enum>(2)</enum><header>Additional allowable
				use</header><text>The Secretary may also reserve a portion of the funding
				provided under this section and use those reserved funds to reduce an
				outstanding debt incurred by Indian Tribes or Tribal Organizations for the
				construction, expansion, or modernization of an ambulatory care facility that
				meets the requirements under paragraph (1). The provisions of this section
				shall apply, except that such applications for funding under this paragraph
				shall be considered separately from applications for funding under paragraph
				(1).</text>
									</paragraph><paragraph id="H3829722D858B443BB8EA94A0B65FB200"><enum>(3)</enum><header>Use only for certain
				portion of costs</header><text>A grant provided under this section may be used
				only for the cost of that portion of a construction, expansion, or
				modernization project that benefits the Service population identified above in
				subsection (b)(1)(C) (ii) and (iii). The requirements of clauses (ii) and (iii)
				of paragraph (1)(C) shall not apply to an Indian Tribe or Tribal Organization
				applying for a grant under this section for a health care facility located or
				to be constructed on an island or when such facility is not located on a road
				system providing direct access to an inpatient hospital where care is available
				to the Service population.</text>
									</paragraph></subsection><subsection id="H0145EF6C87E5477785F07D66B1E1D7F"><enum>(c)</enum><header>Grants</header>
									<paragraph id="H1EA5517D166E405A93BFB0C2BBB8B97F"><enum>(1)</enum><header>Application</header><text>No
				grant may be made under this section unless an application or proposal for the
				grant has been approved by the Secretary in accordance with applicable
				regulations and has set forth reasonable assurance by the applicant that, at
				all times after the construction, expansion, or modernization of a facility
				carried out using a grant received under this section—</text>
										<subparagraph id="H32CCDD690F114E6D84549C0316830029"><enum>(A)</enum><text>adequate financial
				support will be available for the provision of services at such
				facility;</text>
										</subparagraph><subparagraph id="H6283994D54674C13A1EBEED6623DC1F7"><enum>(B)</enum><text>such facility will be
				available to eligible Indians without regard to ability to pay or source of
				payment; and</text>
										</subparagraph><subparagraph id="H79099461DD9E441191066564CB0243D5"><enum>(C)</enum><text>such facility will, as
				feasible without diminishing the quality or quantity of services provided to
				eligible Indians, serve noneligible persons on a cost basis.</text>
										</subparagraph></paragraph><paragraph id="HDE09A6E50327490DB184463F2FB13963"><enum>(2)</enum><header>Priority</header><text>In
				awarding grants under this section, the Secretary shall give priority to Indian
				Tribes and Tribal Organizations that demonstrate—</text>
										<subparagraph id="H00ED778A187B4B4C82432BCB2E3439C"><enum>(A)</enum><text>a need for increased
				ambulatory care services; and</text>
										</subparagraph><subparagraph id="H85943E21F8F743859B7210F108905B76"><enum>(B)</enum><text>insufficient capacity to
				deliver such services.</text>
										</subparagraph></paragraph><paragraph id="HD891B6786CB7498BA16C009B5F2941E6"><enum>(3)</enum><header>Peer review
				panels</header><text>The Secretary may provide for the establishment of peer
				review panels, as necessary, to review and evaluate applications and proposals
				and to advise the Secretary regarding such applications using the criteria
				developed pursuant to subsection (a)(1).</text>
									</paragraph></subsection><subsection id="HC700A8631D354B41A0DD7091AC86591E"><enum>(d)</enum><header>Reversion of
				facilities</header><text>If any facility (or portion thereof) with respect to
				which funds have been paid under this section, ceases, at any time after
				completion of the construction, expansion, or modernization carried out with
				such funds, to be used for the purposes of providing health care services to
				eligible Indians, all of the right, title, and interest in and to such facility
				(or portion thereof) shall transfer to the United States unless otherwise
				negotiated by the Service and the Indian Tribe or Tribal Organization.</text>
								</subsection><subsection id="HEA8ACF9642CB411D8973D33F43D6E300"><enum>(e)</enum><header>Funding
				nonrecurring</header><text>Funding provided under this section shall be
				nonrecurring and shall not be available for inclusion in any individual Indian
				Tribe’s tribal share for an award under the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance Act (25
				U.S.C. 450 et seq.)</act-name> or for reallocation or redesign
				thereunder.</text>
								</subsection></section><section id="H2B210CDA1CBE44F1BC45E8BD39D008C"><enum>306.</enum><header>Indian health care
				delivery demonstration project</header>
								<subsection id="H620EAC8062C347E684CEEC4902324DD"><enum>(a)</enum><header>Health care
				demonstration projects</header><text>The Secretary, acting through the Service,
				is authorized to enter into contracts under the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance
				Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>) with Indian Tribes or Tribal
				Organizations for the purpose of carrying out a health care delivery
				demonstration project to test alternative means of delivering health care and
				services to Indians through facilities.</text>
								</subsection><subsection id="H4CE700D4B9BA415CAAF30575B2C0C1E9"><enum>(b)</enum><header>Use of
				funds</header><text>The Secretary, in approving projects pursuant to this
				section, may authorize such contracts for the construction and renovation of
				hospitals, health centers, health stations, and other facilities to deliver
				health care services and is authorized to—</text>
									<paragraph id="H186191CC1B49482D867D5079BB949D96"><enum>(1)</enum><text>waive any leasing
				prohibition;</text>
									</paragraph><paragraph id="H996A136EEFC54BA4B250455440135600"><enum>(2)</enum><text>permit carryover of funds
				appropriated for the provision of health care services;</text>
									</paragraph><paragraph id="HCFB11FFDA99944488EB800608E14E498"><enum>(3)</enum><text>permit the use of other
				available funds;</text>
									</paragraph><paragraph id="HDD3C7628EDDC4E22BC021BC718B2A349"><enum>(4)</enum><text>permit the use of funds
				or property donated from any source for project purposes;</text>
									</paragraph><paragraph id="H165BF29BF6ED4B32BD1EB7F81C40FE6F"><enum>(5)</enum><text>provide for the reversion
				of donated real or personal property to the donor; and</text>
									</paragraph><paragraph id="HDF7DC888A44C4B2184B5D3CFF0A6B6EB"><enum>(6)</enum><text>permit the use of Service
				funds to match other funds, including Federal funds.</text>
									</paragraph></subsection><subsection id="HF47A9E17FD6A4020A6FD1F7E75FEBCD8"><enum>(c)</enum><header>Regulations</header><text>The
				Secretary shall develop and promulgate regulations, not later than 1 year after
				the date of enactment of the <short-title>Indian Health
				Care Improvement Act Amendments of 2007</short-title>, for the review and
				approval of applications submitted under this section.</text>
								</subsection><subsection id="H744A4923436B49AA9C6DFBE96264E0E5"><enum>(d)</enum><header>Criteria</header><text>The
				Secretary may approve projects that meet the following criteria:</text>
									<paragraph id="H204A1D9A98DC471200E23CCF34AADA79"><enum>(1)</enum><text>There is a need for a new
				facility or program or the reorientation of an existing facility or
				program.</text>
									</paragraph><paragraph id="H124E9A0352654295BF2F5EC2A87DCA7"><enum>(2)</enum><text>A significant number of
				Indians, including those with low health status, will be served by the
				project.</text>
									</paragraph><paragraph id="H392C21A5C7FD4BD2B6DAB955DBCF8948"><enum>(3)</enum><text>The project has the
				potential to deliver services in an efficient and effective manner.</text>
									</paragraph><paragraph id="HB8BD9F3C28794F4C9EEB42336D673F39"><enum>(4)</enum><text>The project is
				economically viable.</text>
									</paragraph><paragraph id="H3A903B25969F476C95DF00F227E5C589"><enum>(5)</enum><text>The Indian Tribe or
				Tribal Organization has the administrative and financial capability to
				administer the project.</text>
									</paragraph><paragraph id="H96D69F5BD7D746E7A3F2821999CAE870"><enum>(6)</enum><text>The project is integrated
				with providers of related health and social services and is coordinated with,
				and avoids duplication of, existing services.</text>
									</paragraph></subsection><subsection id="H75BDB06293D342A7A23415A8137BD794"><enum>(e)</enum><header>Peer review
				panels</header><text>The Secretary may provide for the establishment of peer
				review panels, as necessary, to review and evaluate applications using the
				criteria developed pursuant to subsection (d).</text>
								</subsection><subsection id="H95756991E13442EA98C96D629F4C79D3"><enum>(f)</enum><header>Priority</header><text>The
				Secretary shall give priority to applications for demonstration projects in
				each of the following Service Units to the extent that such applications are
				timely filed and meet the criteria specified in subsection (d):</text>
									<paragraph id="HE391FD58C1A94245993283BD3FF0BC13"><enum>(1)</enum><text>Cass Lake,
				Minnesota.</text>
									</paragraph><paragraph id="HFD85473D5F504A1086525EF7F1FAD76B"><enum>(2)</enum><text>Mescalero, New
				Mexico.</text>
									</paragraph><paragraph id="HA84AD0B0B89E4FAE00251FAFBA19CA00"><enum>(3)</enum><text>Owyhee, Nevada.</text>
									</paragraph><paragraph id="HB128C75C505840EF9B4DE410CABE36B0"><enum>(4)</enum><text>Schurz, Nevada.</text>
									</paragraph><paragraph id="H562DDDC563DE46FD00DF6C585000E197"><enum>(5)</enum><text>Ft. Yuma,
				California.</text>
									</paragraph></subsection><subsection id="H7A5F39584D174A89B8744695EBAEE18"><enum>(g)</enum><header>Technical
				assistance</header><text>The Secretary shall provide such technical and other
				assistance as may be necessary to enable applicants to comply with the
				provisions of this section.</text>
								</subsection><subsection id="HC20549FCD826466FA3B88D9811D34CAF"><enum>(h)</enum><header>Service to ineligible
				persons</header><text>Subject to section 807, the authority to provide services
				to persons otherwise ineligible for the health care benefits of the Service and
				the authority to extend hospital privileges in Service facilities to
				non-Service health practitioners as provided in section 807 may be included,
				subject to the terms of such section, in any demonstration project approved
				pursuant to this section.</text>
								</subsection><subsection id="HC10B405476D349F99221DE58F457A359"><enum>(i)</enum><header>Equitable
				treatment</header><text>For purposes of subsection (d)(1), the Secretary shall,
				in evaluating facilities operated under any contract or compact under the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>), use the same criteria that
				the Secretary uses in evaluating facilities operated directly by the
				Service.</text>
								</subsection><subsection id="H9B8DFC90C7074BD3B9FAFB46D2005E28"><enum>(j)</enum><header>Equitable integration
				of facilities</header><text>The Secretary shall ensure that the planning,
				design, construction, renovation, and expansion needs of Service and
				non-Service facilities which are the subject of a contract or compact under the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>) for health services are fully
				and equitably integrated into the implementation of the health care delivery
				demonstration projects under this section.</text>
								</subsection></section><section id="H86D531D4AE74448B9EFDF2EAD3C36FFB"><enum>307.</enum><header>Land
				transfer</header><text display-inline="no-display-inline">Notwithstanding any
				other provision of law, the Bureau of Indian Affairs and all other agencies and
				departments of the United States are authorized to transfer, at no cost, land
				and improvements to the Service for the provision of health care services. The
				Secretary is authorized to accept such land and improvements for such
				purposes.</text>
							</section><section id="H9F0E4FBC505048C79B64ADDC961BFB23"><enum>308.</enum><header>Leases, contracts, and
				other agreements</header><text display-inline="no-display-inline">The
				Secretary, acting through the Service, may enter into leases, contracts, and
				other agreements with Indian Tribes and Tribal Organizations which hold (1)
				title to, (2) a leasehold interest in, or (3) a beneficial interest in (when
				title is held by the United States in trust for the benefit of an Indian Tribe)
				facilities used or to be used for the administration and delivery of health
				services by an Indian Health Program. Such leases, contracts, or agreements may
				include provisions for construction or renovation and provide for compensation
				to the Indian Tribe or Tribal Organization of rental and other costs consistent
				with section 105(l) of the <act-name parsable-cite="ISDA">Indian
				Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450j">25 U.S.C. 450j(l)</external-xref>)</act-name>
				and regulations thereunder.</text>
							</section><section id="HE3B23397C45445C38F7D0195CD000287"><enum>309.</enum><header>Study on loans, loan
				guarantees, and loan repayment</header>
								<subsection id="H80FEB96E1CBC4DC5B91529628C1417E3"><enum>(a)</enum><header>In
				general</header><text>The Secretary, in consultation with the Secretary of the
				Treasury, Indian Tribes, and Tribal Organizations, shall carry out a study to
				determine the feasibility of establishing a loan fund to provide to Indian
				Tribes and Tribal Organizations direct loans or guarantees for loans for the
				construction of health care facilities, including—</text>
									<paragraph id="HC716C927716D438180C8E3D89345839"><enum>(1)</enum><text>inpatient
				facilities;</text>
									</paragraph><paragraph id="H5DBDD5AD489947D7B33239002E576BDF"><enum>(2)</enum><text>outpatient
				facilities;</text>
									</paragraph><paragraph id="H26FAEAD0940A408DBB1F60CAF74805D"><enum>(3)</enum><text>staff quarters;</text>
									</paragraph><paragraph id="H857CD50590444BCE8C8B7B2505C3F92B"><enum>(4)</enum><text>hostels; and</text>
									</paragraph><paragraph id="H369332D81B144954A71FBC449BEA48E7"><enum>(5)</enum><text>specialized care
				facilities, such as behavioral health and elder care facilities.</text>
									</paragraph></subsection><subsection id="H898422E464404DA08D273C33BA2C2B47"><enum>(b)</enum><header>Determinations</header><text>In
				carrying out the study under subsection (a), the Secretary shall
				determine—</text>
									<paragraph id="HBCC82E5F643343E6970846405800FD09"><enum>(1)</enum><text>the maximum principal
				amount of a loan or loan guarantee that should be offered to a recipient from
				the loan fund;</text>
									</paragraph><paragraph id="H4A8FC638E068472CA06767896E0054A1"><enum>(2)</enum><text>the percentage of
				eligible costs, not to exceed 100 percent, that may be covered by a loan or
				loan guarantee from the loan fund (including costs relating to planning,
				design, financing, site land development, construction, rehabilitation,
				renovation, conversion, improvements, medical equipment and furnishings, and
				other facility-related costs and capital purchase (but excluding
				staffing));</text>
									</paragraph><paragraph id="HDA2E74E49AFA4B15AA09DB809CA4EB83"><enum>(3)</enum><text>the cumulative total of
				the principal of direct loans and loan guarantees, respectively, that may be
				outstanding at any 1 time;</text>
									</paragraph><paragraph id="H358CC134E5734451B1EE3DCDFE7F35D"><enum>(4)</enum><text>the maximum term of a
				loan or loan guarantee that may be made for a facility from the loan
				fund;</text>
									</paragraph><paragraph id="H3A5CA2B57B644F5DA05D74BA56E9F724"><enum>(5)</enum><text>the maximum percentage of
				funds from the loan fund that should be allocated for payment of costs
				associated with planning and applying for a loan or loan guarantee;</text>
									</paragraph><paragraph id="HE6EF306A03B640D1BCCD14F2F0CC1FDB"><enum>(6)</enum><text>whether acceptance by the
				Secretary of an assignment of the revenue of an Indian Tribe or Tribal
				Organization as security for any direct loan or loan guarantee from the loan
				fund would be appropriate;</text>
									</paragraph><paragraph id="H79E85E95A6BE4F258C0979EF4CE34BA"><enum>(7)</enum><text>whether, in the planning
				and design of health facilities under this section, users eligible under
				section 807(c) may be included in any projection of patient population;</text>
									</paragraph><paragraph id="H582BE34355624CB48FBA407B4EBAA096"><enum>(8)</enum><text>whether funds of the
				Service provided through loans or loan guarantees from the loan fund should be
				eligible for use in matching other Federal funds under other programs;</text>
									</paragraph><paragraph id="H410525C20BAD4BE598B357CAF577C84E"><enum>(9)</enum><text>the appropriateness of,
				and best methods for, coordinating the loan fund with the health care priority
				system of the Service under section 301; and</text>
									</paragraph><paragraph id="H0F1B737872B9494300E46688A8940762"><enum>(10)</enum><text>any legislative or
				regulatory changes required to implement recommendations of the Secretary based
				on results of the study.</text>
									</paragraph></subsection><subsection id="H9EF1F048E858443A87ABB05F949B6704"><enum>(c)</enum><header>Report</header><text>Not
				later than September 30, 2009, the Secretary shall submit to the Committee on
				Indian Affairs of the Senate and the Committee on Natural Resources and the
				Committee on Energy and Commerce of the House of Representatives a report that
				describes—</text>
									<paragraph id="H4FEDE71F568245B39700747F9B2550CB"><enum>(1)</enum><text>the manner of
				consultation made as required by subsection (a); and</text>
									</paragraph><paragraph id="H1FA23B5A821C49229EABBD7B50C0BA4C"><enum>(2)</enum><text>the results of the study,
				including any recommendations of the Secretary based on results of the
				study.</text>
									</paragraph></subsection></section><section id="H1FF96DCE7CC14F51B73FB6AC129FAFA2"><enum>310.</enum><header>Tribal
				leasing</header><text display-inline="no-display-inline">A Tribal Health
				Program may lease permanent structures for the purpose of providing health care
				services without obtaining advance approval in appropriation Acts.</text>
							</section><section id="HE20CEE604FE240A4AD58F66F3C4840CC"><enum>311.</enum><header>Indian Health
				Service/tribal facilities joint venture program</header>
								<subsection id="HA13EB2BDF0AD4A8487C5D0941709D00"><enum>(a)</enum><header>In
				general</header><text>The Secretary, acting through the Service, shall make
				arrangements with Indian Tribes and Tribal Organizations to establish joint
				venture demonstration projects under which an Indian Tribe or Tribal
				Organization shall expend tribal, private, or other available funds, for the
				acquisition or construction of a health facility for a minimum of 10 years,
				under a no-cost lease, in exchange for agreement by the Service to provide the
				equipment, supplies, and staffing for the operation and maintenance of such a
				health facility. An Indian Tribe or Tribal Organization may use tribal funds,
				private sector, or other available resources, including loan guarantees, to
				fulfill its commitment under a joint venture entered into under this
				subsection. An Indian Tribe or Tribal Organization shall be eligible to
				establish a joint venture project if, when it submits a letter of intent,
				it—</text>
									<paragraph id="H8628EFAD64674722A83B7D1BA189613E"><enum>(1)</enum><text>has begun but not
				completed the process of acquisition or construction of a health facility to be
				used in the joint venture project; or</text>
									</paragraph><paragraph id="H82F8A18697AD44448F8479ED5398A15C"><enum>(2)</enum><text>has not begun the process
				of acquisition or construction of a health facility for use in the joint
				venture project.</text>
									</paragraph></subsection><subsection id="HE1CB1C200E9B4321B07BC2C6B3C1B11C"><enum>(b)</enum><header>Requirements</header><text>The
				Secretary shall make such an arrangement with an Indian Tribe or Tribal
				Organization only if—</text>
									<paragraph id="HEC0452C6CFE0434200B18174266C8135"><enum>(1)</enum><text>the Secretary first
				determines that the Indian Tribe or Tribal Organization has the administrative
				and financial capabilities necessary to complete the timely acquisition or
				construction of the relevant health facility; and</text>
									</paragraph><paragraph id="H19994AFF3E56420E953188D5D118BD46"><enum>(2)</enum><text>the Indian Tribe or
				Tribal Organization meets the need criteria determined using the criteria
				developed under the health care facility priority system under section 301,
				unless the Secretary determines, pursuant to regulations, that other criteria
				will result in a more cost-effective and efficient method of facilitating and
				completing construction of health care facilities.</text>
									</paragraph></subsection><subsection id="H1F2E4222D7F24ABFB12D020034D588A2"><enum>(c)</enum><header>Continued
				operation</header><text>The Secretary shall negotiate an agreement with the
				Indian Tribe or Tribal Organization regarding the continued operation of the
				facility at the end of the initial 10 year no-cost lease period.</text>
								</subsection><subsection id="H573AD3E0D21442CBBFC54FD058F405FA"><enum>(d)</enum><header>Breach of
				agreement</header><text>An Indian Tribe or Tribal Organization that has entered
				into a written agreement with the Secretary under this section, and that
				breaches or terminates without cause such agreement, shall be liable to the
				United States for the amount that has been paid to the Indian Tribe or Tribal
				Organization, or paid to a third party on the Indian Tribe’s or Tribal
				Organization’s behalf, under the agreement. The Secretary has the right to
				recover tangible property (including supplies) and equipment, less
				depreciation, and any funds expended for operations and maintenance under this
				section. The preceding sentence does not apply to any funds expended for the
				delivery of health care services, personnel, or staffing.</text>
								</subsection><subsection id="H74CF47CFE36D468695783960EA017945"><enum>(e)</enum><header>Recovery for
				nonuse</header><text>An Indian Tribe or Tribal Organization that has entered
				into a written agreement with the Secretary under this subsection shall be
				entitled to recover from the United States an amount that is proportional to
				the value of such facility if, at any time within the 10-year term of the
				agreement, the Service ceases to use the facility or otherwise breaches the
				agreement.</text>
								</subsection><subsection id="HC9AE1DB820DA41D280C28BAA5EBDC4DF"><enum>(f)</enum><header>Definition</header><text>For
				the purposes of this section, the term <term>health facility</term> or
				<term>health facilities</term> includes quarters needed to provide housing for
				staff of the relevant Tribal Health Program.</text>
								</subsection></section><section id="HDA67EBA540894EB700D8E3113E9DC72"><enum>312.</enum><header>Location of
				facilities</header>
								<subsection id="HCBC18CAA23B84DA18E2C50AF0991579"><enum>(a)</enum><header>In
				general</header><text>In all matters involving the reorganization or
				development of Service facilities or in the establishment of related employment
				projects to address unemployment conditions in economically depressed areas,
				the Bureau of Indian Affairs and the Service shall give priority to locating
				such facilities and projects on Indian lands, or lands in Alaska owned by any
				Alaska Native village, or village or regional corporation under the Alaska
				Native Claims Settlement Act (<external-xref legal-doc="usc" parsable-cite="usc/43/1601">43 U.S.C. 1601 et seq.</external-xref>), or any land allotted to
				any Alaska Native, if requested by the Indian owner and the Indian Tribe with
				jurisdiction over such lands or other lands owned or leased by the Indian Tribe
				or Tribal Organization. Top priority shall be given to Indian land owned by 1
				or more Indian Tribes.</text>
								</subsection><subsection id="H0DDEC7C18BC34702A8BA99C7D83D083"><enum>(b)</enum><header>Definition</header><text>For
				purposes of this section, the term <term>Indian lands</term> means—</text>
									<paragraph id="H819817A5CEB841DFA02EEE81811518C1"><enum>(1)</enum><text>all lands within the
				exterior boundaries of any reservation; and</text>
									</paragraph><paragraph id="H2C822BF1DAE54CEF937D20EF35F60131"><enum>(2)</enum><text>any lands title to which
				is held in trust by the United States for the benefit of any Indian Tribe or
				individual Indian or held by any Indian Tribe or individual Indian subject to
				restriction by the United States against alienation.</text>
									</paragraph></subsection></section><section id="HFAF46CECB8A442688115CB4BE198F1D6"><enum>313.</enum><header>Maintenance and
				improvement of health care facilities</header>
								<subsection id="H0F08DD738B3241A989DAFC5F6600AD61"><enum>(a)</enum><header>Report</header><text>The
				Secretary shall submit to the President, for inclusion in the report required
				to be transmitted to Congress under section 801, a report which identifies the
				backlog of maintenance and repair work required at both Service and tribal
				health care facilities, including new health care facilities expected to be in
				operation in the next fiscal year. The report shall also identify the need for
				renovation and expansion of existing facilities to support the growth of health
				care programs.</text>
								</subsection><subsection id="H525C8A306B2D487F95A424729775061D"><enum>(b)</enum><header>Maintenance of newly
				constructed space</header><text>The Secretary, acting through the Service, is
				authorized to expend maintenance and improvement funds to support maintenance
				of newly constructed space only if such space falls within the approved
				supportable space allocation for the Indian Tribe or Tribal Organization.
				Supportable space allocation shall be defined through the health care facility
				priority system under section 301(c).</text>
								</subsection><subsection id="H671814D54DDE442C81E405C498FE2F5F"><enum>(c)</enum><header>Replacement
				facilities</header><text>In addition to using maintenance and improvement funds
				for renovation, modernization, and expansion of facilities, an Indian Tribe or
				Tribal Organization may use maintenance and improvement funds for construction
				of a replacement facility if the costs of renovation of such facility would
				exceed a maximum renovation cost threshold. The maximum renovation cost
				threshold shall be determined through the negotiated rulemaking process
				provided for under section 802.</text>
								</subsection></section><section id="H8A7AF554E9D34FD4B723E76239A11DD3"><enum>314.</enum><header>Tribal management of
				federally-owned quarters</header>
								<subsection id="H18858E3F4EAE48E89FAFA08D743BFC43"><enum>(a)</enum><header>Rental Rates</header>
									<paragraph id="H7D72A60E8FA24F5BA237A182669ECE3E"><enum>(1)</enum><header>Establishment</header><text>Notwithstanding
				any other provision of law, a Tribal Health Program which operates a hospital
				or other health facility and the federally-owned quarters associated therewith
				pursuant to a contract or compact under the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance
				Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>) shall have the authority to establish
				the rental rates charged to the occupants of such quarters by providing notice
				to the Secretary of its election to exercise such authority.</text>
									</paragraph><paragraph id="H4F2E8DAA21914D07BA34EF47A22EB753"><enum>(2)</enum><header>Objectives</header><text>In
				establishing rental rates pursuant to authority of this subsection, a Tribal
				Health Program shall endeavor to achieve the following objectives:</text>
										<subparagraph id="HED5D431DB93A4F44A57CC2B6F4C36C3D"><enum>(A)</enum><text>To base such rental rates
				on the reasonable value of the quarters to the occupants thereof.</text>
										</subparagraph><subparagraph id="HBA754E9742B34341B016D6BFDB43F9FF"><enum>(B)</enum><text>To generate sufficient
				funds to prudently provide for the operation and maintenance of the quarters,
				and subject to the discretion of the Tribal Health Program, to supply reserve
				funds for capital repairs and replacement of the quarters.</text>
										</subparagraph></paragraph><paragraph id="HCED53C4966184C45A7CCECC59E24F761"><enum>(3)</enum><header>Equitable
				funding</header><text>Any quarters whose rental rates are established by a
				Tribal Health Program pursuant to this subsection shall remain eligible for
				quarters improvement and repair funds to the same extent as all federally-owned
				quarters used to house personnel in Services-supported programs.</text>
									</paragraph><paragraph id="H64B51B88C57C4D77A46BAE8908D50046"><enum>(4)</enum><header>Notice of rate
				change</header><text>A Tribal Health Program which exercises the authority
				provided under this subsection shall provide occupants with no less than 60
				days notice of any change in rental rates.</text>
									</paragraph></subsection><subsection id="H5FE5F8851842458083791DAAE43CF23B"><enum>(b)</enum><header>Direct collection of
				rent</header>
									<paragraph id="HC4C1EA97AB514262A32EEEE7884D9413"><enum>(1)</enum><header>In
				general</header><text>Notwithstanding any other provision of law, and subject
				to paragraph (2), a Tribal Health Program shall have the authority to collect
				rents directly from Federal employees who occupy such quarters in accordance
				with the following:</text>
										<subparagraph id="HFABE25E31FCE4627B83472CF437DD3A2"><enum>(A)</enum><text>The Tribal Health Program
				shall notify the Secretary and the subject Federal employees of its election to
				exercise its authority to collect rents directly from such Federal
				employees.</text>
										</subparagraph><subparagraph id="HAA0625BF88054EC8BBD0014E7E7CB9EF"><enum>(B)</enum><text>Upon receipt of a notice
				described in subparagraph (A), the Federal employees shall pay rents for
				occupancy of such quarters directly to the Tribal Health Program and the
				Secretary shall have no further authority to collect rents from such employees
				through payroll deduction or otherwise.</text>
										</subparagraph><subparagraph id="H458249E353314232B233A0FD14F85F17"><enum>(C)</enum><text>Such rent payments shall
				be retained by the Tribal Health Program and shall not be made payable to or
				otherwise be deposited with the United States.</text>
										</subparagraph><subparagraph id="H9C5CF8B03B1E479EA1A5D034E738351C"><enum>(D)</enum><text>Such rent payments shall
				be deposited into a separate account which shall be used by the Tribal Health
				Program for the maintenance (including capital repairs and replacement) and
				operation of the quarters and facilities as the Tribal Health Program shall
				determine.</text>
										</subparagraph></paragraph><paragraph id="H2B6D85ACD80E406A9B09A797D67CC467"><enum>(2)</enum><header>Retrocession of
				authority</header><text>If a Tribal Health Program which has made an election
				under paragraph (1) requests retrocession of its authority to directly collect
				rents from Federal employees occupying federally-owned quarters, such
				retrocession shall become effective on the earlier of—</text>
										<subparagraph id="HA25A1EC29AA24B01B35DF87D046809F"><enum>(A)</enum><text>the first day of the
				month that begins no less than 180 days after the Tribal Health Program
				notifies the Secretary of its desire to retrocede; or</text>
										</subparagraph><subparagraph id="H4A28D3AEFECA43B0A493C08CBF38FCDB"><enum>(B)</enum><text>such other date as may be
				mutually agreed by the Secretary and the Tribal Health Program.</text>
										</subparagraph></paragraph></subsection><subsection id="H67467724BF464219B648CD5C52062163"><enum>(c)</enum><header>Rates in
				Alaska</header><text>To the extent that a Tribal Health Program, pursuant to
				authority granted in subsection (a), establishes rental rates for
				federally-owned quarters provided to a Federal employee in Alaska, such rents
				may be based on the cost of comparable private rental housing in the nearest
				established community with a year-round population of 1,500 or more
				individuals.</text>
								</subsection></section><section id="H3274E1CF5D79458881181C390840EB43"><enum>315.</enum><header>Applicability of
				<act-name parsable-cite="BAA">Buy American Act</act-name> requirement</header>
								<subsection id="H7BE7353AC4F94286B5A0047431A82648"><enum>(a)</enum><header>Applicability</header><text>The
				Secretary shall ensure that the requirements of the
				<act-name parsable-cite="BAA">Buy American Act</act-name> apply to all
				procurements made with funds provided pursuant to section 317. Indian Tribes
				and Tribal Organizations shall be exempt from these requirements.</text>
								</subsection><subsection id="H52DDD2AC5F1B4A9982D539255BD22C6D"><enum>(b)</enum><header>Effect of
				violation</header><text>If it has been finally determined by a court or Federal
				agency that any person intentionally affixed a label bearing a <quote>Made in
				America</quote> inscription or any inscription with the same meaning, to any
				product sold in or shipped to the United States that is not made in the United
				States, such person shall be ineligible to receive any contract or subcontract
				made with funds provided pursuant to section 317, pursuant to the debarment,
				suspension, and ineligibility procedures described in sections 9.400 through
				9.409 of title 48, Code of Federal Regulations.</text>
								</subsection><subsection id="HE0F6768AAB5D47CBAEEFE001B153CF71"><enum>(c)</enum><header>Definitions</header><text>For
				purposes of this section, the term <term><act-name parsable-cite="BAA">Buy
				American Act</act-name></term> means title III of the Act entitled <quote>An
				Act making appropriations for the Treasury and Post Office Departments for the
				fiscal year ending June 30, 1934, and for other purposes</quote>, approved
				March 3, 1933 (<external-xref legal-doc="usc" parsable-cite="usc/41/10a">41 U.S.C. 10a et seq.</external-xref>).</text>
								</subsection></section><section id="H7036D3080E674E7B95AEFF36D989AAC0"><enum>316.</enum><header>Other funding for
				facilities</header>
								<subsection id="H2129C2CDACF54CC4871CB8D0A4587CF0"><enum>(a)</enum><header>Authority To accept
				funds</header><text>The Secretary is authorized to accept from any source,
				including Federal and State agencies, funds that are available for the
				construction of health care facilities and use such funds to plan, design, and
				construct health care facilities for Indians and to place such funds into a
				contract or compact under the <act-name parsable-cite="ISDA">Indian
				Self-Determination and Education Assistance Act</act-name> (25 U.S.C. 450 et
				seq.). Receipt of such funds shall have no effect on the priorities established
				pursuant to section 301.</text>
								</subsection><subsection id="HBC74CD2DAB5B4330B392B2638D1F01A5"><enum>(b)</enum><header>Interagency
				agreements</header><text>The Secretary is authorized to enter into interagency
				agreements with other Federal agencies or State agencies and other entities and
				to accept funds from such Federal or State agencies or other sources to provide
				for the planning, design, and construction of health care facilities to be
				administered by Indian Health Programs in order to carry out the purposes of
				this Act and the purposes for which the funds were appropriated or for which
				the funds were otherwise provided.</text>
								</subsection><subsection id="HCE87C0E4C77E4B1E8E00F52FC2D216D7"><enum>(c)</enum><header>Establishment of
				standards</header><text>The Secretary, through the Service, shall establish
				standards by regulation for the planning, design, and construction of health
				care facilities serving Indians under this Act.</text>
								</subsection></section><section id="HD61EC3F7CF474047B9784785F0265D5"><enum>317.</enum><header>Authorization of
				appropriations</header><text display-inline="no-display-inline">There are
				authorized to be appropriated such sums as may be necessary for each fiscal
				year through fiscal year 2017 to carry out this title.</text>
							</section></title><title id="H2EC08E5764E84108919626DA90DB1B29"><enum>IV</enum><header>Access to health
				services</header>
							<section id="HE3BF1FF179694F44B9F288FF16636606"><enum>401.</enum><header>Treatment of payments
				under <act-name parsable-cite="SSA">Social Security Act</act-name> health
				benefits programs</header>
								<subsection id="H26A5320A1F5148CA00BFC330BE7C4CF4"><enum>(a)</enum><header>Disregard of Medicare,
				Medicaid, and SCHIP payments in determining appropriations</header><text>Any
				payments received by an Indian Health Program or by an Urban Indian
				Organization under title XVIII, XIX, or XXI of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> for services
				provided to Indians eligible for benefits under such respective titles shall
				not be considered in determining appropriations for the provision of health
				care and services to Indians.</text>
								</subsection><subsection id="H97AF03F0993744FC8EC2EF50C3A0AE6C"><enum>(b)</enum><header>Nonpreferential
				treatment</header><text>Nothing in this Act authorizes the Secretary to provide
				services to an Indian with coverage under title XVIII, XIX, or XXI of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> in preference to
				an Indian without such coverage.</text>
								</subsection><subsection id="H0623695496C54A1AAE954B21797F1666"><enum>(c)</enum><header>Use of funds</header>
									<paragraph id="H0F4FC751A40944038568CCEB0027E7E4"><enum>(1)</enum><header>Special fund</header>
										<subparagraph id="HFE0671D96A154F0B95BCBFB33E44C83F"><enum>(A)</enum><header>100 percent
				pass-through of payments due to facilities</header><text>Notwithstanding any
				other provision of law, but subject to paragraph (2), payments to which a
				facility of the Service is entitled by reason of a provision of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> shall be placed in
				a special fund to be held by the Secretary. In making payments from such fund,
				the Secretary shall ensure that each Service Unit of the Service receives 100
				percent of the amount to which the facilities of the Service, for which such
				Service Unit makes collections, are entitled by reason of a provision of the
				<act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
										</subparagraph><subparagraph id="H9566F14B166340A4926F5BE42E99BF20"><enum>(B)</enum><header>Use of
				funds</header><text>Amounts received by a facility of the Service under
				subparagraph (A) shall first be used (to such extent or in such amounts as are
				provided in appropriation Acts) for the purpose of making any improvements in
				the programs of the Service operated by or through such facility which may be
				necessary to achieve or maintain compliance with the applicable conditions and
				requirements of titles XVIII and XIX of the <act-name parsable-cite="SSA">Social Security Act</act-name>. Any amounts so received
				that are in excess of the amount necessary to achieve or maintain such
				conditions and requirements shall, subject to consultation with the Indian
				Tribes being served by the Service Unit, be used for reducing the health
				resource deficiencies (as determined under section 201(d)) of such Indian
				Tribes.</text>
										</subparagraph></paragraph><paragraph id="H5E246D6CE57F4FD7A79EA1F2000082CA"><enum>(2)</enum><header>Direct payment
				option</header><text>Paragraph (1) shall not apply to a Tribal Health Program
				upon the election of such Program under subsection (d) to receive payments
				directly. No payment may be made out of the special fund described in such
				paragraph with respect to reimbursement made for services provided by such
				Program during the period of such election.</text>
									</paragraph></subsection><subsection id="HE3D02ABF228C44BFA3D11F6E47E35B5"><enum>(d)</enum><header>Direct billing</header>
									<paragraph id="H273F794D4D384C6781447BA847233266"><enum>(1)</enum><header>In
				general</header><text>Subject to complying with the requirements of paragraph
				(2), a Tribal Health Program may elect to directly bill for, and receive
				payment for, health care items and services provided by such Program for which
				payment is made under title XVIII or XIX of the <act-name parsable-cite="SSA">Social Security Act</act-name> or from any other third
				party payor.</text>
									</paragraph><paragraph id="H03820A9FCCF64DE68FA400036D0350E3"><enum>(2)</enum><header>Direct
				reimbursement</header>
										<subparagraph id="H05E8E4EE3C58419E83FB86752F5199D2"><enum>(A)</enum><header>Use of
				funds</header><text>Each Tribal Health Program making the election described in
				paragraph (1) with respect to a program under a title of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> shall be
				reimbursed directly by that program for items and services furnished without
				regard to subsection (c)(1), but all amounts so reimbursed shall be used by the
				Tribal Health Program for the purpose of making any improvements in facilities
				of the Tribal Health Program that may be necessary to achieve or maintain
				compliance with the conditions and requirements applicable generally to such
				items and services under the program under such title and to provide additional
				health care services, improvements in health care facilities and Tribal Health
				Programs, any health care related purpose, or otherwise to achieve the
				objectives provided in section 3 of this Act.</text>
										</subparagraph><subparagraph id="H4B6F40D25D50402DBADD78A65B3D95C"><enum>(B)</enum><header>Audits</header><text>The
				amounts paid to a Tribal Health Program making the election described in
				paragraph (1) with respect to a program under a title of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> shall be subject
				to all auditing requirements applicable to the program under such title, as
				well as all auditing requirements applicable to programs administered by an
				Indian Health Program. Nothing in the preceding sentence shall be construed as
				limiting the application of auditing requirements applicable to amounts paid
				under title XVIII, XIX, or XXI of the Social Security Act.</text>
										</subparagraph><subparagraph id="HAC3ED18651EE4E2A99378302E429FB4"><enum>(C)</enum><header>Identification of
				source of payments</header><text>Any Tribal Health Program that receives
				reimbursements or payments under title XVIII, XIX, or XXI of the
				<act-name parsable-cite="SSA">Social Security Act</act-name>, shall provide to
				the Service a list of each provider enrollment number (or other identifier)
				under which such Program receives such reimbursements or payments.</text>
										</subparagraph></paragraph><paragraph id="HC982FACEC137490F986E245141BF896B"><enum>(3)</enum><header>Examination and
				implementation of changes</header>
										<subparagraph id="HBDAA4DCBF62643D28BEF818411302F49"><enum>(A)</enum><header>In
				general</header><text>The Secretary, acting through the Service and with the
				assistance of the Administrator of the Centers for Medicare &amp; Medicaid
				Services, shall examine on an ongoing basis and implement any administrative
				changes that may be necessary to facilitate direct billing and reimbursement
				under the program established under this subsection, including any agreements
				with States that may be necessary to provide for direct billing under a program
				under a title of the <act-name parsable-cite="SSA">Social Security
				Act</act-name>.</text>
										</subparagraph><subparagraph id="H66A8A4159EF14187B2FF13A47E09D969"><enum>(B)</enum><header>Coordination of
				information</header><text>The Service shall provide the Administrator of the
				Centers for Medicare &amp; Medicaid Services with copies of the lists submitted
				to the Service under paragraph (2)(C), enrollment data regarding patients
				served by the Service (and by Tribal Health Programs, to the extent such data
				is available to the Service), and such other information as the Administrator
				may require for purposes of administering title XVIII, XIX, or XXI of the
				<act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
										</subparagraph></paragraph><paragraph id="HE26BC14B0B1D47F38F9BE3B8E83EE533"><enum>(4)</enum><header>Withdrawal from
				program</header><text>A Tribal Health Program that bills directly under the
				program established under this subsection may withdraw from participation in
				the same manner and under the same conditions that an Indian Tribe or Tribal
				Organization may retrocede a contracted program to the Secretary under the
				authority of the <act-name parsable-cite="ISDA">Indian Self-Determination and
				Education Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>). All cost
				accounting and billing authority under the program established under this
				subsection shall be returned to the Secretary upon the Secretary’s acceptance
				of the withdrawal of participation in this program.</text>
									</paragraph><paragraph id="H8F1BA3710E5E46F9BEFE7C065CAFA576"><enum>(5)</enum><header>Termination for failure
				to comply with requirements</header><text>The Secretary may terminate the
				participation of a Tribal Health Program or in the direct billing program
				established under this subsection if the Secretary determines that the Program
				has failed to comply with the requirements of paragraph (2). The Secretary
				shall provide a Tribal Health Program with notice of a determination that the
				Program has failed to comply with any such requirement and a reasonable
				opportunity to correct such noncompliance prior to terminating the Program's
				participation in the direct billing program established under this
				subsection.</text>
									</paragraph></subsection><subsection id="HB6339045735A4F00BE92B19506A8B8E"><enum>(e)</enum><header>Related provisions
				under the Social Security Act</header><text>For provisions related to
				subsections (c) and (d), see sections 1880, 1911, and 2107(e)(1)(D) of the
				Social Security Act.</text>
								</subsection></section><section id="HCF1982BB69AA47E0AB2122C80059E6D0"><enum>402.</enum><header>Grants to and
				contracts with the Service, Indian Tribes, Tribal Organizations, and Urban
				Indian Organizations to facilitate outreach, enrollment, and coverage of
				Indians under Social Security Act health benefit programs and other health
				benefits programs</header>
								<subsection id="HCECA0E8E31B84AD186CF552B008F5047"><enum>(a)</enum><header>Indian Tribes and
				Tribal Organizations</header><text>From funds appropriated to carry out this
				title in accordance with section 416, the Secretary, acting through the
				Service, shall make grants to or enter into contracts with Indian Tribes and
				Tribal Organizations to assist such Tribes and Tribal Organizations in
				establishing and administering programs on or near reservations and trust lands
				to assist individual Indians—</text>
									<paragraph id="H605041AA83F24473A2C41703994DEF75"><enum>(1)</enum><text>to enroll for benefits
				under a program established under title XVIII, XIX, or XXI of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> and other health
				benefits programs; and</text>
									</paragraph><paragraph id="H77C21AA12EE24BBB8428AE76960093D0"><enum>(2)</enum><text>with respect to such
				programs for which the charging of premiums and cost sharing is not prohibited
				under such programs, to pay premiums or cost sharing for coverage for such
				benefits, which may be based on financial need (as determined by the Indian
				Tribe or Tribes or Tribal Organizations being served based on a schedule of
				income levels developed or implemented by such Tribe, Tribes, or Tribal
				Organizations).</text>
									</paragraph></subsection><subsection id="H7C56B50D5C8449BE853D67F0F56E333"><enum>(b)</enum><header>Conditions</header><text>The
				Secretary, acting through the Service, shall place conditions as deemed
				necessary to effect the purpose of this section in any grant or contract which
				the Secretary makes with any Indian Tribe or Tribal Organization pursuant to
				this section. Such conditions shall include requirements that the Indian Tribe
				or Tribal Organization successfully undertake—</text>
									<paragraph id="H7EA7AE5BF5534BF0AE912FEA232898E1"><enum>(1)</enum><text>to determine the
				population of Indians eligible for the benefits described in subsection
				(a);</text>
									</paragraph><paragraph id="H7D18D764C3F047D0B0D686058FD7D099"><enum>(2)</enum><text>to educate Indians with
				respect to the benefits available under the respective programs;</text>
									</paragraph><paragraph id="HCF8EC61A675A449C9C43D93B63F66405"><enum>(3)</enum><text>to provide transportation
				for such individual Indians to the appropriate offices for enrollment or
				applications for such benefits; and</text>
									</paragraph><paragraph id="H3E305B874B1644C9B3C7085807890075"><enum>(4)</enum><text>to develop and implement
				methods of improving the participation of Indians in receiving benefits under
				such programs.</text>
									</paragraph></subsection><subsection id="HE16176B32D544A63A91900A1DF06E2DF"><enum>(c)</enum><header>Application to Urban
				Indian Organizations</header>
									<paragraph id="HEE56A8597A284988B44960C4802252C8"><enum>(1)</enum><header>In
				general</header><text>The provisions of subsection (a) shall apply with respect
				to grants and other funding to Urban Indian Organizations with respect to
				populations served by such organizations in the same manner they apply to
				grants and contracts with Indian Tribes and Tribal Organizations with respect
				to programs on or near reservations.</text>
									</paragraph><paragraph id="HE2385A9CB8254E0487C7D3F6FE300C1"><enum>(2)</enum><header>Requirements</header><text>The
				Secretary shall include in the grants or contracts made or provided under
				paragraph (1) requirements that are—</text>
										<subparagraph id="H6BE042AA98414189A4EFBDEB36D1C879"><enum>(A)</enum><text>consistent with the
				requirements imposed by the Secretary under subsection (b);</text>
										</subparagraph><subparagraph id="HA58639F18C914C66ACD662AA9F91A48F"><enum>(B)</enum><text>appropriate to Urban
				Indian Organizations and Urban Indians; and</text>
										</subparagraph><subparagraph id="H18C6EECFA84F4C17A830DA5FFFC3800"><enum>(C)</enum><text>necessary to effect the
				purposes of this section.</text>
										</subparagraph></paragraph></subsection><subsection id="HD07A3FD3446C415F8EDBCB08C804B1EA"><enum>(d)</enum><header>Facilitating
				cooperation</header><text>The Secretary, acting through the Centers for
				Medicare &amp; Medicaid Services, shall take such steps as are necessary to
				facilitate cooperation with, and agreements between, States and the Service,
				Indian Tribes, Tribal Organizations, or Urban Indian Organizations with respect
				to the provision of health care items and services to Indians under the
				programs established under title XVIII, XIX, or XXI of the Social Security
				Act.</text>
								</subsection><subsection id="HF37EF98146E94462B25C51861545177D"><enum>(e)</enum><header>Agreements relating To
				improving enrollment of indians under <act-name parsable-cite="SSA">Social
				Security Act</act-name> health benefits programs</header><text>For provisions
				relating to agreements between the Secretary, acting through the Service, and
				Indian Tribes, Tribal Organizations, and Urban Indian Organizations for the
				collection, preparation, and submission of applications by Indians for
				assistance under the Medicaid and State children's health insurance programs
				established under titles XIX and XXI of the <act-name parsable-cite="SSA">Social Security Act</act-name>, and benefits under the
				Medicare program established under title XVIII of such Act, see subsections (a)
				and (b) of section 1139 of the Social Security Act.</text>
								</subsection><subsection id="HCC5FEEF6A5224CC088C0B2A1D3BD28CE"><enum>(f)</enum><header>Definition of premiums
				and cost sharing</header><text>In this section:</text>
									<paragraph id="H74BFACF5DBF44A99801290001D2FD6D7"><enum>(1)</enum><header>Premium</header><text>The
				term <term>premium</term> includes any enrollment fee or similar charge.</text>
									</paragraph><paragraph id="HFDB3D01400E0403B91F9046E708BF878"><enum>(2)</enum><header>Cost
				sharing</header><text>The term <term>cost sharing</term> includes any
				deduction, deductible, copayment, coinsurance, or similar charge.</text>
									</paragraph></subsection></section><section id="H2F525F4DD9CE45A90003B4E4155C661"><enum>403.</enum><header>Reimbursement from
				certain third parties of costs of health services</header>
								<subsection id="HDE8038A51FCA46E5BF692D8D888E8EC5"><enum>(a)</enum><header>Right of
				recovery</header><text>Except as provided in subsection (f), the United States,
				an Indian Tribe, or Tribal Organization shall have the right to recover from an
				insurance company, health maintenance organization, employee benefit plan,
				third-party tortfeasor, or any other responsible or liable third party
				(including a political subdivision or local governmental entity of a State) the
				reasonable charges billed by the Secretary, an Indian Tribe, or Tribal
				Organization in providing health services through the Service, an Indian Tribe,
				or Tribal Organization to any individual to the same extent that such
				individual, or any nongovernmental provider of such services, would be eligible
				to receive damages, reimbursement, or indemnification for such charges or
				expenses if—</text>
									<paragraph id="H845FB13FA7844B638447F26B09689952"><enum>(1)</enum><text>such services had been
				provided by a nongovernmental provider; and</text>
									</paragraph><paragraph id="H44C2FE3F8E5447FCB5E3E496853EC98E"><enum>(2)</enum><text>such individual had been
				required to pay such charges or expenses and did pay such charges or
				expenses.</text>
									</paragraph></subsection><subsection id="H8E7698B7C2AC4FB39FBBEAB595DED31"><enum>(b)</enum><header>Limitations on
				recoveries from States</header><text>Subsection (a) shall provide a right of
				recovery against any State, only if the injury, illness, or disability for
				which health services were provided is covered under—</text>
									<paragraph id="H875E96E0855C419B99DAC71DA146EEF"><enum>(1)</enum><text>workers’ compensation
				laws; or</text>
									</paragraph><paragraph id="H855D5EE18255484785B31B49458FA800"><enum>(2)</enum><text>a no-fault automobile
				accident insurance plan or program.</text>
									</paragraph></subsection><subsection id="HECDF7E167E1245DE9646265EB69FDAFF"><enum>(c)</enum><header>Nonapplication of other
				laws</header><text>No law of any State, or of any political subdivision of a
				State and no provision of any contract, insurance or health maintenance
				organization policy, employee benefit plan, self-insurance plan, managed care
				plan, or other health care plan or program entered into or renewed after the
				date of the enactment of the Indian Health Care Amendments of 1988, shall
				prevent or hinder the right of recovery of the United States, an Indian Tribe,
				or Tribal Organization under subsection (a).</text>
								</subsection><subsection id="HECEC1B458D1F48ACBF762134AE61BBE"><enum>(d)</enum><header>No effect on private
				rights of action</header><text>No action taken by the United States, an Indian
				Tribe, or Tribal Organization to enforce the right of recovery provided under
				this section shall operate to deny to the injured person the recovery for that
				portion of the person’s damage not covered hereunder.</text>
								</subsection><subsection id="H497B40E9AC014A81A5577400472EEB49"><enum>(e)</enum><header>Enforcement</header>
									<paragraph id="HB70FDDDA921246FFB5DA494F784610F5"><enum>(1)</enum><header>In
				general</header><text>The United States, an Indian Tribe, or Tribal
				Organization may enforce the right of recovery provided under subsection (a)
				by—</text>
										<subparagraph id="H102801140896431AB4A273FADFDA805E"><enum>(A)</enum><text>intervening or joining in
				any civil action or proceeding brought—</text>
											<clause id="HF25724D7F4154FC6AB57C6A5C7C537DE"><enum>(i)</enum><text>by the individual for
				whom health services were provided by the Secretary, an Indian Tribe, or Tribal
				Organization; or</text>
											</clause><clause id="HBEC748CD676A411E85BFD38B66DF3348"><enum>(ii)</enum><text>by any representative or
				heirs of such individual, or</text>
											</clause></subparagraph><subparagraph id="HAF35925995D445C28C021520CFC1DBD"><enum>(B)</enum><text>instituting a civil
				action, including a civil action for injunctive relief and other relief and
				including, with respect to a political subdivision or local governmental entity
				of a State, such an action against an official thereof.</text>
										</subparagraph></paragraph><paragraph id="HAFDBEE4A597B45F5B437DF6541F29132"><enum>(2)</enum><header>Notice</header><text>All
				reasonable efforts shall be made to provide notice of action instituted under
				paragraph (1)(B) to the individual to whom health services were provided,
				either before or during the pendency of such action.</text>
									</paragraph><paragraph id="H0A2BDD7837324E2ABFD37E9B86B6F3E3"><enum>(3)</enum><header>Recovery from
				tortfeasors</header>
										<subparagraph id="H60C4BEFB4EC6478F990093B96E8F73C6"><enum>(A)</enum><header>In
				general</header><text>In any case in which an Indian Tribe or Tribal
				Organization that is authorized or required under a compact or contract issued
				pursuant to the Indian Self-Determination and Education Assistance Act (25
				U.S.C. 450 et seq.) to furnish or pay for health services to a person who is
				injured or suffers a disease on or after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title> under circumstances that establish grounds for a claim of
				liability against the tortfeasor with respect to the injury or disease, the
				Indian Tribe or Tribal Organization shall have a right to recover from the
				tortfeasor (or an insurer of the tortfeasor) the reasonable value of the health
				services so furnished, paid for, or to be paid for, in accordance with the
				Federal Medical Care Recovery Act (<external-xref legal-doc="usc" parsable-cite="usc/42/2651">42 U.S.C. 2651 et seq.</external-xref>), to the same extent
				and under the same circumstances as the United States may recover under that
				Act.</text>
										</subparagraph><subparagraph id="HEF95865E37D64B78BD98CD6C3755D3E6"><enum>(B)</enum><header>Treatment</header><text>The
				right of an Indian Tribe or Tribal Organization to recover under subparagraph
				(A) shall be independent of the rights of the injured or diseased person served
				by the Indian Tribe or Tribal Organization.</text>
										</subparagraph></paragraph></subsection><subsection id="H06D22DAC12D844D4AA81F75765FC85D7"><enum>(f)</enum><header>Limitation</header><text>Absent
				specific written authorization by the governing body of an Indian Tribe for the
				period of such authorization (which may not be for a period of more than 1 year
				and which may be revoked at any time upon written notice by the governing body
				to the Service), the United States shall not have a right of recovery under
				this section if the injury, illness, or disability for which health services
				were provided is covered under a self-insurance plan funded by an Indian Tribe,
				Tribal Organization, or Urban Indian Organization. Where such authorization is
				provided, the Service may receive and expend such amounts for the provision of
				additional health services consistent with such authorization.</text>
								</subsection><subsection id="H61E5B64D870643DBB62CEFBA6F3CCA62"><enum>(g)</enum><header>Costs and attorneys’
				fees</header><text>In any action brought to enforce the provisions of this
				section, a prevailing plaintiff shall be awarded its reasonable attorneys’ fees
				and costs of litigation.</text>
								</subsection><subsection id="H450045754C6243669DCBE96082415C5C"><enum>(h)</enum><header>Nonapplication of
				claims filing requirements</header><text>An insurance company, health
				maintenance organization, self-insurance plan, managed care plan, or other
				health care plan or program (under the <act-name parsable-cite="SSA">Social
				Security Act</act-name> or otherwise) may not deny a claim for benefits
				submitted by the Service or by an Indian Tribe or Tribal Organization based on
				the format in which the claim is submitted if such format complies with the
				format required for submission of claims under title XVIII of the
				<act-name parsable-cite="SSA">Social Security Act</act-name> or recognized
				under section 1175 of such Act.</text>
								</subsection><subsection id="HCB2C39E2C25F432CA26D4F8201873F8C"><enum>(i)</enum><header>Application to Urban
				Indian Organizations</header><text>The previous provisions of this section
				shall apply to Urban Indian Organizations with respect to populations served by
				such Organizations in the same manner they apply to Indian Tribes and Tribal
				Organizations with respect to populations served by such Indian Tribes and
				Tribal Organizations.</text>
								</subsection><subsection id="HE2BC9885BD744D4FBD613619B30700BB"><enum>(j)</enum><header>Statute of
				limitations</header><text>The provisions of <external-xref legal-doc="usc" parsable-cite="usc/28/2415">section 2415</external-xref> of title 28, United
				States Code, shall apply to all actions commenced under this section, and the
				references therein to the United States are deemed to include Indian Tribes,
				Tribal Organizations, and Urban Indian Organizations.</text>
								</subsection><subsection id="H7459C31B71814D8E9F0138B1C7BE5B28"><enum>(k)</enum><header>Savings</header><text>Nothing
				in this section shall be construed to limit any right of recovery available to
				the United States, an Indian Tribe, or Tribal Organization under the provisions
				of any applicable, Federal, State, or Tribal law, including medical lien
				laws.</text>
								</subsection></section><section id="HF8F489675CE14499BE2F65839400AFA"><enum>404.</enum><header>Crediting of
				reimbursements</header>
								<subsection id="HAFAA440D58D542058B4398CC6F724512"><enum>(a)</enum><header>Use of amounts</header>
									<paragraph id="H8F0CC099D5DA4670B3B48B06AF0732B6"><enum>(1)</enum><header>Retention by
				program</header><text>Except as provided in section 202(f) (relating to the
				Catastrophic Health Emergency Fund) and section 807 (relating to health
				services for ineligible persons), all reimbursements received or recovered
				under any of the programs described in paragraph (2), including under section
				807, by reason of the provision of health services by the Service, by an Indian
				Tribe or Tribal Organization, or by an Urban Indian Organization, shall be
				credited to the Service, such Indian Tribe or Tribal Organization, or such
				Urban Indian Organization, respectively, and may be used as provided in section
				401. In the case of such a service provided by or through a Service Unit, such
				amounts shall be credited to such unit and used for such purposes.</text>
									</paragraph><paragraph id="H7B36968611A64875B79D1CCB5F044DF3"><enum>(2)</enum><header>Programs
				covered</header><text>The programs referred to in paragraph (1) are the
				following:</text>
										<subparagraph id="HB02F9F29B20B4DCF877D28B2FA9DCE7D"><enum>(A)</enum><text>Titles XVIII, XIX, and
				XXI of the <act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
										</subparagraph><subparagraph id="HC02D9667C7A245C18FEA33E7B50094C2"><enum>(B)</enum><text>This Act, including
				section 807.</text>
										</subparagraph><subparagraph id="H288FDF883F0F4FA9B13905099CA6E231"><enum>(C)</enum><text>Public Law 87–693.</text>
										</subparagraph><subparagraph id="H01AB7C5B27E745AE82C6179E985776FB"><enum>(D)</enum><text>Any other provision of
				law.</text>
										</subparagraph></paragraph></subsection><subsection id="HA78EB6D15A5A4D0280A440184CC9374D"><enum>(b)</enum><header>No offset of
				amounts</header><text>The Service may not offset or limit any amount obligated
				to any Service Unit or entity receiving funding from the Service because of the
				receipt of reimbursements under subsection (a).</text>
								</subsection></section><section id="HCDAD584313C546E4B2DE35C86DC589A9"><enum>405.</enum><header>Purchasing health care
				coverage</header>
								<subsection id="H6FE0D40EDB734BFE83EDA5B448DA1E50"><enum>(a)</enum><header>In
				general</header><text>Insofar as amounts are made available under law
				(including a provision of the <act-name parsable-cite="SSA">Social Security
				Act</act-name>, the <act-name parsable-cite="ISDA">Indian Self-Determination
				and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>)</act-name>, or other law,
				other than under section 402) to Indian Tribes, Tribal Organizations, and Urban
				Indian Organizations for health benefits for Service beneficiaries, Indian
				Tribes, Tribal Organizations, and Urban Indian Organizations may use such
				amounts to purchase health benefits coverage for such beneficiaries in any
				manner, including through—</text>
									<paragraph id="HFD0F8CC88C82445DB6B13B6CA00AB3B"><enum>(1)</enum><text>a tribally owned and
				operated health care plan;</text>
									</paragraph><paragraph id="H0D786B2B296E4080B3B9F33BE0BB9BAF"><enum>(2)</enum><text>a State or locally
				authorized or licensed health care plan;</text>
									</paragraph><paragraph id="H23F565D505324AABA5AB763988A99CE0"><enum>(3)</enum><text>a health insurance
				provider or managed care organization; or</text>
									</paragraph><paragraph id="H8AD209402BBD4324B7942BA31531057C"><enum>(4)</enum><text>a self-insured
				plan.</text>
									</paragraph><continuation-text continuation-text-level="subsection">The
				purchase of such coverage by an Indian Tribe, Tribal Organization, or Urban
				Indian Organization may be based on the financial needs of such beneficiaries
				(as determined by the Indian Tribe or Tribes being served based on a schedule
				of income levels developed or implemented by such Indian Tribe or
				Tribes).</continuation-text></subsection><subsection id="H0D975F6276AD4CBB92AB2C03152400C6"><enum>(b)</enum><header>Expenses for
				self-insured plan</header><text>In the case of a self-insured plan under
				subsection (a)(4), the amounts may be used for expenses of operating the plan,
				including administration and insurance to limit the financial risks to the
				entity offering the plan.</text>
								</subsection><subsection id="H0251E21FD20244419BF980CEFA74A532"><enum>(c)</enum><header>Construction</header><text>Nothing
				in this section shall be construed as affecting the use of any amounts not
				referred to in subsection (a).</text>
								</subsection></section><section id="HC4CE67D6BF824026AC926D5841D46826"><enum>406.</enum><header>Sharing arrangements
				with Federal agencies</header>
								<subsection id="H34D8DD68FB0F4D949FFC575467315E3B"><enum>(a)</enum><header>Authority</header>
									<paragraph id="HBEB5092380A94B71A5A82D1F7DE133E7"><enum>(1)</enum><header>In
				general</header><text>The Secretary may enter into (or expand) arrangements for
				the sharing of medical facilities and services between the Service, Indian
				Tribes, and Tribal Organizations and the Department of Veterans Affairs and the
				Department of Defense.</text>
									</paragraph><paragraph id="H1359E120A6EF4954B9342E91B0525270"><enum>(2)</enum><header>Consultation by
				Secretary required</header><text>The Secretary may not finalize any arrangement
				between the Service and a Department described in paragraph (1) without first
				consulting with the Indian Tribes which will be significantly affected by the
				arrangement.</text>
									</paragraph></subsection><subsection id="H2E4CCE8B57BF44F2A4541F15042CCA70"><enum>(b)</enum><header>Limitations</header><text>The
				Secretary shall not take any action under this section or under subchapter IV
				of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> of title 38, United States Code, which would impair—</text>
									<paragraph id="HE2EDEA5A6B594466890359CB2E00959D"><enum>(1)</enum><text>the priority access of
				any Indian to health care services provided through the Service and the
				eligibility of any Indian to receive health services through the
				Service;</text>
									</paragraph><paragraph id="H363C57D3973C40B2AC2800498270EB6F"><enum>(2)</enum><text>the quality of health
				care services provided to any Indian through the Service;</text>
									</paragraph><paragraph id="H850027F881864A978DE2AE18841C694D"><enum>(3)</enum><text>the priority access of
				any veteran to health care services provided by the Department of Veterans
				Affairs;</text>
									</paragraph><paragraph id="HECDAB87F86C44DF9B8104E9CEA588D88"><enum>(4)</enum><text>the quality of health
				care services provided by the Department of Veterans Affairs or the Department
				of Defense; or</text>
									</paragraph><paragraph id="H5D2C501985F9408F9CB3A38E1416200"><enum>(5)</enum><text>the eligibility of any
				Indian who is a veteran to receive health services through the Department of
				Veterans Affairs.</text>
									</paragraph></subsection><subsection id="HD7C820930F7C4E548758AC99044B43D1"><enum>(c)</enum><header>Reimbursement</header><text>The
				Service, Indian Tribe, or Tribal Organization shall be reimbursed by the
				Department of Veterans Affairs or the Department of Defense (as the case may
				be) where services are provided through the Service, an Indian Tribe, or a
				Tribal Organization to beneficiaries eligible for services from either such
				Department, notwithstanding any other provision of law.</text>
								</subsection><subsection id="H1471F5D1AA3D4F8CBAE701E48B045218"><enum>(d)</enum><header>Construction</header><text>Nothing
				in this section may be construed as creating any right of a non-Indian veteran
				to obtain health services from the Service.</text>
								</subsection></section><section id="H9E6724D3591D43F08484C874C8E907B1"><enum>407.</enum><header>Payor of last
				resort</header><text display-inline="no-display-inline">Indian Health Programs
				and health care programs operated by Urban Indian Organizations shall be the
				payor of last resort for services provided to persons eligible for services
				from Indian Health Programs and Urban Indian Organizations, notwithstanding any
				Federal, State, or local law to the contrary.</text>
							</section><section id="H5D5537DD3619439A9EC3027D93CCB326"><enum>408.</enum><header>Nondiscrimination
				under Federal health care programs in qualifications for reimbursement for
				services</header>
								<subsection id="HA506B389EE164F59AAB7BC54E946807"><enum>(a)</enum><header>Requirement To satisfy
				generally applicable participation requirements</header>
									<paragraph id="HF6529651A13B4A9194E7F5B9B8806BE0"><enum>(1)</enum><header>In
				general</header><text display-inline="yes-display-inline">A Federal health care
				program must accept an entity that is operated by the Service, an Indian Tribe,
				Tribal Organization, or Urban Indian Organization as a provider eligible to
				receive payment under the program for health care services furnished to an
				Indian on the same basis as any other provider qualified to participate as a
				provider of health care services under the program if the entity meets
				generally applicable State or other requirements for participation as a
				provider of health care services under the program.</text>
									</paragraph><paragraph id="H581EF26BE77348D7A4251DEAEA7E46BA"><enum>(2)</enum><header>Satisfaction of state
				or local licensure or recognition requirements</header><text display-inline="yes-display-inline">Any requirement for participation as a
				provider of health care services under a Federal health care program that an
				entity be licensed or recognized under the State or local law where the entity
				is located to furnish health care services shall be deemed to have been met in
				the case of an entity operated by the Service, an Indian Tribe, Tribal
				Organization, or Urban Indian Organization if the entity meets all the
				applicable standards for such licensure or recognition, regardless of whether
				the entity obtains a license or other documentation under such State or local
				law. In accordance with section 221, the absence of the licensure of a health
				care professional employed by such an entity under the State or local law where
				the entity is located shall not be taken into account for purposes of
				determining whether the entity meets such standards, if the professional is
				licensed in another State.</text>
									</paragraph></subsection><subsection id="H5B41747AC1AF4E99BF8135D9C8D927CB"><enum>(b)</enum><header>Application of
				exclusion from participation in Federal health care programs</header>
									<paragraph id="H768090DFD01544159CD3F6F694003E05"><enum>(1)</enum><header>Excluded
				entities</header><text display-inline="yes-display-inline">No entity operated
				by the Service, an Indian Tribe, Tribal Organization, or Urban Indian
				Organization that has been excluded from participation in any Federal health
				care program or for which a license is under suspension or has been revoked by
				the State where the entity is located shall be eligible to receive payment or
				reimbursement under any such program for health care services furnished to an
				Indian.</text>
									</paragraph><paragraph id="H586842E846E44C44A1F8FE60A11C22E3"><enum>(2)</enum><header>Excluded
				individuals</header><text display-inline="yes-display-inline">No individual who
				has been excluded from participation in any Federal health care program or
				whose State license is under suspension shall be eligible to receive payment or
				reimbursement under any such program for health care services furnished by that
				individual, directly or through an entity that is otherwise eligible to receive
				payment for health care services, to an Indian.</text>
									</paragraph><paragraph id="H64241776217F4D3CAB455C68FDDC1EC7"><enum>(3)</enum><header>Federal health care
				program defined</header><text>In this subsection, the term, <term>Federal
				health care program</term> has the meaning given that term in section 1128B(f)
				of the Social Security Act (42 U.S.C. 1320a–7b(f)), except that, for purposes
				of this subsection, such term shall include the health insurance program under
				<external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/89">chapter 89</external-xref> of title 5, United States Code.</text>
									</paragraph></subsection><subsection id="HB35629B2D4E04304A05B7700FCD301F7"><enum>(c)</enum><header>Related
				provisions</header><text>For provisions related to nondiscrimination against
				providers operated by the Service, an Indian Tribe, Tribal Organization, or
				Urban Indian Organization, see section 1139(c) of the Social Security Act (42
				U.S.C. 1320b–9(c)).</text>
								</subsection></section><section id="H25DCC99536B543C1968DCBBD4ED59FDF"><enum>409.</enum><header>Consultation</header><text display-inline="no-display-inline">For provisions related to consultation with
				representatives of Indian Health Programs and Urban Indian Organizations with
				respect to the health care programs established under titles XVIII, XIX, and
				XXI of the Social Security Act, see section 1139(d) of the Social Security Act
				(<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-9">42 U.S.C. 1320b–9(d)</external-xref>).</text>
							</section><section id="H959DB0B120BD4F0EA690D89B0509BAB"><enum>410.</enum><header>State Children's
				Health Insurance Program (SCHIP)</header><text display-inline="no-display-inline">For provisions relating to—</text>
								<paragraph id="HB92C9641D0B54793B34E17F4CD6CEEF2"><enum>(1)</enum><text display-inline="yes-display-inline">outreach to families of Indian children
				likely to be eligible for child health assistance under the State children's
				health insurance program established under title XXI of the Social Security
				Act, see sections 2105(c)(2)(C) and 1139(a) of such Act (42 U.S.C.
				1397ee(c)(2), 1320b–9); and</text>
								</paragraph><paragraph id="H309F9DCD1C574B1BBABD0023F4A6958C"><enum>(2)</enum><text>ensuring that child
				health assistance is provided under such program to targeted low-income
				children who are Indians and that payments are made under such program to
				Indian Health Programs and Urban Indian Organizations operating in the State
				that provide such assistance, see sections 2102(b)(3)(D) and 2105(c)(6)(B) of
				such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397bb">42 U.S.C. 1397bb(b)(3)(D)</external-xref>, 1397ee(c)(6)(B)).</text>
								</paragraph></section><section id="H4CA6BC4142344444BCE4D6CCD048836"><enum>411.</enum><header>Exclusion waiver
				authority for affected Indian Health Programs and safe harbor transactions
				under the Social Security Act</header><text display-inline="no-display-inline">For provisions relating to—</text>
								<paragraph id="H13DA7EF9A21D4D4499332C53A096CA5"><enum>(1)</enum><text display-inline="yes-display-inline">exclusion <act-name parsable-cite="SSA">waiver authority for affected Indian Health
				Programs</act-name> under the Social Security Act, see section 1128(k) of the
				Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320a-7">42 U.S.C. 1320a–7(k)</external-xref>); and</text>
								</paragraph><paragraph id="H3C26EC3251C94A8FB58FBCA371B3721F"><enum>(2)</enum><text>certain transactions
				involving Indian Health Programs deemed to be in safe harbors under that Act,
				see section 1128B(b)(4) of the Social Security Act (42 U.S.C.
				1320a–7b(b)(4)).</text>
								</paragraph></section><section id="H1F9162AAC8844414B93D00191FD85FCE"><enum>412.</enum><header>Premium and cost
				sharing protections and eligibility determinations under Medicaid and SCHIP and
				protection of certain Indian property from Medicaid estate
				recovery</header><text display-inline="no-display-inline">For provisions
				relating to—</text>
								<paragraph id="H679ADCE8C96F4CC9A8B492736A98C3D"><enum>(1)</enum><text display-inline="yes-display-inline">premiums or cost sharing protections for
				Indians furnished items or services directly by Indian Health Programs or
				through referral under the contract health service under the Medicaid program
				established under title XIX of the Social Security Act, see sections 1916(j)
				and 1916A(a)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396o">42 U.S.C. 1396o(j)</external-xref>,
				1396o–1(a)(1));</text>
								</paragraph><paragraph id="HBFF2EE18835342BEBCB9B68968CA206"><enum>(2)</enum><text display-inline="yes-display-inline">rules regarding the treatment of certain
				property for purposes of determining eligibility under such programs, see
				sections 1902(e)(13) and 2107(e)(1)(B) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(e)(13)</external-xref>,
				1397gg(e)(1)(B)); and</text>
								</paragraph><paragraph id="H7E42FE7FB812422C8588F754E8AF327D"><enum>(3)</enum><text display-inline="yes-display-inline">the protection of certain property from
				estate recovery provisions under the Medicaid program, see section
				1917(b)(3)(B) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396p">42 U.S.C. 1396p(b)(3)(B)</external-xref>).</text>
								</paragraph></section><section id="H02D357C3942644C997881402D1C051AB"><enum>413.</enum><header>Treatment under
				Medicaid and SCHIP managed care</header><text display-inline="no-display-inline">For provisions relating to the treatment of
				Indians enrolled in a managed care entity under the Medicaid program under
				title XIX of the Social Security Act and Indian Health Programs and Urban
				Indian Organizations that are providers of items or services to such Indian
				enrollees, see sections 1932(h) and 2107(e)(1)(H) of the Social Security Act
				(<external-xref legal-doc="usc" parsable-cite="usc/42/1396u-2">42 U.S.C. 1396u–2(h)</external-xref>, 1397gg(e)(1)(H)).</text>
							</section><section id="HCB468071386A4460855124F0F45B4B94"><enum>414.</enum><header>Navajo Nation Medicaid
				Agency feasibility study</header>
								<subsection id="H1348DD68DF2E4A8F81F18D7B4498975C"><enum>(a)</enum><header>Study</header><text>The
				Secretary shall conduct a study to determine the feasibility of treating the
				Navajo Nation as a State for the purposes of title XIX of the
				<act-name parsable-cite="SSA">Social Security Act</act-name>, to provide
				services to Indians living within the boundaries of the Navajo Nation through
				an entity established having the same authority and performing the same
				functions as single-State medicaid agencies responsible for the administration
				of the State plan under title XIX of the <act-name parsable-cite="SSA">Social
				Security Act</act-name>.</text>
								</subsection><subsection id="HA3C65DA6A7714947ABB812C435936834"><enum>(b)</enum><header>Considerations</header><text>In
				conducting the study, the Secretary shall consider the feasibility of—</text>
									<paragraph id="HDA74205EF6FF44828478B000F96C687D"><enum>(1)</enum><text>assigning and paying all
				expenditures for the provision of services and related administration funds,
				under title XIX of the <act-name parsable-cite="SSA">Social Security
				Act</act-name>, to Indians living within the boundaries of the Navajo Nation
				that are currently paid to or would otherwise be paid to the State of Arizona,
				New Mexico, or Utah;</text>
									</paragraph><paragraph id="HF5393F9248FE47ECA93D3D35B136E15"><enum>(2)</enum><text>providing assistance to
				the Navajo Nation in the development and implementation of such entity for the
				administration, eligibility, payment, and delivery of medical assistance under
				title XIX of the <act-name parsable-cite="SSA">Social Security
				Act</act-name>;</text>
									</paragraph><paragraph id="HBFE95CB406764209B1CF8D66E48E8F79"><enum>(3)</enum><text>providing an appropriate
				level of matching funds for Federal medical assistance with respect to amounts
				such entity expends for medical assistance for services and related
				administrative costs; and</text>
									</paragraph><paragraph id="H81072F33B72D445E8CFBB9087F0000F2"><enum>(4)</enum><text>authorizing the
				Secretary, at the option of the Navajo Nation, to treat the Navajo Nation as a
				State for the purposes of title XIX of the <act-name parsable-cite="SSA">Social
				Security Act</act-name> (relating to the State children’s health insurance
				program) under terms equivalent to those described in paragraphs (2) through
				(4).</text>
									</paragraph></subsection><subsection id="H13B09D139FE846C1B06BDFFF689B1127"><enum>(c)</enum><header>Report</header><text>Not
				later then 3 years after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, the Secretary shall submit to the Committee on Indian
				Affairs and Committee on Finance of the Senate and the Committee on Natural
				Resources and Committee on Energy and Commerce of the House of Representatives
				a report that includes—</text>
									<paragraph id="H6F388D13C0934879B6C6704B736C2636"><enum>(1)</enum><text>the results of the study
				under this section;</text>
									</paragraph><paragraph id="H6F5D02235D194B69A844D7F9669B6CA"><enum>(2)</enum><text>a summary of any
				consultation that occurred between the Secretary and the Navajo Nation, other
				Indian Tribes, the States of Arizona, New Mexico, and Utah, counties which
				include Navajo Lands, and other interested parties, in conducting this
				study;</text>
									</paragraph><paragraph id="H87FAAC4837F14C3C8CCA9D9F231DEB"><enum>(3)</enum><text>projected costs or
				savings associated with establishment of such entity, and any estimated impact
				on services provided as described in this section in relation to probable costs
				or savings; and</text>
									</paragraph><paragraph id="H95078690EF4F4D398743A725B74C3CFE"><enum>(4)</enum><text>legislative actions that
				would be required to authorize the establishment of such entity if such entity
				is determined by the Secretary to be feasible.</text>
									</paragraph></subsection></section><section id="HDB5FE3A4DDF94E1393223ECA0710D9F4"><enum>415.</enum><header>General
				exceptions</header><text display-inline="no-display-inline">The requirements of
				this title shall not apply to any excepted benefits described in paragraph
				(1)(A) or (3) of section 2791(c) of the Public Health Service Act (42 U.S.C.
				300gg–91).</text>
							</section><section id="H82A2807E7515474F8EC5D63B1CD66200"><enum>416.</enum><header>Authorization of
				appropriations</header><text display-inline="no-display-inline">There are
				authorized to be appropriated such sums as may be necessary for each fiscal
				year through fiscal year 2017 to carry out this title.</text>
							</section></title><title id="H6851C0DBF35F4907A65762645B275731"><enum>V</enum><header>Health services for Urban
				Indians</header>
							<section id="HACDDCBDDCE974DEBA615E64E3F9E12E0"><enum>501.</enum><header>Purpose</header><text display-inline="no-display-inline">The purpose of this title is to establish
				and maintain programs in Urban Centers to make health services more accessible
				and available to Urban Indians.</text>
							</section><section id="H4AD84909E6ED43158D00122E00FA6F7F"><enum>502.</enum><header>Contracts with, and
				grants to, Urban Indian Organizations</header><text display-inline="no-display-inline">Under authority of the Act of November 2,
				1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>) (commonly known as the <quote>Snyder Act</quote>), the
				Secretary, acting through the Service, shall enter into contracts with, or make
				grants to, Urban Indian Organizations to assist such organizations in the
				establishment and administration, within Urban Centers, of programs which meet
				the requirements set forth in this title. Subject to section 506, the
				Secretary, acting through the Service, shall include such conditions as the
				Secretary considers necessary to effect the purpose of this title in any
				contract into which the Secretary enters with, or in any grant the Secretary
				makes to, any Urban Indian Organization pursuant to this title.</text>
							</section><section id="HC2F7CDD654A541489CDA21620020B126"><enum>503.</enum><header>Contracts and grants
				for the provision of health care and referral services</header>
								<subsection id="H94CE83E7E1AD40C4B9FED9DD1C009035"><enum>(a)</enum><header>Requirements for grants
				and contracts</header><text>Under authority of the Act of November 2, 1921 (25
				U.S.C. 13) (commonly known as the <quote>Snyder Act</quote>), the Secretary,
				acting through the Service, shall enter into contracts with, and make grants
				to, Urban Indian Organizations for the provision of health care and referral
				services for Urban Indians. Any such contract or grant shall include
				requirements that the Urban Indian Organization successfully undertake
				to—</text>
									<paragraph id="HA1C4C58560E44C49B25F03B2573000F5"><enum>(1)</enum><text>estimate the population
				of Urban Indians residing in the Urban Center or centers that the organization
				proposes to serve who are or could be recipients of health care or referral
				services;</text>
									</paragraph><paragraph id="H2A58BD70030542B486152CFC9782D159"><enum>(2)</enum><text>estimate the current
				health status of Urban Indians residing in such Urban Center or centers;</text>
									</paragraph><paragraph id="HD15705D853784E149DE4923680A95D00"><enum>(3)</enum><text>estimate the current
				health care needs of Urban Indians residing in such Urban Center or
				centers;</text>
									</paragraph><paragraph id="HB5811EBFC0624986B1EE512C32A0293E"><enum>(4)</enum><text>provide basic health
				education, including health promotion and disease prevention education, to
				Urban Indians;</text>
									</paragraph><paragraph id="HFD8F7C7A33C14EC0B3A6A2887317E287"><enum>(5)</enum><text>make recommendations to
				the Secretary and Federal, State, local, and other resource agencies on methods
				of improving health service programs to meet the needs of Urban Indians;
				and</text>
									</paragraph><paragraph id="H1D2FA609DAD04524B95F2533625DDA04"><enum>(6)</enum><text>where necessary, provide,
				or enter into contracts for the provision of, health care services for Urban
				Indians.</text>
									</paragraph></subsection><subsection id="H6FB2C4AAEF644F249251407200BF6E47"><enum>(b)</enum><header>Criteria</header><text>The
				Secretary, acting through the Service, shall, by regulation, prescribe the
				criteria for selecting Urban Indian Organizations to enter into contracts or
				receive grants under this section. Such criteria shall, among other factors,
				include—</text>
									<paragraph id="H77B08EAFD7D8409F97BFE9B600003693"><enum>(1)</enum><text>the extent of unmet
				health care needs of Urban Indians in the Urban Center or centers
				involved;</text>
									</paragraph><paragraph id="H0D250468DE2D4F1590C1B2F950ED6BD7"><enum>(2)</enum><text>the size of the Urban
				Indian population in the Urban Center or centers involved;</text>
									</paragraph><paragraph id="H4FCC521170744EE18850ACA8CAD8C53"><enum>(3)</enum><text>the extent, if any, to
				which the activities set forth in subsection (a) would duplicate any project
				funded under this title, or under any current public health service project
				funded in a manner other than pursuant to this title;</text>
									</paragraph><paragraph id="HE8D60C12CAC44438AEC484D4E2A66632"><enum>(4)</enum><text>the capability of an
				Urban Indian Organization to perform the activities set forth in subsection (a)
				and to enter into a contract with the Secretary or to meet the requirements for
				receiving a grant under this section;</text>
									</paragraph><paragraph id="HA6374AD99AD1448F9500861B881CA318"><enum>(5)</enum><text>the satisfactory
				performance and successful completion by an Urban Indian Organization of other
				contracts with the Secretary under this title;</text>
									</paragraph><paragraph id="H2A7B008BB66B46AA9348BA23C300182B"><enum>(6)</enum><text>the appropriateness and
				likely effectiveness of conducting the activities set forth in subsection (a)
				in an Urban Center or centers; and</text>
									</paragraph><paragraph id="HABC0D4AF06CB4DE3811B7D6BDBA683B4"><enum>(7)</enum><text>the extent of existing or
				likely future participation in the activities set forth in subsection (a) by
				appropriate health and health-related Federal, State, local, and other
				agencies.</text>
									</paragraph></subsection><subsection id="HA7589B538502477F8419ADC1206D05C5"><enum>(c)</enum><header>Access to health
				promotion and disease prevention programs</header><text>The Secretary, acting
				through the Service, shall facilitate access to or provide health promotion and
				disease prevention services for Urban Indians through grants made to Urban
				Indian Organizations administering contracts entered into or receiving grants
				under subsection (a).</text>
								</subsection><subsection id="H21DE6864438945549CB3DA04009FED33"><enum>(d)</enum><header>Immunization
				services</header>
									<paragraph id="H33BE5F586B104A51958F75CB4C44BF93"><enum>(1)</enum><header>Access or services
				provided</header><text>The Secretary, acting through the Service, shall
				facilitate access to, or provide, immunization services for Urban Indians
				through grants made to Urban Indian Organizations administering contracts
				entered into or receiving grants under this section.</text>
									</paragraph><paragraph id="HB3F4BB8A9DFD41049B52E8A9F8C35C26"><enum>(2)</enum><header>Definition</header><text>For
				purposes of this subsection, the term <term>immunization services</term> means
				services to provide without charge immunizations against vaccine-preventable
				diseases.</text>
									</paragraph></subsection><subsection id="H16BD852261EE4931875C002FBF589650"><enum>(e)</enum><header>Behavioral health
				services</header>
									<paragraph id="H1589B52D050145E18179A7D32B28851"><enum>(1)</enum><header>Access or services
				provided</header><text>The Secretary, acting through the Service, shall
				facilitate access to, or provide, behavioral health services for Urban Indians
				through grants made to Urban Indian Organizations administering contracts
				entered into or receiving grants under subsection (a).</text>
									</paragraph><paragraph id="HC0B7BB12AE56413BB02E9FCF75D85D5"><enum>(2)</enum><header>Assessment
				required</header><text>Except as provided by paragraph (3)(A), a grant may not
				be made under this subsection to an Urban Indian Organization until that
				organization has prepared, and the Service has approved, an assessment of the
				following:</text>
										<subparagraph id="H3886C51B7768417BA9722BD5FD7E8B85"><enum>(A)</enum><text>The behavioral health
				needs of the Urban Indian population concerned.</text>
										</subparagraph><subparagraph id="HDAD47A51FDCA4A7EBC3D413C03F8F414"><enum>(B)</enum><text>The behavioral health
				services and other related resources available to that population.</text>
										</subparagraph><subparagraph id="H05627F4F58EB44BEB12B8860589DDCC6"><enum>(C)</enum><text>The barriers to obtaining
				those services and resources.</text>
										</subparagraph><subparagraph id="HC24AAC1624784CECA8D998DF21248305"><enum>(D)</enum><text>The needs that are unmet
				by such services and resources.</text>
										</subparagraph></paragraph><paragraph id="H1CEEF900ED2B43B6B40043A8BCA2258"><enum>(3)</enum><header>Purposes of
				grants</header><text>Grants may be made under this subsection for the
				following:</text>
										<subparagraph id="H516B199D96C04898B79513A9CBF83EFB"><enum>(A)</enum><text>To prepare assessments
				required under paragraph (2).</text>
										</subparagraph><subparagraph id="HBAD4063711EA48758703003BB39C47C5"><enum>(B)</enum><text>To provide outreach,
				educational, and referral services to Urban Indians regarding the availability
				of direct behavioral health services, to educate Urban Indians about behavioral
				health issues and services, and effect coordination with existing behavioral
				health providers in order to improve services to Urban Indians.</text>
										</subparagraph><subparagraph id="H3B0CC4C65AFB49F0B319DE7EB3950241"><enum>(C)</enum><text>To provide outpatient
				behavioral health services to Urban Indians, including the identification and
				assessment of illness, therapeutic treatments, case management, support groups,
				family treatment, and other treatment.</text>
										</subparagraph><subparagraph id="HEF6443D9C00A4260A3F0A545EF8832C"><enum>(D)</enum><text>To develop innovative
				behavioral health service delivery models which incorporate Indian cultural
				support systems and resources.</text>
										</subparagraph></paragraph></subsection><subsection id="H495C81CA7199471D9FA9657597C75224"><enum>(f)</enum><header>Prevention of child
				abuse</header>
									<paragraph id="H8CD8FBDD46B84D9DAF12B8DFA5ED9300"><enum>(1)</enum><header>Access or services
				provided</header><text>The Secretary, acting through the Service, shall
				facilitate access to or provide services for Urban Indians through grants to
				Urban Indian Organizations administering contracts entered into or receiving
				grants under subsection (a) to prevent and treat child abuse (including sexual
				abuse) among Urban Indians.</text>
									</paragraph><paragraph id="HEEC8A9A4B0CF490F90681675E4188528"><enum>(2)</enum><header>Evaluation
				required</header><text>Except as provided by paragraph (3)(A), a grant may not
				be made under this subsection to an Urban Indian Organization until that
				organization has prepared, and the Service has approved, an assessment that
				documents the prevalence of child abuse in the Urban Indian population
				concerned and specifies the services and programs (which may not duplicate
				existing services and programs) for which the grant is requested.</text>
									</paragraph><paragraph id="HEA2608217F4D4FCBB83D99B5514D5B09"><enum>(3)</enum><header>Purposes of
				grants</header><text>Grants may be made under this subsection for the
				following:</text>
										<subparagraph id="H9FA7B5B559BB4311A6EAD29B02CF4DCD"><enum>(A)</enum><text>To prepare assessments
				required under paragraph (2).</text>
										</subparagraph><subparagraph id="H0D9C2F6A9F8F446F9182BD2BC25C38C2"><enum>(B)</enum><text>For the development of
				prevention, training, and education programs for Urban Indians, including child
				education, parent education, provider training on identification and
				intervention, education on reporting requirements, prevention campaigns, and
				establishing service networks of all those involved in Indian child
				protection.</text>
										</subparagraph><subparagraph id="H256A4B38176444C88E66D10736596FB1"><enum>(C)</enum><text>To provide direct
				outpatient treatment services (including individual treatment, family
				treatment, group therapy, and support groups) to Urban Indians who are child
				victims of abuse (including sexual abuse) or adult survivors of child sexual
				abuse, to the families of such child victims, and to Urban Indian perpetrators
				of child abuse (including sexual abuse).</text>
										</subparagraph></paragraph><paragraph id="H7663E538FB434F5BA3DC485905B96BC7"><enum>(4)</enum><header>Considerations when
				making grants</header><text>In making grants to carry out this subsection, the
				Secretary shall take into consideration—</text>
										<subparagraph id="H6C9007828B0A496F97E2F8694FC0B8C9"><enum>(A)</enum><text>the support for the Urban
				Indian Organization demonstrated by the child protection authorities in the
				area, including committees or other services funded under the Indian Child
				Welfare Act of 1978 (<external-xref legal-doc="usc" parsable-cite="usc/25/1901">25 U.S.C. 1901 et seq.</external-xref>), if any;</text>
										</subparagraph><subparagraph id="HCDE0EE55904D40A68FA99A2C76CA471"><enum>(B)</enum><text>the capability and
				expertise demonstrated by the Urban Indian Organization to address the complex
				problem of child sexual abuse in the community; and</text>
										</subparagraph><subparagraph id="HD37EEA02025E4D07AA5255D40082BD00"><enum>(C)</enum><text>the assessment required
				under paragraph (2).</text>
										</subparagraph></paragraph></subsection><subsection id="H1CFFB16AB52846299B52E742D971522E"><enum>(g)</enum><header>Other
				grants</header><text>The Secretary, acting through the Service, may enter into
				a contract with or make grants to an Urban Indian Organization that provides or
				arranges for the provision of health care services (through satellite
				facilities, provider networks, or otherwise) to Urban Indians in more than 1
				Urban Center.</text>
								</subsection></section><section id="H4C5C4BC166394B3DA66F51BDCD9E4549"><enum>504.</enum><header>Contracts and grants
				for the determination of unmet health care needs</header>
								<subsection id="H456EFA4B6D59471B941423F9F3037B74"><enum>(a)</enum><header>Grants and contracts
				authorized</header><text>Under authority of the Act of November 2, 1921 (25
				U.S.C. 13) (commonly known as the <quote>Snyder Act</quote>), the Secretary,
				acting through the Service, may enter into contracts with or make grants to
				Urban Indian Organizations situated in Urban Centers for which contracts have
				not been entered into or grants have not been made under section 503.</text>
								</subsection><subsection id="HA496DD71AFE94B3FB37899DCFD0FF77"><enum>(b)</enum><header>Purpose</header><text>The
				purpose of a contract or grant made under this section shall be the
				determination of the matters described in subsection (c)(1) in order to assist
				the Secretary in assessing the health status and health care needs of Urban
				Indians in the Urban Center involved and determining whether the Secretary
				should enter into a contract or make a grant under section 503 with respect to
				the Urban Indian Organization which the Secretary has entered into a contract
				with, or made a grant to, under this section.</text>
								</subsection><subsection id="H4B3A45D71D2D4196969BF7CDBD9ECA10"><enum>(c)</enum><header>Grant and contract
				requirements</header><text>Any contract entered into, or grant made, by the
				Secretary under this section shall include requirements that—</text>
									<paragraph id="HE03205B756684D19B0806F6C00AE002C"><enum>(1)</enum><text>the Urban Indian
				Organization successfully undertakes to—</text>
										<subparagraph id="H7E2DBC6FF4E64DAB85C0393973F43D7C"><enum>(A)</enum><text>document the health care
				status and unmet health care needs of Urban Indians in the Urban Center
				involved; and</text>
										</subparagraph><subparagraph id="H8566859A798B48748124CBB0DDED5E01"><enum>(B)</enum><text>with respect to Urban
				Indians in the Urban Center involved, determine the matters described in
				paragraphs (2), (3), (4), and (7) of section 503(b); and</text>
										</subparagraph></paragraph><paragraph id="H816D5377B5A24D93A14E2920D76214B5"><enum>(2)</enum><text>the Urban Indian
				Organization complete performance of the contract, or carry out the
				requirements of the grant, within 1 year after the date on which the Secretary
				and such organization enter into such contract, or within 1 year after such
				organization receives such grant, whichever is applicable.</text>
									</paragraph></subsection><subsection id="H8B97A8FAEEC5428EAE1DA7B7B9EE106"><enum>(d)</enum><header>No
				renewals</header><text>The Secretary may not renew any contract entered into or
				grant made under this section.</text>
								</subsection></section><section id="H9D1644ADD1C14C7092F9D00C322CA3D"><enum>505.</enum><header>Evaluations;
				renewals</header>
								<subsection id="H81CB3A8A88C74CFC8D4046A0D25095E3"><enum>(a)</enum><header>Procedures for
				evaluations</header><text>The Secretary, acting through the Service, shall
				develop procedures to evaluate compliance with grant requirements and
				compliance with and performance of contracts entered into by Urban Indian
				Organizations under this title. Such procedures shall include provisions for
				carrying out the requirements of this section.</text>
								</subsection><subsection id="HD630B570AB3B45B2995B9D77970081B1"><enum>(b)</enum><header>Evaluations</header><text>The
				Secretary, acting through the Service, shall evaluate the compliance of each
				Urban Indian Organization which has entered into a contract or received a grant
				under section 503 with the terms of such contract or grant. For purposes of
				this evaluation, the Secretary shall—</text>
									<paragraph id="HD16997338C524790A296A639780411DC"><enum>(1)</enum><text>acting through the
				Service, conduct an annual onsite evaluation of the organization; or</text>
									</paragraph><paragraph id="H64DB87108323466BB6A70722E54DFC2D"><enum>(2)</enum><text>accept in lieu of such
				onsite evaluation evidence of the organization’s provisional or full
				accreditation by a private independent entity recognized by the Secretary for
				purposes of conducting quality reviews of providers participating in the
				Medicare program under title XVIII of the <act-name parsable-cite="SSA">Social
				Security Act</act-name>.</text>
									</paragraph></subsection><subsection id="HA1471E1320E24A849825FDB0F7492181"><enum>(c)</enum><header>Noncompliance;
				unsatisfactory performance</header><text>If, as a result of the evaluations
				conducted under this section, the Secretary determines that an Urban Indian
				Organization has not complied with the requirements of a grant or complied with
				or satisfactorily performed a contract under section 503, the Secretary shall,
				prior to renewing such contract or grant, attempt to resolve with the
				organization the areas of noncompliance or unsatisfactory performance and
				modify the contract or grant to prevent future occurrences of noncompliance or
				unsatisfactory performance. If the Secretary determines that the noncompliance
				or unsatisfactory performance cannot be resolved and prevented in the future,
				the Secretary shall not renew the contract or grant with the organization and
				is authorized to enter into a contract or make a grant under section 503 with
				another Urban Indian Organization which is situated in the same Urban Center as
				the Urban Indian Organization whose contract or grant is not renewed under this
				section.</text>
								</subsection><subsection id="HBE384E8EB2E54845AC88F35C00CD01F5"><enum>(d)</enum><header>Considerations for
				renewals</header><text>In determining whether to renew a contract or grant with
				an Urban Indian Organization under section 503 which has completed performance
				of a contract or grant under section 504, the Secretary shall review the
				records of the Urban Indian Organization, the reports submitted under section
				507, and shall consider the results of the onsite evaluations or accreditations
				under subsection (b).</text>
								</subsection></section><section id="HA14BDE8AE11A49F88439749C6CC7D95B"><enum>506.</enum><header>Other contract and
				grant requirements</header>
								<subsection id="HC66AE08C58A24F70823747E6D7B67472"><enum>(a)</enum><header>Procurement</header><text>Contracts
				with Urban Indian Organizations entered into pursuant to this title shall be in
				accordance with all Federal contracting laws and regulations relating to
				procurement except that in the discretion of the Secretary, such contracts may
				be negotiated without advertising and need not conform to the provisions of
				sections 1304 and 3131 through 3133 of title 40, United States Code.</text>
								</subsection><subsection id="HC3C4CFE0B8194DA8AAEAF1F69E6BC91C"><enum>(b)</enum><header>Payments under
				contracts or grants</header>
									<paragraph id="H59D1B33C016F4AA2B9929FCCA94B0923"><enum>(1)</enum><header>In
				general</header><text>Payments under any contracts or grants pursuant to this
				title, notwithstanding any term or condition of such contract or grant—</text>
										<subparagraph id="H9D313A11E89143F3BB0862AEAFA4BA68"><enum>(A)</enum><text>may be made in a single
				advance payment by the Secretary to the Urban Indian Organization by no later
				than the end of the first 30 days of the funding period with respect to which
				the payments apply, unless the Secretary determines through an evaluation under
				section 505 that the organization is not capable of administering such a single
				advance payment; and</text>
										</subparagraph><subparagraph id="HA4B8291904AA4C7BA581737C028EC908"><enum>(B)</enum><text>if any portion thereof is
				unexpended by the Urban Indian Organization during the funding period with
				respect to which the payments initially apply, shall be carried forward for
				expenditure with respect to allowable or reimbursable costs incurred by the
				organization during 1 or more subsequent funding periods without additional
				justification or documentation by the organization as a condition of carrying
				forward the availability for expenditure of such funds.</text>
										</subparagraph></paragraph><paragraph id="H0439384D76E043D3ABF8481D234C6859"><enum>(2)</enum><header>Semiannual and
				quarterly payments and reimbursements</header><text>If the Secretary determines
				under paragraph (1)(A) that an Urban Indian Organization is not capable of
				administering an entire single advance payment, on request of the Urban Indian
				Organization, the payments may be made—</text>
										<subparagraph id="HC9AAA235DFC04DE1BC4429D5AED96619"><enum>(A)</enum><text>in semiannual or
				quarterly payments by not later than 30 days after the date on which the
				funding period with respect to which the payments apply begins; or</text>
										</subparagraph><subparagraph id="HDBCBA8C115954FBD95E3A597C56F0A9"><enum>(B)</enum><text>by way of
				reimbursement.</text>
										</subparagraph></paragraph></subsection><subsection id="H5C18D99D5D54456292B1166673EC1810"><enum>(c)</enum><header>Revision or amendment
				of contracts</header><text>Notwithstanding any provision of law to the
				contrary, the Secretary may, at the request and consent of an Urban Indian
				Organization, revise or amend any contract entered into by the Secretary with
				such organization under this title as necessary to carry out the purposes of
				this title.</text>
								</subsection><subsection id="H583B7BDEB7574D07805C247B50F5C4F1"><enum>(d)</enum><header>Fair and uniform
				services and assistance</header><text>Contracts with or grants to Urban Indian
				Organizations and regulations adopted pursuant to this title shall include
				provisions to assure the fair and uniform provision to Urban Indians of
				services and assistance under such contracts or grants by such
				organizations.</text>
								</subsection></section><section id="H8B82D515FA584BA2B741B0C73FDA2123"><enum>507.</enum><header>Reports and
				records</header>
								<subsection id="HC4C2616D26F3484FBBFC3044C638FB59"><enum>(a)</enum><header>Reports</header>
									<paragraph id="H3AB6C88BFC114161A1513FAF17351D15"><enum>(1)</enum><header>In
				general</header><text>For each fiscal year during which an Urban Indian
				Organization receives or expends funds pursuant to a contract entered into or a
				grant received pursuant to this title, such Urban Indian Organization shall
				submit to the Secretary not more frequently than every 6 months, a report that
				includes the following:</text>
										<subparagraph id="H54AC196509AF416BAD58D15CA6ACF027"><enum>(A)</enum><text>In the case of a contract
				or grant under section 503, recommendations pursuant to section
				503(a)(5).</text>
										</subparagraph><subparagraph id="H6BDA45CA01BF49A9A1CA520034313E1D"><enum>(B)</enum><text>Information on activities
				conducted by the organization pursuant to the contract or grant.</text>
										</subparagraph><subparagraph id="HF40B4DA600D9445183B65613BC7396C8"><enum>(C)</enum><text>An accounting of the
				amounts and purpose for which Federal funds were expended.</text>
										</subparagraph><subparagraph id="H6131F212987C47158005A9BF00CA009E"><enum>(D)</enum><text>A minimum set of data,
				using uniformly defined elements, as specified by the Secretary after
				consultation with Urban Indian Organizations.</text>
										</subparagraph></paragraph><paragraph id="H309D42E38D4B47E9A0780179E3BB3EB0"><enum>(2)</enum><header>Health status and
				services</header>
										<subparagraph id="H1371E66B6AE54D8E83AC4576F942F9EE"><enum>(A)</enum><header>In
				general</header><text>Not later than 18 months after the date of enactment of
				the <short-title>Indian Health Care Improvement Act
				Amendments of 2007</short-title>, the Secretary, acting through the Service,
				shall submit to Congress a report evaluating—</text>
											<clause id="HD763097644C64432AF937400E5BC0093"><enum>(i)</enum><text>the health status of
				Urban Indians;</text>
											</clause><clause id="H29A92B655F964A739D36B721EE7A652"><enum>(ii)</enum><text>the services provided to
				Indians pursuant to this title; and</text>
											</clause><clause id="H5BD5BDE33BCA4E16B700E4A229AAF180"><enum>(iii)</enum><text>areas of unmet needs in
				the delivery of health services to Urban Indians.</text>
											</clause></subparagraph><subparagraph id="H16BB321E33D14F18BD174D916939E0AD"><enum>(B)</enum><header>Consultation and
				contracts</header><text>In preparing the report under paragraph (1), the
				Secretary—</text>
											<clause id="HA9F205EF5134487C82174F7632C2AA1F"><enum>(i)</enum><text>shall consult with Urban
				Indian Organizations; and</text>
											</clause><clause id="HCE702ADC14CC4C7383AE4E5BEFC2D0E7"><enum>(ii)</enum><text>may enter into a
				contract with a national organization representing Urban Indian Organizations
				to conduct any aspect of the report.</text>
											</clause></subparagraph></paragraph></subsection><subsection id="H8AC124E55BCC40C59F18F5DAEE30BD66"><enum>(b)</enum><header>Audit</header><text>The
				reports and records of the Urban Indian Organization with respect to a contract
				or grant under this title shall be subject to audit by the Secretary and the
				Comptroller General of the United States.</text>
								</subsection><subsection id="HAAD197092E9A44D8981236FCC4CE08D"><enum>(c)</enum><header>Costs of
				audits</header><text>The Secretary shall allow as a cost of any contract or
				grant entered into or awarded under section 502 or 503 the cost of an annual
				independent financial audit conducted by—</text>
									<paragraph id="H64BA8B9379E54C8FA45C6F3F325225F8"><enum>(1)</enum><text>a certified public
				accountant; or</text>
									</paragraph><paragraph id="H0C2A7A1E7DB3481DA7EEC3004BD7923"><enum>(2)</enum><text>a certified public
				accounting firm qualified to conduct Federal compliance audits.</text>
									</paragraph></subsection></section><section id="H66364ADC12664A35BAE300260522FBCD"><enum>508.</enum><header>Limitation on contract
				authority</header><text display-inline="no-display-inline">The authority of the
				Secretary to enter into contracts or to award grants under this title shall be
				to the extent, and in an amount, provided for in appropriation Acts.</text>
							</section><section id="HCA4E293F92714752B6EDE646375E8155"><enum>509.</enum><header>Facilities</header>
								<subsection id="HFBEB4E6D681549B3801B3EAD29BD2B9E"><enum>(a)</enum><header>Grants</header><text>The
				Secretary, acting through the Service, may make grants to contractors or grant
				recipients under this title for the lease, purchase, renovation, construction,
				or expansion of facilities, including leased facilities, in order to assist
				such contractors or grant recipients in complying with applicable licensure or
				certification requirements.</text>
								</subsection><subsection id="HA0298E66B9004EF495F6DB6305C2AAB0"><enum>(b)</enum><header>Loan fund
				study</header><text>The Secretary, acting through the Service, may carry out a
				study to determine the feasibility of establishing a loan fund to provide to
				Urban Indian Organizations direct loans or guarantees for loans for the
				construction of health care facilities in a manner consistent with section 309,
				including by submitting a report in accordance with subsection (c) of that
				section.</text>
								</subsection></section><section id="HD119E30487814872B2D9BE27C2260852"><enum>510.</enum><header>Division of Urban
				Indian Health</header><text display-inline="no-display-inline">There is
				established within the Service a Division of Urban Indian Health, which shall
				be responsible for—</text>
								<paragraph id="HE3F6E9808827475DACC16B2E21DF5BFD"><enum>(1)</enum><text>carrying out the
				provisions of this title;</text>
								</paragraph><paragraph id="HC01E7155B2014630A55E2FD5BE976D75"><enum>(2)</enum><text>providing central
				oversight of the programs and services authorized under this title; and</text>
								</paragraph><paragraph id="H67570DAA88C64E978294A25BCA083DFD"><enum>(3)</enum><text>providing technical
				assistance to Urban Indian Organizations.</text>
								</paragraph></section><section id="H22C91CB2F14E4CB185BE003822726952"><enum>511.</enum><header>Grants for alcohol and
				substance abuse-related services</header>
								<subsection id="H2E2B9E21C9514ED9AA3955F43B38278B"><enum>(a)</enum><header>Grants
				authorized</header><text>The Secretary, acting through the Service, may make
				grants for the provision of health-related services in prevention of, treatment
				of, rehabilitation of, or school- and community-based education regarding,
				alcohol and substance abuse in Urban Centers to those Urban Indian
				Organizations with which the Secretary has entered into a contract under this
				title or under section 201.</text>
								</subsection><subsection id="HD3E977EECC8E45AFB6D97E8BADA55E42"><enum>(b)</enum><header>Goals</header><text>Each
				grant made pursuant to subsection (a) shall set forth the goals to be
				accomplished pursuant to the grant. The goals shall be specific to each grant
				as agreed to between the Secretary and the grantee.</text>
								</subsection><subsection id="H68DBC0565C3A414EA5C44D67FF60CD20"><enum>(c)</enum><header>Criteria</header><text>The
				Secretary shall establish criteria for the grants made under subsection (a),
				including criteria relating to the following:</text>
									<paragraph id="H8CFA36BC84D34ECA986D187E33F717E7"><enum>(1)</enum><text>The size of the Urban
				Indian population.</text>
									</paragraph><paragraph id="H812D9573CC344B8B810076AB841E009F"><enum>(2)</enum><text>Capability of the
				organization to adequately perform the activities required under the
				grant.</text>
									</paragraph><paragraph id="H42BE1619607E4D8C00BC6D9E8FDFAA3F"><enum>(3)</enum><text>Satisfactory performance
				standards for the organization in meeting the goals set forth in such grant.
				The standards shall be negotiated and agreed to between the Secretary and the
				grantee on a grant-by-grant basis.</text>
									</paragraph><paragraph id="H5135B192DFFF429088EFA72DC500F14C"><enum>(4)</enum><text>Identification of the
				need for services.</text>
									</paragraph></subsection><subsection id="HDAE97DF62EC945568D607E43B8123888"><enum>(d)</enum><header>Allocation of
				grants</header><text>The Secretary shall develop a methodology for allocating
				grants made pursuant to this section based on the criteria established pursuant
				to subsection (c).</text>
								</subsection><subsection id="H45771E8D3C6F43D496A99E5E2D91C3E5"><enum>(e)</enum><header>Grants subject to
				criteria</header><text>Any grant received by an Urban Indian Organization under
				this Act for substance abuse prevention, treatment, and rehabilitation shall be
				subject to the criteria set forth in subsection (c).</text>
								</subsection></section><section id="HC4CF351E67F148F8A0E9EA5987B79559"><enum>512.</enum><header>Treatment of certain
				demonstration projects</header><text display-inline="no-display-inline">Notwithstanding any other provision of law,
				the Tulsa Clinic and Oklahoma City Clinic demonstration projects shall—</text>
								<paragraph id="HE4E634DDB4764DD58E727D291E2DF361"><enum>(1)</enum><text>be permanent programs
				within the Service’s direct care program;</text>
								</paragraph><paragraph id="H4E9D1A00813B4163AA15EB6EA32F5400"><enum>(2)</enum><text>continue to be treated as
				Service Units and Operating Units in the allocation of resources and
				coordination of care; and</text>
								</paragraph><paragraph id="H5404E90BB48D40328F8E3DFBC1BCEBBC"><enum>(3)</enum><text>continue to meet the
				requirements and definitions of an Urban Indian Organization in this Act, and
				shall not be subject to the provisions of the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance Act (25
				U.S.C. 450 et seq.)</act-name>.</text>
								</paragraph></section><section id="HDBE826FADFAB4011AB8C2057791365A3"><enum>513.</enum><header>Urban NIAAA
				transferred programs</header>
								<subsection id="H02B48B3CBB064FE29E45C62757A84200"><enum>(a)</enum><header>Grants and
				contracts</header><text>The Secretary, through the Division of Urban Indian
				Health, shall make grants or enter into contracts with Urban Indian
				Organizations, to take effect not later than September 30, 2010, for the
				administration of Urban Indian alcohol programs that were originally
				established under the National Institute on Alcoholism and Alcohol Abuse
				(hereafter in this section referred to as <quote>NIAAA</quote>) and transferred
				to the Service.</text>
								</subsection><subsection id="HD3B4F28DB6D743FFB43137AB2B2B5DFA"><enum>(b)</enum><header>Use of
				funds</header><text>Grants provided or contracts entered into under this
				section shall be used to provide support for the continuation of alcohol
				prevention and treatment services for Urban Indian populations and such other
				objectives as are agreed upon between the Service and a recipient of a grant or
				contract under this section.</text>
								</subsection><subsection id="H4F1B81F74E8143FBABF600B9738EF18B"><enum>(c)</enum><header>Eligibility</header><text>Urban
				Indian Organizations that operate Indian alcohol programs originally funded
				under the NIAAA and subsequently transferred to the Service are eligible for
				grants or contracts under this section.</text>
								</subsection><subsection id="H871172EC27A54A10BEECC32248D625E3"><enum>(d)</enum><header>Report</header><text>The
				Secretary shall evaluate and report to Congress on the activities of programs
				funded under this section not less than every 5 years.</text>
								</subsection></section><section id="H35B64385678947E08992BD641ED6A4C6"><enum>514.</enum><header>Consultation with
				Urban Indian Organizations</header>
								<subsection id="H13FC2ED70CA841CCA642D86F6D083020"><enum>(a)</enum><header>In
				general</header><text>The Secretary shall ensure that the Service consults, to
				the greatest extent practicable, with Urban Indian Organizations.</text>
								</subsection><subsection id="HA80419DA557C47B0AE280011F94709FA"><enum>(b)</enum><header>Definition of
				consultation</header><text>For purposes of subsection (a), consultation is the
				open and free exchange of information and opinions which leads to mutual
				understanding and comprehension and which emphasizes trust, respect, and shared
				responsibility.</text>
								</subsection></section><section id="HA1DD93920F6A4D36A0D77D3BFDE5003B"><enum>515.</enum><header>Urban youth treatment
				center demonstration</header>
								<subsection id="HB59632B1AE7749068BEC169F74F6CDF0"><enum>(a)</enum><header>Construction and
				operation</header><text>The Secretary, acting through the Service, through
				grant or contract, is authorized to fund the construction and operation of at
				least 2 residential treatment centers in each State described in subsection (b)
				to demonstrate the provision of alcohol and substance abuse treatment services
				to Urban Indian youth in a culturally competent residential setting.</text>
								</subsection><subsection id="H1109E55C26FB4A9096CE428F0061C7F3"><enum>(b)</enum><header>Definition of
				State</header><text>A State described in this subsection is a State in
				which—</text>
									<paragraph id="HD872CDC9E9C64D8AB65F3B3663DEB8B8"><enum>(1)</enum><text>there resides Urban
				Indian youth with need for alcohol and substance abuse treatment services in a
				residential setting; and</text>
									</paragraph><paragraph id="HA357FC2739924AA5ACA4CA4200EC3B4E"><enum>(2)</enum><text>there is a significant
				shortage of culturally competent residential treatment services for Urban
				Indian youth.</text>
									</paragraph></subsection></section><section id="HB1C4F65CF6FC4E22AB70E682EAC2057D"><enum>516.</enum><header>Grants for diabetes
				prevention, treatment, and control</header>
								<subsection id="H43E868AEF0B248A9B35351804000CE8"><enum>(a)</enum><header>Grants
				authorized</header><text>The Secretary may make grants to those Urban Indian
				Organizations that have entered into a contract or have received a grant under
				this title for the provision of services for the prevention and treatment of,
				and control of the complications resulting from, diabetes among Urban
				Indians.</text>
								</subsection><subsection id="H8532086B788F4BE1A41C41D2C98707F2"><enum>(b)</enum><header>Goals</header><text>Each
				grant made pursuant to subsection (a) shall set forth the goals to be
				accomplished under the grant. The goals shall be specific to each grant as
				agreed to between the Secretary and the grantee.</text>
								</subsection><subsection id="HDA1DB0B7133B43E7B303CDD5A6796729"><enum>(c)</enum><header>Establishment of
				criteria</header><text>The Secretary shall establish criteria for the grants
				made under subsection (a) relating to—</text>
									<paragraph id="HCF453EE76EEB433EBB7E7D5BCA87B6BC"><enum>(1)</enum><text>the size and location of
				the Urban Indian population to be served;</text>
									</paragraph><paragraph id="HAB30B830ED8B4CF1AEF5AD50B45FE1DA"><enum>(2)</enum><text>the need for prevention
				of and treatment of, and control of the complications resulting from, diabetes
				among the Urban Indian population to be served;</text>
									</paragraph><paragraph id="H593B15CA63B3408600548FDD839B001E"><enum>(3)</enum><text>performance standards for
				the organization in meeting the goals set forth in such grant that are
				negotiated and agreed to by the Secretary and the grantee;</text>
									</paragraph><paragraph id="H0F6F36F7BE9246258234ABA48379FA17"><enum>(4)</enum><text>the capability of the
				organization to adequately perform the activities required under the grant;
				and</text>
									</paragraph><paragraph id="HAE8D8A621D8F499A006BC249DE5D81B8"><enum>(5)</enum><text>the willingness of the
				organization to collaborate with the registry, if any, established by the
				Secretary under section 204(e) in the Area Office of the Service in which the
				organization is located.</text>
									</paragraph></subsection><subsection id="H36BFF5BA60814D1B8FC3B14D1562F7AE"><enum>(d)</enum><header>Funds subject to
				criteria</header><text>Any funds received by an Urban Indian Organization under
				this Act for the prevention, treatment, and control of diabetes among Urban
				Indians shall be subject to the criteria developed by the Secretary under
				subsection (c).</text>
								</subsection></section><section id="H6EEAA27177B74282A84E5C6FA74B5543"><enum>517.</enum><header>Community health
				representatives</header><text display-inline="no-display-inline">The Secretary,
				acting through the Service, may enter into contracts with, and make grants to,
				Urban Indian Organizations for the employment of Indians trained as health
				service providers through the Community Health Representatives Program under
				section 109 in the provision of health care, health promotion, and disease
				prevention services to Urban Indians.</text>
							</section><section id="H4A8ECF18307D4E2897A6F9E6C09232F"><enum>518.</enum><header>Effective
				date</header><text display-inline="no-display-inline">The amendments made by
				the <short-title>Indian Health Care Improvement Act
				Amendments of 2007</short-title> to this title shall take effect beginning on
				the date of enactment of that Act, regardless of whether the Secretary has
				promulgated regulations implementing such amendments.</text>
							</section><section id="HC2D72D89B236467D00F5DEE1509F133F"><enum>519.</enum><header>Eligibility for
				services</header><text display-inline="no-display-inline">Urban Indians shall
				be eligible for, and the ultimate beneficiaries of, health care or referral
				services provided pursuant to this title.</text>
							</section><section id="H421A3B67B44447A08FE44CD2B261DEF"><enum>520.</enum><header>Authorization of
				appropriations</header><text display-inline="no-display-inline">There are
				authorized to be appropriated such sums as may be necessary for each fiscal
				year through fiscal year 2017 to carry out this title.</text>
							</section></title><title id="H68E572909A864344B6A16BC3702D1D5D"><enum>VI</enum><header>Organizational
				improvements</header>
							<section id="H3353D0EFE6D644F6B954840705487FFF"><enum>601.</enum><header>Establishment of the
				Indian Health Service as an agency of the Public Health Service</header>
								<subsection id="HE61AED10C5DD4B18B857CFA13CB5B3ED"><enum>(a)</enum><header>Establishment</header>
									<paragraph id="H005FD43536694E20AA4E415D48EE7DD"><enum>(1)</enum><header>In
				general</header><text>In order to more effectively and efficiently carry out
				the responsibilities, authorities, and functions of the United States to
				provide health care services to Indians and Indian Tribes, as are or may be
				hereafter provided by Federal statute or treaties, there is established within
				the Public Health Service of the Department the Indian Health Service.</text>
									</paragraph><paragraph id="HA74969D06D3B4ABB96D7E4709B0031CF"><enum>(2)</enum><header>Assistant Secretary of
				Indian Health</header><text>The Service shall be administered by an Assistant
				Secretary of Indian Health, who shall be appointed by the President, by and
				with the advice and consent of the Senate. The Assistant Secretary shall report
				to the Secretary. Effective with respect to an individual appointed by the
				President, by and with the advice and consent of the Senate, after January 1,
				2007, the term of service of the Assistant Secretary shall be 4 years. An
				Assistant Secretary may serve more than 1 term.</text>
									</paragraph><paragraph id="H156ED82727C7446E94919645D0B0977D"><enum>(3)</enum><header>Incumbent</header><text>The
				individual serving in the position of Director of the Service on the day before
				the date of enactment of the <short-title>Indian Health
				Care Improvement Act Amendments of 2007</short-title> shall serve as Assistant
				Secretary.</text>
									</paragraph><paragraph id="H95517653530B41B09741843853B97313"><enum>(4)</enum><header>Advocacy and
				consultation</header><text>The position of Assistant Secretary is established
				to, in a manner consistent with the government-to-government relationship
				between the United States and Indian Tribes—</text>
										<subparagraph id="HA0F8597FF45340D3BB09795F4E78BA74"><enum>(A)</enum><text>facilitate advocacy for
				the development of appropriate Indian health policy; and</text>
										</subparagraph><subparagraph id="H73F5ED7E74F84BA7BA9F70068DB50500"><enum>(B)</enum><text>promote consultation on
				matters relating to Indian health.</text>
										</subparagraph></paragraph></subsection><subsection id="H8EDBD0AB56234C548F3F711D5C8C80D7"><enum>(b)</enum><header>Agency</header><text>The
				Service shall be an agency within the Public Health Service of the Department,
				and shall not be an office, component, or unit of any other agency of the
				Department.</text>
								</subsection><subsection id="H63BAC3D4C0B7486B9D64D7C77887E4F5"><enum>(c)</enum><header>Duties</header><text>The
				Assistant Secretary shall—</text>
									<paragraph id="HB92786F2F9114887BCEF1E1857E07DC6"><enum>(1)</enum><text>perform all functions
				that were, on the day before the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, carried out by or under the direction of the individual
				serving as Director of the Service on that day;</text>
									</paragraph><paragraph id="HD02427A83A554952B1FFADF9CBF9F2C"><enum>(2)</enum><text>perform all functions of
				the Secretary relating to the maintenance and operation of hospital and health
				facilities for Indians and the planning for, and provision and utilization of,
				health services for Indians;</text>
									</paragraph><paragraph id="HACD04A699E52456982A7A570B1509671"><enum>(3)</enum><text>administer all health
				programs under which health care is provided to Indians based upon their status
				as Indians which are administered by the Secretary, including programs
				under—</text>
										<subparagraph id="HBADCEBF515AD47DEB2A554EEE03841F2"><enum>(A)</enum><text>this Act;</text>
										</subparagraph><subparagraph id="H108ED634828C4CD5992752804909AF59"><enum>(B)</enum><text>the Act of November 2,
				1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>);</text>
										</subparagraph><subparagraph id="H67E205552FBF41638B61789B3F8D2B5F"><enum>(C)</enum><text>the Act of August 5, 1954
				(<external-xref legal-doc="usc" parsable-cite="usc/42/2001">42 U.S.C. 2001 et seq.</external-xref>);</text>
										</subparagraph><subparagraph id="HA4088EFF2D18462991E9F98CD563AAAE"><enum>(D)</enum><text>the Act of August 16,
				1957 (<external-xref legal-doc="usc" parsable-cite="usc/42/2005">42 U.S.C. 2005 et seq.</external-xref>); and</text>
										</subparagraph><subparagraph id="H823883BCBBE940708561736BD7DFB445"><enum>(E)</enum><text>the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>);</text>
										</subparagraph></paragraph><paragraph id="HB49CD40D0BDE4770A3858127B9375F22"><enum>(4)</enum><text>administer all
				scholarship and loan functions carried out under title I;</text>
									</paragraph><paragraph id="HE917E7C7BC1E411E9BAB83128D83B400"><enum>(5)</enum><text>report directly to the
				Secretary concerning all policy- and budget-related matters affecting Indian
				health;</text>
									</paragraph><paragraph id="H3E8E680463304618AAD8EE8F07E93D62"><enum>(6)</enum><text>collaborate with the
				Assistant Secretary for Health concerning appropriate matters of Indian health
				that affect the agencies of the Public Health Service;</text>
									</paragraph><paragraph id="HC881FCD7FA3C44FEA4A8AD9C9B00A5E4"><enum>(7)</enum><text>advise each Assistant
				Secretary of the Department concerning matters of Indian health with respect to
				which that Assistant Secretary has authority and responsibility;</text>
									</paragraph><paragraph id="HA129C207C32043B1BC44CFE8EF23DED8"><enum>(8)</enum><text>advise the heads of other
				agencies and programs of the Department concerning matters of Indian health
				with respect to which those heads have authority and responsibility;</text>
									</paragraph><paragraph id="H102F1ED859E24975B64BFFCDCC8BF443"><enum>(9)</enum><text>coordinate the activities
				of the Department concerning matters of Indian health; and</text>
									</paragraph><paragraph id="H274D1D2E7DC94957B789DDC4E4A56086"><enum>(10)</enum><text>perform such other
				functions as the Secretary may designate.</text>
									</paragraph></subsection><subsection id="H7A22D36C7B9C4CE8A862269F38D6ABE"><enum>(d)</enum><header>Authority</header>
									<paragraph id="HCBF20B3008814316A9E2B736C87600DB"><enum>(1)</enum><header>In
				general</header><text>The Secretary, acting through the Assistant Secretary,
				shall have the authority—</text>
										<subparagraph id="HF9670F94113845B0AA3399CF0413A29C"><enum>(A)</enum><text>except to the extent
				provided for in paragraph (2), to appoint and compensate employees for the
				Service in accordance with title 5, United States Code;</text>
										</subparagraph><subparagraph id="HC85F0A0643B146A8A2482DDB37535428"><enum>(B)</enum><text>to enter into contracts
				for the procurement of goods and services to carry out the functions of the
				Service; and</text>
										</subparagraph><subparagraph id="HE428A9E3BDC44EE8953898AF00E9556E"><enum>(C)</enum><text>to manage, expend, and
				obligate all funds appropriated for the Service.</text>
										</subparagraph></paragraph><paragraph id="HFB194BC555AC44E9AA4B5D2CE5D65246"><enum>(2)</enum><header>Personnel
				actions</header><text>Notwithstanding any other provision of law, the
				provisions of section 12 of the Act of June 18, 1934 (48 Stat. 986; 25 U.S.C.
				472), shall apply to all personnel actions taken with respect to new positions
				created within the Service as a result of its establishment under subsection
				(a).</text>
									</paragraph></subsection><subsection id="H2F55729311DF4C4ABE638888A004E76"><enum>(e)</enum><header>References</header><text>Any
				reference to the Director of the Indian Health Service in any other Federal
				law, Executive order, rule, regulation, or delegation of authority, or in any
				document of or relating to the Director of the Indian Health Service, shall be
				deemed to refer to the Assistant Secretary.</text>
								</subsection></section><section id="HE990B1235AB94E03ADF19E5536FDC0DC"><enum>602.</enum><header>Automated management
				information system</header>
								<subsection id="H128F7CC391AE45BDAF00939F7F736839"><enum>(a)</enum><header>Establishment</header>
									<paragraph id="H290CEF058436463A90F7EEA63C4302CC"><enum>(1)</enum><header>In
				general</header><text>The Secretary shall establish an automated management
				information system for the Service.</text>
									</paragraph><paragraph id="H695EFAEEF8254DD8B630E9D3A8412813"><enum>(2)</enum><header>Requirements of
				system</header><text>The information system established under paragraph (1)
				shall include—</text>
										<subparagraph id="H6B7388B8786340CCBF21003400634562"><enum>(A)</enum><text>a financial management
				system;</text>
										</subparagraph><subparagraph id="H657D382F882148DEBCFAB1A56126B3BC"><enum>(B)</enum><text>a patient care
				information system for each area served by the Service;</text>
										</subparagraph><subparagraph id="H337F3C2119004885A02B8282964C94FB"><enum>(C)</enum><text>a privacy component that
				protects the privacy of patient information held by, or on behalf of, the
				Service;</text>
										</subparagraph><subparagraph id="HE0FF7C805F01488000EAA82904791605"><enum>(D)</enum><text>a services-based cost
				accounting component that provides estimates of the costs associated with the
				provision of specific medical treatments or services in each Area office of the
				Service;</text>
										</subparagraph><subparagraph id="H5220ACF1F85F4511AE818B9D449F8B29"><enum>(E)</enum><text>an interface mechanism
				for patient billing and accounts receivable system; and</text>
										</subparagraph><subparagraph id="HB3F478119D4A4F2FBF092CD71366D2A3"><enum>(F)</enum><text>a training
				component.</text>
										</subparagraph></paragraph></subsection><subsection id="HFB1A7098AB564BC38DE90624328DF73"><enum>(b)</enum><header>Provision of systems to
				tribes and organizations</header><text>The Secretary shall provide each Tribal
				Health Program automated management information systems which—</text>
									<paragraph id="H33825B7F39F04EFDB88F471C1D9FB97E"><enum>(1)</enum><text>meet the management
				information needs of such Tribal Health Program with respect to the treatment
				by the Tribal Health Program of patients of the Service; and</text>
									</paragraph><paragraph id="H09113086A27044F2ACF97F77DDD9A8BD"><enum>(2)</enum><text>meet the management
				information needs of the Service.</text>
									</paragraph></subsection><subsection id="HC1ACB2C21BDC49F892007EFCAD324B1E"><enum>(c)</enum><header>Access to
				records</header><text>Notwithstanding any other provision of law, each patient
				shall have reasonable access to the medical or health records of such patient
				which are held by, or on behalf of, the Service.</text>
								</subsection><subsection id="H422716FA84A94B44B52C41DC9EAF3D63"><enum>(d)</enum><header>Authority To enhance
				information technology</header><text>The Secretary, acting through the
				Assistant Secretary, shall have the authority to enter into contracts,
				agreements, or joint ventures with other Federal agencies, States, private and
				nonprofit organizations, for the purpose of enhancing information technology in
				Indian Health Programs and facilities.</text>
								</subsection></section><section id="H077E53D0213D496FAC72AAF51C1CBE84"><enum>603.</enum><header>Authorization of
				appropriations</header><text display-inline="no-display-inline">There is
				authorized to be appropriated such sums as may be necessary for each fiscal
				year through fiscal year 2017 to carry out this title.</text>
							</section></title><title id="H1C35625D7BDF405D94000062F800E093"><enum>VII</enum><header>Behavioral health
				programs</header>
							<section id="H3E46D697950244A883D058A6F126DA62"><enum>701.</enum><header>Behavioral health
				prevention and treatment services</header>
								<subsection id="HC9A0D9DBD74049DBA3C052D00B61507"><enum>(a)</enum><header>Purposes</header><text>The
				purposes of this section are as follows:</text>
									<paragraph id="H860E88B7F50B488E95D9F259CB88BD14"><enum>(1)</enum><text>To authorize and direct
				the Secretary, acting through the Service, Indian Tribes, Tribal Organizations,
				and Urban Indian Organizations, to develop a comprehensive behavioral health
				prevention and treatment program which emphasizes collaboration among alcohol
				and substance abuse, social services, and mental health programs.</text>
									</paragraph><paragraph id="HA341A4EFF5EB43CC8ECE96631C210059"><enum>(2)</enum><text>To provide information,
				direction, and guidance relating to mental illness and dysfunction and
				self-destructive behavior, including child abuse and family violence, to those
				Federal, tribal, State, and local agencies responsible for programs in Indian
				communities in areas of health care, education, social services, child and
				family welfare, alcohol and substance abuse, law enforcement, and judicial
				services.</text>
									</paragraph><paragraph id="HA9F7671F09F74868A770D21398834326"><enum>(3)</enum><text>To assist Indian Tribes
				to identify services and resources available to address mental illness and
				dysfunctional and self-destructive behavior.</text>
									</paragraph><paragraph id="H58A82FF891934AA38D187BF85D773E8B"><enum>(4)</enum><text>To provide authority and
				opportunities for Indian Tribes and Tribal Organizations to develop, implement,
				and coordinate with community-based programs which include identification,
				prevention, education, referral, and treatment services, including through
				multidisciplinary resource teams.</text>
									</paragraph><paragraph id="H54EAC0275D53438AB4E6E0D49114636B"><enum>(5)</enum><text>To ensure that Indians,
				as citizens of the United States and of the States in which they reside, have
				the same access to behavioral health services to which all citizens have
				access.</text>
									</paragraph><paragraph id="H1A199BD813804C78A2552B38C61BCB77"><enum>(6)</enum><text>To modify or supplement
				existing programs and authorities in the areas identified in paragraph
				(2).</text>
									</paragraph></subsection><subsection id="H38688A90DD874B3396F79BD5CB636B6"><enum>(b)</enum><header>Plans</header>
									<paragraph id="H294E22FE419840508F7B42AEBC59375D"><enum>(1)</enum><header>Development</header><text>The
				Secretary, acting through the Service, Indian Tribes, Tribal Organizations, and
				Urban Indian Organizations, shall encourage Indian Tribes and Tribal
				Organizations to develop tribal plans, and Urban Indian Organizations to
				develop local plans, and for all such groups to participate in developing
				areawide plans for Indian Behavioral Health Services. The plans shall include,
				to the extent feasible, the following components:</text>
										<subparagraph id="H2FC58F227FBF4AD4B083E17700FB2D1B"><enum>(A)</enum><text>An assessment of the
				scope of alcohol or other substance abuse, mental illness, and dysfunctional
				and self-destructive behavior, including suicide, child abuse, and family
				violence, among Indians, including—</text>
											<clause id="H014C5ECA6A7F424A8758732236B5F2A9"><enum>(i)</enum><text>the number of Indians
				served who are directly or indirectly affected by such illness or behavior;
				or</text>
											</clause><clause id="H8D11C93BD9974AA99441B100FD002946"><enum>(ii)</enum><text>an estimate of the
				financial and human cost attributable to such illness or behavior.</text>
											</clause></subparagraph><subparagraph id="H7DE2677E1E5B4C3CA406172274D19B9"><enum>(B)</enum><text>An assessment of the
				existing and additional resources necessary for the prevention and treatment of
				such illness and behavior, including an assessment of the progress toward
				achieving the availability of the full continuum of care described in
				subsection (c).</text>
										</subparagraph><subparagraph id="H68F95A08EE374130AFF5DF99F55FD337"><enum>(C)</enum><text>An estimate of the
				additional funding needed by the Service, Indian Tribes, Tribal Organizations,
				and Urban Indian Organizations to meet their responsibilities under the
				plans.</text>
										</subparagraph></paragraph><paragraph id="H6E6E2875A47C40FABDF96B842237D38F"><enum>(2)</enum><header>National
				clearinghouse</header><text>The Secretary, acting through the Service, shall
				coordinate with existing national clearinghouses and information centers to
				include at the clearinghouses and centers plans and reports on the outcomes of
				such plans developed by Indian Tribes, Tribal Organizations, Urban Indian
				Organizations, and Service Areas relating to behavioral health. The Secretary
				shall ensure access to these plans and outcomes by any Indian Tribe, Tribal
				Organization, Urban Indian Organization, or the Service.</text>
									</paragraph><paragraph id="H30BC23EB22054BDD8233EA00A1C72E95"><enum>(3)</enum><header>Technical
				assistance</header><text>The Secretary shall provide technical assistance to
				Indian Tribes, Tribal Organizations, and Urban Indian Organizations in
				preparation of plans under this section and in developing standards of care
				that may be used and adopted locally.</text>
									</paragraph></subsection><subsection id="H871CB70DE1EC4E62A92368459C904926"><enum>(c)</enum><header>Programs</header><text>The
				Secretary, acting through the Service, Indian Tribes, and Tribal Organizations,
				shall provide, to the extent feasible and if funding is available, programs
				including the following:</text>
									<paragraph id="H0D104D87EFC645AC8D5BD478C7705800"><enum>(1)</enum><header>Comprehensive
				care</header><text>A comprehensive continuum of behavioral health care which
				provides—</text>
										<subparagraph id="H23CEBE91846740E980094707D2494C2F"><enum>(A)</enum><text>community-based
				prevention, intervention, outpatient, and behavioral health aftercare;</text>
										</subparagraph><subparagraph id="H9A6DE87C66A34F1AAE1568CC82D423D9"><enum>(B)</enum><text>detoxification (social
				and medical);</text>
										</subparagraph><subparagraph id="H4B6A71A10BD64362BF1319781319002F"><enum>(C)</enum><text>acute
				hospitalization;</text>
										</subparagraph><subparagraph id="H49607505375E451CA63C122B3DA006F"><enum>(D)</enum><text>intensive outpatient/day
				treatment;</text>
										</subparagraph><subparagraph id="H620B1CD9879C4C308E49575E49A9C5B6"><enum>(E)</enum><text>residential
				treatment;</text>
										</subparagraph><subparagraph id="H3C6189D45DEE49E5AD1BB4257CA45BFE"><enum>(F)</enum><text>transitional living for
				those needing a temporary, stable living environment that is supportive of
				treatment and recovery goals;</text>
										</subparagraph><subparagraph id="H1028BF7B591E43C18BE2E058BD9E1B61"><enum>(G)</enum><text>emergency shelter;</text>
										</subparagraph><subparagraph id="HAAEFF94D15DD4BCBAF9FF532BA61A9FD"><enum>(H)</enum><text>intensive case
				management; and</text>
										</subparagraph><subparagraph id="H1FB7941CDCD84E5AA20842FADE49F080"><enum>(I)</enum><text>diagnostic
				services.</text>
										</subparagraph></paragraph><paragraph id="H9B1EA404580B47DF84CD00D2A8B5329"><enum>(2)</enum><header>Child
				care</header><text>Behavioral health services for Indians from birth through
				age 17, including—</text>
										<subparagraph id="H63DB514E5AF146B89F97CCCA0467758B"><enum>(A)</enum><text>preschool and school age
				fetal alcohol disorder services, including assessment and behavioral
				intervention;</text>
										</subparagraph><subparagraph id="HE49520B8B2194AB50030F7AE6D8E36C9"><enum>(B)</enum><text>mental health and
				substance abuse services (emotional, organic, alcohol, drug, inhalant, and
				tobacco);</text>
										</subparagraph><subparagraph id="H2435275373364D72B3A0BB1BC083F8C"><enum>(C)</enum><text>identification and
				treatment of co-occurring disorders and comorbidity;</text>
										</subparagraph><subparagraph id="HAF208E6CB7144EBF9B81057C3FFBD1E9"><enum>(D)</enum><text>prevention of alcohol,
				drug, inhalant, and tobacco use;</text>
										</subparagraph><subparagraph id="HA236AC094FC54A559B41B371E6013036"><enum>(E)</enum><text>early intervention,
				treatment, and aftercare;</text>
										</subparagraph><subparagraph id="H3A7BBF4B737849B5003030E5F0D4F08F"><enum>(F)</enum><text>promotion of healthy
				approaches to risk and safety issues; and</text>
										</subparagraph><subparagraph id="HD0AED9C016BB48119B6F931D050386BB"><enum>(G)</enum><text>identification and
				treatment of neglect and physical, mental, and sexual abuse.</text>
										</subparagraph></paragraph><paragraph id="H6332953F037A4662B9487DDB47D9DDED"><enum>(3)</enum><header>Adult
				care</header><text>Behavioral health services for Indians from age 18 through
				55, including—</text>
										<subparagraph id="HDF7EF32070A04BA5A3AA343E03269D59"><enum>(A)</enum><text>early intervention,
				treatment, and aftercare;</text>
										</subparagraph><subparagraph id="H9F9337713DE34588007FF6A000E7AFFA"><enum>(B)</enum><text>mental health and
				substance abuse services (emotional, alcohol, drug, inhalant, and tobacco),
				including sex specific services;</text>
										</subparagraph><subparagraph id="HE6DDA7D478C742208159BF292D39E9C"><enum>(C)</enum><text>identification and
				treatment of co-occurring disorders (dual diagnosis) and comorbidity;</text>
										</subparagraph><subparagraph id="HA137AD6BA495443C9500EFFA68C1C6BB"><enum>(D)</enum><text>promotion of healthy
				approaches for risk-related behavior;</text>
										</subparagraph><subparagraph id="H44FEFF0659924DE0BE786D88FDD419C5"><enum>(E)</enum><text>treatment services for
				women at risk of giving birth to a child with a fetal alcohol disorder;
				and</text>
										</subparagraph><subparagraph id="H044A943AE5A543F28C8CC26EFF390393"><enum>(F)</enum><text>sex specific treatment
				for sexual assault and domestic violence.</text>
										</subparagraph></paragraph><paragraph id="H67B7147B48584101B5EEE9715DA84005"><enum>(4)</enum><header>Family
				care</header><text>Behavioral health services for families, including—</text>
										<subparagraph id="HC0F3465D8D354A5BB45FB5C30406E13B"><enum>(A)</enum><text>early intervention,
				treatment, and aftercare for affected families;</text>
										</subparagraph><subparagraph id="HE0C38C2164A3406396A3008E6009291F"><enum>(B)</enum><text>treatment for sexual
				assault and domestic violence; and</text>
										</subparagraph><subparagraph id="H431A2B43769C4514B6AB8634001D33DA"><enum>(C)</enum><text>promotion of healthy
				approaches relating to parenting, domestic violence, and other abuse
				issues.</text>
										</subparagraph></paragraph><paragraph id="HF7017FCA4E3C4AF1B1A6A5832168BDF"><enum>(5)</enum><header>Elder
				care</header><text>Behavioral health services for Indians 56 years of age and
				older, including—</text>
										<subparagraph id="HC9B6623F9CB34589BA99A8A25F65BA91"><enum>(A)</enum><text>early intervention,
				treatment, and aftercare;</text>
										</subparagraph><subparagraph id="H881C14973E38439F9CA9DE8CE5EDFC39"><enum>(B)</enum><text>mental health and
				substance abuse services (emotional, alcohol, drug, inhalant, and tobacco),
				including sex specific services;</text>
										</subparagraph><subparagraph id="H4AD90EF3FCA04730B4BFE14CFA148300"><enum>(C)</enum><text>identification and
				treatment of co-occurring disorders (dual diagnosis) and comorbidity;</text>
										</subparagraph><subparagraph id="HC2A7A6A417F94BB4B4795FC8BBEC535D"><enum>(D)</enum><text>promotion of healthy
				approaches to managing conditions related to aging;</text>
										</subparagraph><subparagraph id="H68DD9420357143B8918D2B171C707E60"><enum>(E)</enum><text>sex specific treatment
				for sexual assault, domestic violence, neglect, physical and mental abuse and
				exploitation; and</text>
										</subparagraph><subparagraph id="HBA0258701A8E4E3CA9D3D9241BBC5FD"><enum>(F)</enum><text>identification and
				treatment of dementias regardless of cause.</text>
										</subparagraph></paragraph></subsection><subsection id="H95360423139A4BAA9DFA69DB180991FF"><enum>(d)</enum><header>Community behavioral
				health plan</header>
									<paragraph id="H4CDB3E0BE6C54FD1A90595608F9E4E32"><enum>(1)</enum><header>Establishment</header><text>The
				governing body of any Indian Tribe, Tribal Organization, or Urban Indian
				Organization may adopt a resolution for the establishment of a community
				behavioral health plan providing for the identification and coordination of
				available resources and programs to identify, prevent, or treat substance
				abuse, mental illness, or dysfunctional and self-destructive behavior,
				including child abuse and family violence, among its members or its service
				population. This plan should include behavioral health services, social
				services, intensive outpatient services, and continuing aftercare.</text>
									</paragraph><paragraph id="HB18ED0D39B0C4D399283F980684BA385"><enum>(2)</enum><header>Technical
				assistance</header><text>At the request of an Indian Tribe, Tribal
				Organization, or Urban Indian Organization, the Bureau of Indian Affairs and
				the Service shall cooperate with and provide technical assistance to the Indian
				Tribe, Tribal Organization, or Urban Indian Organization in the development and
				implementation of such plan.</text>
									</paragraph><paragraph id="H2F932C8FCDD5430496FCABD1EDC85FCA"><enum>(3)</enum><header>Funding</header><text>The
				Secretary, acting through the Service, may make funding available to Indian
				Tribes and Tribal Organizations which adopt a resolution pursuant to paragraph
				(1) to obtain technical assistance for the development of a community
				behavioral health plan and to provide administrative support in the
				implementation of such plan.</text>
									</paragraph></subsection><subsection id="H14847E7965764C8E8F97CAA082646CE8"><enum>(e)</enum><header>Coordination for
				availability of services</header><text>The Secretary, acting through the
				Service, Indian Tribes, Tribal Organizations, and Urban Indian Organizations,
				shall coordinate behavioral health planning, to the extent feasible, with other
				Federal agencies and with State agencies, to encourage comprehensive behavioral
				health services for Indians regardless of their place of residence.</text>
								</subsection><subsection id="HF48370F4EC09434AA094AFF3CC007C"><enum>(f)</enum><header>Mental health care need
				assessment</header><text>Not later than 1 year after the date of enactment of
				the <short-title>Indian Health Care Improvement Act
				Amendments of 2007</short-title>, the Secretary, acting through the Service,
				shall make an assessment of the need for inpatient mental health care among
				Indians and the availability and cost of inpatient mental health facilities
				which can meet such need. In making such assessment, the Secretary shall
				consider the possible conversion of existing, underused Service hospital beds
				into psychiatric units to meet such need.</text>
								</subsection></section><section id="H15AF39EC36A341D1A083E73C5458B99"><enum>702.</enum><header>Memoranda of agreement
				with the Department of the Interior</header>
								<subsection id="H658424BD57A04D4E9CC1E9A72187FBF8"><enum>(a)</enum><header>Contents</header><text>Not
				later than 12 months after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, the Secretary, acting through the Service, and the
				Secretary of the Interior shall develop and enter into a memoranda of
				agreement, or review and update any existing memoranda of agreement, as
				required by section 4205 of the Indian Alcohol and Substance Abuse Prevention
				and Treatment Act of 1986 (<external-xref legal-doc="usc" parsable-cite="usc/25/2411">25 U.S.C. 2411</external-xref>) under which the Secretaries address
				the following:</text>
									<paragraph id="H88DEEAB314DA44368155EFCCA4742C58"><enum>(1)</enum><text>The scope and nature of
				mental illness and dysfunctional and self-destructive behavior, including child
				abuse and family violence, among Indians.</text>
									</paragraph><paragraph id="HE537B80588304950A334354521DE773C"><enum>(2)</enum><text>The existing Federal,
				tribal, State, local, and private services, resources, and programs available
				to provide behavioral health services for Indians.</text>
									</paragraph><paragraph id="H2790C42F554D46F79F68DD938929B22B"><enum>(3)</enum><text>The unmet need for
				additional services, resources, and programs necessary to meet the needs
				identified pursuant to paragraph (1).</text>
									</paragraph><paragraph id="H5F92B99A2300403DA5130053EC8AB7D"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="HAF5409D67F144A0B865D880254C7F85E"><enum>(A)</enum><text>The right of Indians, as
				citizens of the United States and of the States in which they reside, to have
				access to behavioral health services to which all citizens have access.</text>
										</subparagraph><subparagraph changed="added" committee-id="HII00" id="H11B9CB42D49440BC9D2440C3B91C3042" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>The right of Indians to
				participate in, and receive the benefit of, such services.</text>
										</subparagraph><subparagraph changed="added" committee-id="HII00" id="HD2636EC7668B459089ADBADAB192FDEE" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>The actions necessary to
				protect the exercise of such right.</text>
										</subparagraph></paragraph><paragraph id="H500CF80A3552494D82B1FDF17F748D2E"><enum>(5)</enum><text>The responsibilities of
				the Bureau of Indian Affairs and the Service, including mental illness
				identification, prevention, education, referral, and treatment services
				(including services through multidisciplinary resource teams), at the central,
				area, and agency and Service Unit, Service Area, and headquarters levels to
				address the problems identified in paragraph (1).</text>
									</paragraph><paragraph id="H9B0349FA3BAB473DA100DE3CE54FAD44"><enum>(6)</enum><text>A strategy for the
				comprehensive coordination of the behavioral health services provided by the
				Bureau of Indian Affairs and the Service to meet the problems identified
				pursuant to paragraph (1), including—</text>
										<subparagraph id="HAC0C7CBCC8E542C987456F13145BD054"><enum>(A)</enum><text>the coordination of
				alcohol and substance abuse programs of the Service, the Bureau of Indian
				Affairs, and Indian Tribes and Tribal Organizations (developed under the Indian
				Alcohol and Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C.
				2401 et seq.)) with behavioral health initiatives pursuant to this Act,
				particularly with respect to the referral and treatment of dually diagnosed
				individuals requiring behavioral health and substance abuse treatment;
				and</text>
										</subparagraph><subparagraph id="H96AEAC0ED6F84B7E93A87823AEE99ED9"><enum>(B)</enum><text>ensuring that the Bureau
				of Indian Affairs and Service programs and services (including
				multidisciplinary resource teams) addressing child abuse and family violence
				are coordinated with such non-Federal programs and services.</text>
										</subparagraph></paragraph><paragraph id="HE13DE2A45E0546FC8430DFA8CA874FE6"><enum>(7)</enum><text>Directing appropriate
				officials of the Bureau of Indian Affairs and the Service, particularly at the
				agency and Service Unit levels, to cooperate fully with tribal requests made
				pursuant to community behavioral health plans adopted under section 701(c) and
				section 4206 of the Indian Alcohol and Substance Abuse Prevention and Treatment
				Act of 1986 (<external-xref legal-doc="usc" parsable-cite="usc/25/2412">25 U.S.C. 2412</external-xref>).</text>
									</paragraph><paragraph id="HE2280BB7AE27447F815BF446C520727"><enum>(8)</enum><text>Providing for an annual
				review of such agreement by the Secretaries which shall be provided to Congress
				and Indian Tribes and Tribal Organizations.</text>
									</paragraph></subsection><subsection id="H0DA7A9609F7347A4A811CC0572E7F65E"><enum>(b)</enum><header>Specific provisions
				required</header><text>The memoranda of agreement updated or entered into
				pursuant to subsection (a) shall include specific provisions pursuant to which
				the Service shall assume responsibility for—</text>
									<paragraph id="HC30EA71F12FA4F1A8ED53E1A67F286D"><enum>(1)</enum><text>the determination of the
				scope of the problem of alcohol and substance abuse among Indians, including
				the number of Indians within the jurisdiction of the Service who are directly
				or indirectly affected by alcohol and substance abuse and the financial and
				human cost;</text>
									</paragraph><paragraph id="HC5EEB3DD4BFD4DE4944D6B48369E59F7"><enum>(2)</enum><text>an assessment of the
				existing and needed resources necessary for the prevention of alcohol and
				substance abuse and the treatment of Indians affected by alcohol and substance
				abuse; and</text>
									</paragraph><paragraph id="HC3E6542173264398A0B7EE00DC7B6C87"><enum>(3)</enum><text>an estimate of the
				funding necessary to adequately support a program of prevention of alcohol and
				substance abuse and treatment of Indians affected by alcohol and substance
				abuse.</text>
									</paragraph></subsection><subsection id="H58491B954887466E9F2870DB726DB01"><enum>(c)</enum><header>Publication</header><text>Each
				memorandum of agreement entered into or renewed (and amendments or
				modifications thereto) under subsection (a) shall be published in the Federal
				Register. At the same time as publication in the Federal Register, the
				Secretary shall provide a copy of such memoranda, amendment, or modification to
				each Indian Tribe, Tribal Organization, and Urban Indian Organization.</text>
								</subsection></section><section id="HDB66C4AA56334066A47DC055417C3C03"><enum>703.</enum><header>Comprehensive
				behavioral health prevention and treatment program</header>
								<subsection id="HC3F95853BD68417EA3AA4EF99F33D55C"><enum>(a)</enum><header>Establishment</header>
									<paragraph id="H16CB6FC2198E4864A336DA5D65ADA000"><enum>(1)</enum><header>In
				general</header><text>The Secretary, acting through the Service, Indian Tribes,
				and Tribal Organizations, shall provide a program of comprehensive behavioral
				health, prevention, treatment, and aftercare, which shall include—</text>
										<subparagraph id="H1F71E23C7BF3407A91004EAF29E91B2B"><enum>(A)</enum><text>prevention, through
				educational intervention, in Indian communities;</text>
										</subparagraph><subparagraph id="H457C8BF50AA349E5BDFF85BCB7FB0EE"><enum>(B)</enum><text>acute detoxification,
				psychiatric hospitalization, residential, and intensive outpatient
				treatment;</text>
										</subparagraph><subparagraph id="H6F62955B71F84A77A839C06005868003"><enum>(C)</enum><text>community-based
				rehabilitation and aftercare;</text>
										</subparagraph><subparagraph id="H929AC53C280949C49633738D29EE692B"><enum>(D)</enum><text>community education and
				involvement, including extensive training of health care, educational, and
				community-based personnel;</text>
										</subparagraph><subparagraph id="H12F3C2BB939D4DA8B893DEDA7FD1D040"><enum>(E)</enum><text>specialized residential
				treatment programs for high-risk populations, including pregnant and postpartum
				women and their children; and</text>
										</subparagraph><subparagraph id="H2712AC549BBA44159DEEB589F06B92C6"><enum>(F)</enum><text>diagnostic
				services.</text>
										</subparagraph></paragraph><paragraph id="H5BA014063A2242F98B625EACF2DD9500"><enum>(2)</enum><header>Target
				populations</header><text>The target population of such programs shall be
				members of Indian Tribes. Efforts to train and educate key members of the
				Indian community shall also target employees of health, education, judicial,
				law enforcement, legal, and social service programs.</text>
									</paragraph></subsection><subsection id="H56D601DB37B34D8A946DF2A6C031C013"><enum>(b)</enum><header>Contract health
				services</header>
									<paragraph id="HB235CDEDA48742F29C391B32A4A1679E"><enum>(1)</enum><header>In
				general</header><text>The Secretary, acting through the Service, Indian Tribes,
				and Tribal Organizations, may enter into contracts with public or private
				providers of behavioral health treatment services for the purpose of carrying
				out the program required under subsection (a).</text>
									</paragraph><paragraph id="H6EAC79198293433AA6D8FA899D850074"><enum>(2)</enum><header>Provision of
				assistance</header><text>In carrying out this subsection, the Secretary shall
				provide assistance to Indian Tribes and Tribal Organizations to develop
				criteria for the certification of behavioral health service providers and
				accreditation of service facilities which meet minimum standards for such
				services and facilities.</text>
									</paragraph></subsection></section><section id="HC956226FF04548D4B7DD7F1DCB8500B0"><enum>704.</enum><header>Mental health
				technician program</header>
								<subsection id="H7D44B851743C4D589E8D63F34171FEF5"><enum>(a)</enum><header>In
				general</header><text>Under the authority of the Act of November 2, 1921 (25
				U.S.C. 13) (commonly known as the <quote>Snyder Act</quote>), the Secretary
				shall establish and maintain a mental health technician program within the
				Service which—</text>
									<paragraph id="H5E351DCB179B4F8BA33D003EDA981209"><enum>(1)</enum><text>provides for the training
				of Indians as mental health technicians; and</text>
									</paragraph><paragraph id="H5E56CBAD921D4CF6A9F6CD9757106C3C"><enum>(2)</enum><text>employs such technicians
				in the provision of community-based mental health care that includes
				identification, prevention, education, referral, and treatment services.</text>
									</paragraph></subsection><subsection id="HDE3AB142E6BA477795585E791580C2EA"><enum>(b)</enum><header>Paraprofessional
				training</header><text>In carrying out subsection (a), the Secretary, acting
				through the Service, Indian Tribes, and Tribal Organizations, shall provide
				high-standard paraprofessional training in mental health care necessary to
				provide quality care to the Indian communities to be served. Such training
				shall be based upon a curriculum developed or approved by the Secretary which
				combines education in the theory of mental health care with supervised
				practical experience in the provision of such care.</text>
								</subsection><subsection id="H9CD0E0E2AE514172BC6E00119795C9DB"><enum>(c)</enum><header>Supervision and
				evaluation of technicians</header><text>The Secretary, acting through the
				Service, Indian Tribes, and Tribal Organizations, shall supervise and evaluate
				the mental health technicians in the training program.</text>
								</subsection><subsection id="H0029EFA7D23D42D4854971A328BAAD27"><enum>(d)</enum><header>Traditional health care
				practices</header><text>The Secretary, acting through the Service, shall ensure
				that the program established pursuant to this subsection involves the use and
				promotion of the traditional health care practices of the Indian Tribes to be
				served.</text>
								</subsection></section><section id="HF6E8D124387847A99C97DEB8EA64EDE3"><enum>705.</enum><header>Licensing requirement
				for mental health care workers</header>
								<subsection id="H7393E3AF11F746A9BD8512DBBCD44C15"><enum>(a)</enum><header>In
				general</header><text>Subject to the provisions of section 221, and except as
				provided in subsection (b), any individual employed as a psychologist, social
				worker, or marriage and family therapist for the purpose of providing mental
				health care services to Indians in a clinical setting under this Act is
				required to be licensed as a psychologist, social worker, or marriage and
				family therapist, respectively.</text>
								</subsection><subsection id="H339E1A563ED54F44BBA162564CEC6B0"><enum>(b)</enum><header>Trainees</header><text>An
				individual may be employed as a trainee in psychology, social work, or marriage
				and family therapy to provide mental health care services described in
				subsection (a) if such individual—</text>
									<paragraph id="HCC0958C270D349A08801B7598456FCF8"><enum>(1)</enum><text>works under the direct
				supervision of a licensed psychologist, social worker, or marriage and family
				therapist, respectively;</text>
									</paragraph><paragraph id="H60D0F55D5A824825A3BFAE3445F20025"><enum>(2)</enum><text>is enrolled in or has
				completed at least 2 years of course work at a post-secondary, accredited
				education program for psychology, social work, marriage and family therapy, or
				counseling; and</text>
									</paragraph><paragraph id="HF0CDBFAE13E148488B80008877EE81C4"><enum>(3)</enum><text>meets such other
				training, supervision, and quality review requirements as the Secretary may
				establish.</text>
									</paragraph></subsection></section><section id="H69644AF270724B9496E1E137522FB4EB"><enum>706.</enum><header>Indian women treatment
				programs</header>
								<subsection id="H29F4FFF63C304DB9A3D010536721C5DE"><enum>(a)</enum><header>Grants</header><text>The
				Secretary, consistent with section 701, may make grants to Indian Tribes,
				Tribal Organizations, and Urban Indian Organizations to develop and implement a
				comprehensive behavioral health program of prevention, intervention, treatment,
				and relapse prevention services that specifically addresses the cultural,
				historical, social, and child care needs of Indian women, regardless of
				age.</text>
								</subsection><subsection id="H8CE4CFE6742C41CC9E9E3F47E65DBDF4"><enum>(b)</enum><header>Use of grant
				funds</header><text>A grant made pursuant to this section may be used
				to—</text>
									<paragraph id="H803904EAAEBB4164A8B5789F4681ECF0"><enum>(1)</enum><text>develop and provide
				community training, education, and prevention programs for Indian women
				relating to behavioral health issues, including fetal alcohol disorders;</text>
									</paragraph><paragraph id="HF6D71AF4F84047039C0328613545D352"><enum>(2)</enum><text>identify and provide
				psychological services, counseling, advocacy, support, and relapse prevention
				to Indian women and their families; and</text>
									</paragraph><paragraph id="H34EFBDDA82374258817CC8BE00E22B98"><enum>(3)</enum><text>develop prevention and
				intervention models for Indian women which incorporate traditional health care
				practices, cultural values, and community and family involvement.</text>
									</paragraph></subsection><subsection id="H77E9ECCA7CEC4629AA25B5202DD98302"><enum>(c)</enum><header>Criteria</header><text>The
				Secretary, in consultation with Indian Tribes and Tribal Organizations, shall
				establish criteria for the review and approval of applications and proposals
				for funding under this section.</text>
								</subsection><subsection id="H4895267B56E2472AA5678C66A246D8C7"><enum>(d)</enum><header>Earmark of certain
				funds</header><text>Twenty percent of the funds appropriated pursuant to this
				section shall be used to make grants to Urban Indian Organizations.</text>
								</subsection></section><section id="H87E6D793AFA149A4BA92CED1C22DB9F"><enum>707.</enum><header>Indian youth
				program</header>
								<subsection id="HA17A5A16788A41989FFAB95687EFD00"><enum>(a)</enum><header>Detoxification and
				rehabilitation</header><text>The Secretary, acting through the Service,
				consistent with section 701, shall develop and implement a program for acute
				detoxification and treatment for Indian youths, including behavioral health
				services. The program shall include regional treatment centers designed to
				include detoxification and rehabilitation for both sexes on a referral basis
				and programs developed and implemented by Indian Tribes or Tribal Organizations
				at the local level under the <act-name parsable-cite="ISDA">Indian
				Self-Determination and Education Assistance Act (25 U.S.C. 450 et
				seq.)</act-name>. Regional centers shall be integrated with the intake and
				rehabilitation programs based in the referring Indian community.</text>
								</subsection><subsection id="H68522561859B4BD0988CE24C2793DD96"><enum>(b)</enum><header>Alcohol and substance
				abuse treatment centers or facilities</header>
									<paragraph id="HA05CCC2BF56542E495051091E5450211"><enum>(1)</enum><header>Establishment</header>
										<subparagraph id="HAB98730374E543979B1FA6CFDDA1ABE6"><enum>(A)</enum><header>In
				general</header><text>The Secretary, acting through the Service, Indian Tribes,
				and Tribal Organizations, shall construct, renovate, or, as necessary,
				purchase, and appropriately staff and operate, at least 1 youth regional
				treatment center or treatment network in each area under the jurisdiction of an
				Area Office.</text>
										</subparagraph><subparagraph id="H70D83D5C577B4C2AA0FAA042DD97344"><enum>(B)</enum><header>Area office in
				California</header><text>For the purposes of this subsection, the Area Office
				in California shall be considered to be 2 Area Offices, 1 office whose
				jurisdiction shall be considered to encompass the northern area of the State of
				California, and 1 office whose jurisdiction shall be considered to encompass
				the remainder of the State of California for the purpose of implementing
				California treatment networks.</text>
										</subparagraph></paragraph><paragraph id="HBE039164589C4F0CBBA0FE64721262F0"><enum>(2)</enum><header>Funding</header><text>For
				the purpose of staffing and operating such centers or facilities, funding shall
				be pursuant to the Act of November 2, 1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>).</text>
									</paragraph><paragraph id="H12926B16CA62420883F52329F7C9D633"><enum>(3)</enum><header>Location</header><text>A
				youth treatment center constructed or purchased under this subsection shall be
				constructed or purchased at a location within the area described in paragraph
				(1) agreed upon (by appropriate tribal resolution) by a majority of the Indian
				Tribes to be served by such center.</text>
									</paragraph><paragraph id="H7E6F8A67C8E24D309055AFFB7F917638"><enum>(4)</enum><header>Specific provision of
				funds</header>
										<subparagraph id="H95EBE1860D5E4557A033842B24AC452B"><enum>(A)</enum><header>In
				general</header><text>Notwithstanding any other provision of this title, the
				Secretary may, from amounts authorized to be appropriated for the purposes of
				carrying out this section, make funds available to—</text>
											<clause id="HEA322ADC04E34BDCAC1B2EA8C9B6DDD"><enum>(i)</enum><text>the Tanana Chiefs
				Conference, Incorporated, for the purpose of leasing, constructing, renovating,
				operating, and maintaining a residential youth treatment facility in Fairbanks,
				Alaska; and</text>
											</clause><clause id="H5DBA4E2AE5BA499388D9C79E2631D0D2"><enum>(ii)</enum><text>the Southeast Alaska
				Regional Health Corporation to staff and operate a residential youth treatment
				facility without regard to the proviso set forth in section 4(l) of the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b(l)</external-xref>).</text>
											</clause></subparagraph><subparagraph id="H22350295603C4068BA97D00128F3CEA"><enum>(B)</enum><header>Provision of services
				to eligible youths</header><text>Until additional residential youth treatment
				facilities are established in Alaska pursuant to this section, the facilities
				specified in subparagraph (A) shall make every effort to provide services to
				all eligible Indian youths residing in Alaska.</text>
										</subparagraph></paragraph></subsection><subsection id="HCDCB573454864F4199E3F89A49F887C"><enum>(c)</enum><header>Intermediate adolescent
				behavioral health services</header>
									<paragraph id="HE60A3F7B669243509D4606F97D4525B1"><enum>(1)</enum><header>In
				general</header><text>The Secretary, acting through the Service, Indian Tribes,
				and Tribal Organizations, may provide intermediate behavioral health services
				to Indian children and adolescents, including—</text>
										<subparagraph id="H2A218217554A4512BF2D208FC951DB6B"><enum>(A)</enum><text>pretreatment
				assistance;</text>
										</subparagraph><subparagraph id="H06B6B60F8C8D46D5BCDA685D5CF518E"><enum>(B)</enum><text>inpatient, outpatient,
				and aftercare services;</text>
										</subparagraph><subparagraph id="H0D456B95A1BD45DBA0A006438169EB72"><enum>(C)</enum><text>emergency care;</text>
										</subparagraph><subparagraph id="HD0CC900BCDEE4A0F812967D900D84BA6"><enum>(D)</enum><text>suicide prevention and
				crisis intervention; and</text>
										</subparagraph><subparagraph id="H39D6B390733548B4A6005B73702BEF75"><enum>(E)</enum><text>prevention and treatment
				of mental illness and dysfunctional and self-destructive behavior, including
				child abuse and family violence.</text>
										</subparagraph></paragraph><paragraph id="HDA37D2BB3FA345C38600DAF8935DA055"><enum>(2)</enum><header>Use of
				funds</header><text>Funds provided under this subsection may be used—</text>
										<subparagraph id="H7000EC30AC454D788EDFFC804F6CB375"><enum>(A)</enum><text>to construct or renovate
				an existing health facility to provide intermediate behavioral health
				services;</text>
										</subparagraph><subparagraph id="H46D4DC8E73784C059BFA757D1EFE6F52"><enum>(B)</enum><text>to hire behavioral health
				professionals;</text>
										</subparagraph><subparagraph id="H7AF496AAED244D82AD203017A6EBC582"><enum>(C)</enum><text>to staff, operate, and
				maintain an intermediate mental health facility, group home, sober housing,
				transitional housing or similar facilities, or youth shelter where intermediate
				behavioral health services are being provided;</text>
										</subparagraph><subparagraph id="HCBF77B9E32134B9D9F1C63C04DD69938"><enum>(D)</enum><text>to make renovations and
				hire appropriate staff to convert existing hospital beds into adolescent
				psychiatric units; and</text>
										</subparagraph><subparagraph id="H75AFD616EAD74D5A80911B6BD5BF66A"><enum>(E)</enum><text>for intensive home- and
				community-based services.</text>
										</subparagraph></paragraph><paragraph id="H1A2265AA71744B96ADC2E4C0F1DEBF45"><enum>(3)</enum><header>Criteria</header><text>The
				Secretary, acting through the Service, shall, in consultation with Indian
				Tribes and Tribal Organizations, establish criteria for the review and approval
				of applications or proposals for funding made available pursuant to this
				subsection.</text>
									</paragraph></subsection><subsection id="HC594335A8B204439B3DA92C980C1DC9"><enum>(d)</enum><header>Federally-owned
				structures</header>
									<paragraph id="H2FBF9D8127E74CE8A8E73400FF55AE66"><enum>(1)</enum><header>In
				general</header><text>The Secretary, in consultation with Indian Tribes and
				Tribal Organizations, shall—</text>
										<subparagraph id="H8B84FE4A62E340CCAB22567073E904A7"><enum>(A)</enum><text>identify and use, where
				appropriate, federally-owned structures suitable for local residential or
				regional behavioral health treatment for Indian youths; and</text>
										</subparagraph><subparagraph id="HAC2CF1FD33FE42F28218FD42462F7EC7"><enum>(B)</enum><text>establish guidelines for
				determining the suitability of any such federally-owned structure to be used
				for local residential or regional behavioral health treatment for Indian
				youths.</text>
										</subparagraph></paragraph><paragraph id="H2501F4264E08497D862C7560C3533816"><enum>(2)</enum><header>Terms and conditions
				for use of structure</header><text>Any structure described in paragraph (1) may
				be used under such terms and conditions as may be agreed upon by the Secretary
				and the agency having responsibility for the structure and any Indian Tribe or
				Tribal Organization operating the program.</text>
									</paragraph></subsection><subsection id="H33166112257B4B2394B45574363466CC"><enum>(e)</enum><header>Rehabilitation and
				aftercare services</header>
									<paragraph id="HAA1B02E88072425F866D9D91726D90D4"><enum>(1)</enum><header>In
				general</header><text>The Secretary, Indian Tribes, or Tribal Organizations, in
				cooperation with the Secretary of the Interior, shall develop and implement
				within each Service Unit, community-based rehabilitation and follow-up services
				for Indian youths who are having significant behavioral health problems, and
				require long-term treatment, community reintegration, and monitoring to support
				the Indian youths after their return to their home community.</text>
									</paragraph><paragraph id="H4316A81A265C4BA1BD6292ECDBAF071D"><enum>(2)</enum><header>Administration</header><text>Services
				under paragraph (1) shall be provided by trained staff within the community who
				can assist the Indian youths in their continuing development of self-image,
				positive problem-solving skills, and nonalcohol or substance abusing behaviors.
				Such staff may include alcohol and substance abuse counselors, mental health
				professionals, and other health professionals and paraprofessionals, including
				community health representatives.</text>
									</paragraph></subsection><subsection id="HA31818ACA30243C7919213BADA4E745E"><enum>(f)</enum><header>Inclusion of family in
				youth treatment program</header><text>In providing the treatment and other
				services to Indian youths authorized by this section, the Secretary, acting
				through the Service, Indian Tribes, and Tribal Organizations, shall provide for
				the inclusion of family members of such youths in the treatment programs or
				other services as may be appropriate. Not less than 10 percent of the funds
				appropriated for the purposes of carrying out subsection (e) shall be used for
				outpatient care of adult family members related to the treatment of an Indian
				youth under that subsection.</text>
								</subsection><subsection id="HBE20788874364D07B04EF95D21DB1D5F"><enum>(g)</enum><header>Multidrug abuse
				program</header><text>The Secretary, acting through the Service, Indian Tribes,
				Tribal Organizations, and Urban Indian Organizations, shall provide, consistent
				with section 701, programs and services to prevent and treat the abuse of
				multiple forms of substances, including alcohol, drugs, inhalants, and tobacco,
				among Indian youths residing in Indian communities, on or near reservations,
				and in urban areas and provide appropriate mental health services to address
				the incidence of mental illness among such youths.</text>
								</subsection><subsection id="H18F08E4A986D4582ACE84C7BA4A608F8"><enum>(h)</enum><header>Indian youth mental
				health</header><text>The Secretary, acting through the Service, shall collect
				data for the report under section 801 with respect to—</text>
									<paragraph id="H1AE10E2D436144B1B114E992E36B3B83"><enum>(1)</enum><text>the number of Indian
				youth who are being provided mental health services through the Service and
				Tribal Health Programs;</text>
									</paragraph><paragraph id="HDF205A3E6FAC406A00CB1607C8A92D1"><enum>(2)</enum><text>a description of, and
				costs associated with, the mental health services provided for Indian youth
				through the Service and Tribal Health Programs;</text>
									</paragraph><paragraph id="H5A8E5FC9154E422CA000480453009900"><enum>(3)</enum><text>the number of youth
				referred to the Service or Tribal Health Programs for mental health
				services;</text>
									</paragraph><paragraph id="HB53E5504469F4D8898DF14CE798ABD2"><enum>(4)</enum><text>the number of Indian
				youth provided residential treatment for mental health and behavioral problems
				through the Service and Tribal Health Programs, reported separately for on- and
				off-reservation facilities; and</text>
									</paragraph><paragraph id="HF7587808828A44CEB654A5831FD50485"><enum>(5)</enum><text>the costs of the services
				described in paragraph (4).</text>
									</paragraph></subsection></section><section id="HFBAEC4339EBE4D86979439D8EBF52306"><enum>708.</enum><header>Indian youth
				telemental health demonstration project</header>
								<subsection id="H519702CCC76C44FAA2F6DF39EAFAA480"><enum>(a)</enum><header>Purpose</header><text>The
				purpose of this section is to authorize the Secretary to carry out a
				demonstration project to test the use of telemental health services in suicide
				prevention, intervention and treatment of Indian youth, including
				through—</text>
									<paragraph id="HBD73D02ABA05472BB6C1B932666F5D"><enum>(1)</enum><text>the use of psychotherapy,
				psychiatric assessments, diagnostic interviews, therapies for mental health
				conditions predisposing to suicide, and alcohol and substance abuse
				treatment;</text>
									</paragraph><paragraph id="HFAAB31494BD648C4AAF0316D3BFB4C68"><enum>(2)</enum><text>the provision of clinical
				expertise to, consultation services with, and medical advice and training for
				frontline health care providers working with Indian youth;</text>
									</paragraph><paragraph id="H0E4D782F3FFF45E4B4A4A3A932723896"><enum>(3)</enum><text>training and related
				support for community leaders, family members and health and education workers
				who work with Indian youth;</text>
									</paragraph><paragraph id="HE2B821956969471FB255C4E7C5A1DF46"><enum>(4)</enum><text>the development of
				culturally-relevant educational materials on suicide; and</text>
									</paragraph><paragraph id="H126A6948F7D042CABAFEA8CA7EA19380"><enum>(5)</enum><text>data collection and
				reporting.</text>
									</paragraph></subsection><subsection id="HD5DF8B064DF04908AC086B765FC41068"><enum>(b)</enum><header>Definitions</header><text>For
				the purpose of this section, the following definitions shall apply:</text>
									<paragraph id="H787A9B694801429CAA9D91A7CD3B1835"><enum>(1)</enum><header>Demonstration
				project</header><text>The term <term>demonstration project</term> means the
				Indian youth telemental health demonstration project authorized under
				subsection (c).</text>
									</paragraph><paragraph id="HF02D86FB8B8D4362861937F829DB04A2"><enum>(2)</enum><header>Telemental
				health</header><text>The term <term>telemental health</term> means the use of
				electronic information and telecommunications technologies to support long
				distance mental health care, patient and professional-related education, public
				health, and health administration.</text>
									</paragraph></subsection><subsection id="H1083DD7F5A654C9088C000AB007C4C8D"><enum>(c)</enum><header>Authorization</header>
									<paragraph id="H9F7293F897CE4AA6ADF304546FC295BF"><enum>(1)</enum><header>In
				general</header><text>The Secretary is authorized to award grants under the
				demonstration project for the provision of telemental health services to Indian
				youth who—</text>
										<subparagraph id="H29BF5D3D43644C68BED64E55243B9B4E"><enum>(A)</enum><text>have expressed suicidal
				ideas;</text>
										</subparagraph><subparagraph id="H89DFEBB5588C45718D9DD66744C301C"><enum>(B)</enum><text>have attempted suicide;
				or</text>
										</subparagraph><subparagraph id="H4A73C533BC1149C18608DFB4C779E09B"><enum>(C)</enum><text>have mental health
				conditions that increase or could increase the risk of suicide.</text>
										</subparagraph></paragraph><paragraph id="H53D644ED074642FFBBB9F83C5040D99D"><enum>(2)</enum><header>Eligibility for
				grants</header><text>Such grants shall be awarded to Indian Tribes and Tribal
				Organizations that operate 1 or more facilities—</text>
										<subparagraph id="H76E632A4DFEF41D4BA29D07968E8147B"><enum>(A)</enum><text>located in Alaska and
				part of the Alaska Federal Health Care Access Network;</text>
										</subparagraph><subparagraph id="H05A77781EB5B43FE00EC38225FB2A88E"><enum>(B)</enum><text>reporting active clinical
				telehealth capabilities; or</text>
										</subparagraph><subparagraph id="H35C1EBEB913F4033A1E5067B9B35D72"><enum>(C)</enum><text>offering school-based
				telemental health services relating to psychiatry to Indian youth.</text>
										</subparagraph></paragraph><paragraph id="H43816EA6B2A945EC00ADA1A3F5FE00D3"><enum>(3)</enum><header>Grant
				period</header><text>The Secretary shall award grants under this section for a
				period of up to 4 years.</text>
									</paragraph><paragraph id="H7B059C0071344F4A90734768EDEDD1B1"><enum>(4)</enum><header>Awarding of
				grants</header><text>Not more than 5 grants shall be provided under paragraph
				(1), with priority consideration given to Indian Tribes and Tribal
				Organizations that—</text>
										<subparagraph id="HC6B859B7F73A419491989D0022004DBC"><enum>(A)</enum><text>serve a particular
				community or geographic area where there is a demonstrated need to address
				Indian youth suicide;</text>
										</subparagraph><subparagraph id="HB5CAB6B9279A48B6AA2421ECC5EAAB1C"><enum>(B)</enum><text>enter in to collaborative
				partnerships with Indian Health Service or Tribal Health Programs or facilities
				to provide services under this demonstration project;</text>
										</subparagraph><subparagraph id="H270E566158B04A4998BA475542FC88CE"><enum>(C)</enum><text>serve an isolated
				community or geographic area which has limited or no access to behavioral
				health services; or</text>
										</subparagraph><subparagraph id="HFDDE356140A644AAB39376FDFC2E2326"><enum>(D)</enum><text>operate a detention
				facility at which Indian youth are detained.</text>
										</subparagraph></paragraph></subsection><subsection id="H3B0E7375BD644F35A8A1C217A7A89924"><enum>(d)</enum><header>Use of funds</header>
									<paragraph id="H537BD73913DF4C4388000211EE3B00C9"><enum>(1)</enum><header>In
				general</header><text>An Indian Tribe or Tribal Organization shall use a grant
				received under subsection (c) for the following purposes:</text>
										<subparagraph id="H8C7604F7CE7E43D480BB5C2BE7B77B72"><enum>(A)</enum><text>To provide telemental
				health services to Indian youth, including the provision of—</text>
											<clause id="HC18021EEC32041519100B086BD95B47E"><enum>(i)</enum><text>psychotherapy;</text>
											</clause><clause id="H9103B73E5A59444AB8702DB57CA7CF83"><enum>(ii)</enum><text>psychiatric assessments
				and diagnostic interviews, therapies for mental health conditions predisposing
				to suicide, and treatment; and</text>
											</clause><clause id="H2757EE111F3A4300B19BFDDCF6D8EC7C"><enum>(iii)</enum><text>alcohol and substance
				abuse treatment.</text>
											</clause></subparagraph><subparagraph id="HEB9698A4BC2C4314BB49F200BA56241C"><enum>(B)</enum><text>To provide
				clinician-interactive medical advice, guidance and training, assistance in
				diagnosis and interpretation, crisis counseling and intervention, and related
				assistance to Service, tribal, or urban clinicians and health services
				providers working with youth being served under this demonstration
				project.</text>
										</subparagraph><subparagraph id="HA50346AE5CB7431AAA1ED39B5F0214D2"><enum>(C)</enum><text>To assist, educate and
				train community leaders, health education professionals and paraprofessionals,
				tribal outreach workers, and family members who work with the youth receiving
				telemental health services under this demonstration project, including with
				identification of suicidal tendencies, crisis intervention and suicide
				prevention, emergency skill development, and building and expanding networks
				among these individuals and with State and local health services
				providers.</text>
										</subparagraph><subparagraph id="HD2BE0ED89047456DBA88AFA6CA68F2EB"><enum>(D)</enum><text>To develop and distribute
				culturally appropriate community educational materials on—</text>
											<clause id="H3046C93CD0FB40EEACAEAC6FAE9488B2"><enum>(i)</enum><text>suicide
				prevention;</text>
											</clause><clause id="H8733B8EAFD434D1D836BF2A00036AAA4"><enum>(ii)</enum><text>suicide
				education;</text>
											</clause><clause id="H8FC57A5440274A6E00CB3005ED2B0547"><enum>(iii)</enum><text>suicide
				screening;</text>
											</clause><clause id="HB5E3BA3F08154A72B6268244AB2C367C"><enum>(iv)</enum><text>suicide intervention;
				and</text>
											</clause><clause id="HF2E3EB3D99194B0B84743E00E5A255EA"><enum>(v)</enum><text>ways to mobilize
				communities with respect to the identification of risk factors for
				suicide.</text>
											</clause></subparagraph><subparagraph id="HBA80E1C7FC574F0B0024C94C38012D28"><enum>(E)</enum><text>For data collection and
				reporting related to Indian youth suicide prevention efforts.</text>
										</subparagraph></paragraph><paragraph id="HDB24F847873F4633AC9CE8E8962E6F9E"><enum>(2)</enum><header>Traditional health care
				practices</header><text>In carrying out the purposes described in paragraph
				(1), an Indian Tribe or Tribal Organization may use and promote the traditional
				health care practices of the Indian Tribes of the youth to be served.</text>
									</paragraph></subsection><subsection id="H873802DEEA954D7EA19B668F025564C4"><enum>(e)</enum><header>Applications</header><text>To
				be eligible to receive a grant under subsection (c), an Indian Tribe or Tribal
				Organization shall prepare and submit to the Secretary an application, at such
				time, in such manner, and containing such information as the Secretary may
				require, including—</text>
									<paragraph id="H5B7905011E8847DAA0CC560010F22954"><enum>(1)</enum><text>a description of the
				project that the Indian Tribe or Tribal Organization will carry out using the
				funds provided under the grant;</text>
									</paragraph><paragraph id="H4A9569BA67074606973F00B325076C1"><enum>(2)</enum><text>a description of the
				manner in which the project funded under the grant would—</text>
										<subparagraph id="H56CC5C313D8C4B16969574A3FFAF4339"><enum>(A)</enum><text>meet the telemental
				health care needs of the Indian youth population to be served by the project;
				or</text>
										</subparagraph><subparagraph id="HE0AF4EAE152F47E8A620F5EC17FBDD9E"><enum>(B)</enum><text>improve the access of the
				Indian youth population to be served to suicide prevention and treatment
				services;</text>
										</subparagraph></paragraph><paragraph id="HDA5941563FB648CFB2536DC4D2A4A8CE"><enum>(3)</enum><text>evidence of support for
				the project from the local community to be served by the project;</text>
									</paragraph><paragraph id="H4965149D60134852A23874DF4CA1088D"><enum>(4)</enum><text>a description of how the
				families and leadership of the communities or populations to be served by the
				project would be involved in the development and ongoing operations of the
				project;</text>
									</paragraph><paragraph id="HC843BBF698CD41E0ACED7BB206D91148"><enum>(5)</enum><text>a plan to involve the
				tribal community of the youth who are provided services by the project in
				planning and evaluating the mental health care and suicide prevention efforts
				provided, in order to ensure the integration of community, clinical,
				environmental, and cultural components of the treatment; and</text>
									</paragraph><paragraph id="H25426E9A060C4B2791CC46B2432B5D49"><enum>(6)</enum><text>a plan for sustaining the
				project after Federal assistance for the demonstration project has
				terminated.</text>
									</paragraph></subsection><subsection id="H3C7C400FBA144FF4A99485C295AC61D1"><enum>(f)</enum><header>Collaboration;
				reporting to national clearinghouse</header>
									<paragraph id="H8F005A7533BD4D81B0D3EC7FAF76AE56"><enum>(1)</enum><header>Collaboration</header><text>The
				Secretary, acting through the Service, shall encourage Indian Tribes and Tribal
				Organizations receiving grants under this section to collaborate to enable
				comparisons about best practices across projects.</text>
									</paragraph><paragraph id="H43885C4C5213406A9F47EFCABAF353F"><enum>(2)</enum><header>Reporting to national
				clearinghouse</header><text>The Secretary, acting through the Service, shall
				also encourage Indian Tribes and Tribal Organizations receiving grants under
				this section to submit relevant, declassified project information to the
				national clearinghouse authorized under section 701(b)(2) in order to better
				facilitate program performance and improve suicide prevention, intervention,
				and treatment services.</text>
									</paragraph></subsection><subsection id="HA6BD1064DBF44C429393CCD8D5D51C00"><enum>(g)</enum><header>Annual
				report</header><text>Each grant recipient shall submit to the Secretary an
				annual report that—</text>
									<paragraph id="HE9BF79D25FF54ED78E66EE6D9C6D770"><enum>(1)</enum><text>describes the number of
				telemental health services provided; and</text>
									</paragraph><paragraph id="H5BE2E8FE9FEC4AEFAAEBB6DE3DFA76F5"><enum>(2)</enum><text>includes any other
				information that the Secretary may require.</text>
									</paragraph></subsection><subsection id="H7E9BC15B5FB246DEBADD2BAEC22900AF"><enum>(h)</enum><header>Report to
				Congress</header><text display-inline="yes-display-inline">Not later than 270
				days after the termination of the demonstration project, the Secretary shall
				submit to the Committee on Indian Affairs of the Senate and the Committee on
				Natural Resources and Committee on Energy and Commerce of the House of
				Representatives a final report, based on the annual reports provided by grant
				recipients under subsection (h), that—</text>
									<paragraph id="H03943E097C1C4491ACB2B365B640A123"><enum>(1)</enum><text>describes the results of
				the projects funded by grants awarded under this section, including any data
				available which indicates the number of attempted suicides;</text>
									</paragraph><paragraph id="H5598B8B3D4644915A6984006D1CFFBB8"><enum>(2)</enum><text>evaluates the impact of
				the telemental health services funded by the grants in reducing the number of
				completed suicides among Indian youth;</text>
									</paragraph><paragraph id="H5509FB2C16AB4F84895388B272D39741"><enum>(3)</enum><text>evaluates whether the
				demonstration project should be—</text>
										<subparagraph id="H43BA2349EF6042D8AE892B1937CFB64E"><enum>(A)</enum><text>expanded to provide more
				than 5 grants; and</text>
										</subparagraph><subparagraph id="HBE64EAEE6540424C929374438CC4ED69"><enum>(B)</enum><text>designated a permanent
				program; and</text>
										</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H9BDC31D499DA421FB106DA87000300D3"><enum>(4)</enum><text>evaluates the benefits of
				expanding the demonstration project to include Urban Indian
				Organizations.</text>
									</paragraph></subsection><subsection id="H779D7A3465994D8E83C829C33AF857F"><enum>(i)</enum><header>Authorization of
				appropriations</header><text>There is authorized to be appropriated to carry
				out this section $1,500,000 for each of fiscal years 2008 through 2011.</text>
								</subsection></section><section id="HE682B898CE59474583F5A23F7927D464"><enum>709.</enum><header>Inpatient and
				community-based mental health facilities design, construction, and
				staffing</header><text display-inline="no-display-inline">Not later than 1 year
				after the date of enactment of the <short-title>Indian
				Health Care Improvement Act Amendments of 2007</short-title>, the Secretary,
				acting through the Service, Indian Tribes, and Tribal Organizations, may
				provide, in each area of the Service, not less than 1 inpatient mental health
				care facility, or the equivalent, for Indians with behavioral health problems.
				For the purposes of this subsection, California shall be considered to be 2
				Area Offices, 1 office whose location shall be considered to encompass the
				northern area of the State of California and 1 office whose jurisdiction shall
				be considered to encompass the remainder of the State of California. The
				Secretary shall consider the possible conversion of existing, underused Service
				hospital beds into psychiatric units to meet such need.</text>
							</section><section id="HEE5D0D734ABA4CFCB4F89B005700AB30"><enum>710.</enum><header>Training and community
				education</header>
								<subsection id="H013EAC6534A54F0EB393C97623CC4C1"><enum>(a)</enum><header>Program</header><text>The
				Secretary, in cooperation with the Secretary of the Interior, shall develop and
				implement or assist Indian Tribes and Tribal Organizations to develop and
				implement, within each Service Unit or tribal program, a program of community
				education and involvement which shall be designed to provide concise and timely
				information to the community leadership of each tribal community. Such program
				shall include education about behavioral health issues to political leaders,
				Tribal judges, law enforcement personnel, members of tribal health and
				education boards, health care providers including traditional practitioners,
				and other critical members of each tribal community. Such program may also
				include community-based training to develop local capacity and tribal community
				provider training for prevention, intervention, treatment, and
				aftercare.</text>
								</subsection><subsection id="HA0A5F94547CF4F2BA85390A84946AE46"><enum>(b)</enum><header>Instruction</header><text>The
				Secretary, acting through the Service, shall, either directly or through Indian
				Tribes and Tribal Organizations, provide instruction in the area of behavioral
				health issues, including instruction in crisis intervention and family
				relations in the context of alcohol and substance abuse, child sexual abuse,
				youth alcohol and substance abuse, and the causes and effects of fetal alcohol
				disorders to appropriate employees of the Bureau of Indian Affairs and the
				Service, and to personnel in schools or programs operated under any contract
				with the Bureau of Indian Affairs or the Service, including supervisors of
				emergency shelters and halfway houses described in section 4213 of the Indian
				Alcohol and Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C.
				2433).</text>
								</subsection><subsection id="HCAFF7B67F8AD459DA807D5FE516008B2"><enum>(c)</enum><header>Training
				models</header><text>In carrying out the education and training programs
				required by this section, the Secretary, in consultation with Indian Tribes,
				Tribal Organizations, Indian behavioral health experts, and Indian alcohol and
				substance abuse prevention experts, shall develop and provide community-based
				training models. Such models shall address—</text>
									<paragraph id="H988021B2247D46D1B908F7946FA3FF8B"><enum>(1)</enum><text>the elevated risk of
				alcohol and behavioral health problems faced by children of alcoholics;</text>
									</paragraph><paragraph id="H627A40820BC04DB896D585BD9539B100"><enum>(2)</enum><text>the cultural, spiritual,
				and mul­ti­gen­er­a­tional aspects of behavioral health problem prevention and
				recovery; and</text>
									</paragraph><paragraph id="H989B9ECCAC9246839CBEC72D005300D3"><enum>(3)</enum><text>community-based and
				multidisciplinary strategies for preventing and treating behavioral health
				problems.</text>
									</paragraph></subsection></section><section id="H2C0628BB92AF4990B0432543A86291C2"><enum>711.</enum><header>Behavioral health
				program</header>
								<subsection id="H2BD46F2988144B28B68D2475FFB90011"><enum>(a)</enum><header>Innovative
				programs</header><text>The Secretary, acting through the Service, Indian
				Tribes, and Tribal Organizations, consistent with section 701, may plan,
				develop, implement, and carry out programs to deliver innovative
				community-based behavioral health services to Indians.</text>
								</subsection><subsection id="HBC1E8AE1A93C46B6B27935F4DC9DC71"><enum>(b)</enum><header>Awards;
				criteria</header><text>The Secretary may award a grant for a project under
				subsection (a) to an Indian Tribe or Tribal Organization and may consider the
				following criteria:</text>
									<paragraph id="HCFC4C9A793CA49B2B4DFB6C63B1FDA84"><enum>(1)</enum><text>The project will address
				significant unmet behavioral health needs among Indians.</text>
									</paragraph><paragraph id="H123C0741DC7C44CE93B084642683C17F"><enum>(2)</enum><text>The project will serve a
				significant number of Indians.</text>
									</paragraph><paragraph id="HC4B81A8E3E5F41449E9D0083B0070837"><enum>(3)</enum><text>The project has the
				potential to deliver services in an efficient and effective manner.</text>
									</paragraph><paragraph id="H02BFF4BE1AA64BF58228A632A85DC3F"><enum>(4)</enum><text>The Indian Tribe or
				Tribal Organization has the administrative and financial capability to
				administer the project.</text>
									</paragraph><paragraph id="HD75C7AD2DBAD4F1D9340969C45938DD5"><enum>(5)</enum><text>The project may deliver
				services in a manner consistent with traditional health care practices.</text>
									</paragraph><paragraph id="HD69B5CDEE37447309C0061219FF8D682"><enum>(6)</enum><text>The project is
				coordinated with, and avoids duplication of, existing services.</text>
									</paragraph></subsection><subsection id="H0EFCB9249BDA4B11BAA891CFAE00EA7B"><enum>(c)</enum><header>Equitable
				treatment</header><text>For purposes of this subsection, the Secretary shall,
				in evaluating project applications or proposals, use the same criteria that the
				Secretary uses in evaluating any other application or proposal for such
				funding.</text>
								</subsection></section><section id="H64384E9989B843CDB89D5B61F65DFFF5"><enum>712.</enum><header>Fetal alcohol disorder
				programs</header>
								<subsection id="HF56DA6614C8E4553A5D0C2DC42FDAA4E"><enum>(a)</enum><header>Programs</header>
									<paragraph id="H51892572903944D8A8E3BF884827A330"><enum>(1)</enum><header>Establishment</header><text>The
				Secretary, consistent with section 701, acting through the Service, Indian
				Tribes, and Tribal Organizations, is authorized to establish and operate fetal
				alcohol disorder programs as provided in this section for the purposes of
				meeting the health status objectives specified in section 3.</text>
									</paragraph><paragraph id="HDE194984133D44A08859B2113C68F41D"><enum>(2)</enum><header>Use of funds</header>
										<subparagraph id="H9B5E19D784CA4AC78BE89E8887BE7BB"><enum>(A)</enum><header>In
				general</header><text>Funding provided pursuant to this section shall be used
				for the following:</text>
											<clause id="H084AE57419E94FF48F4600B9CAEF3736"><enum>(i)</enum><text>To develop and provide
				for Indians community and in-school training, education, and prevention
				programs relating to fetal alcohol disorders.</text>
											</clause><clause id="H117F0999F1454D6BB9FF92FEC495386"><enum>(ii)</enum><text>To identify and provide
				behavioral health treatment to high-risk Indian women and high-risk women
				pregnant with an Indian’s child.</text>
											</clause><clause id="H9920B5116F384FCB8D1153CF939F9921"><enum>(iii)</enum><text>To identify and provide
				appropriate psychological services, educational and vocational support,
				counseling, advocacy, and information to fetal alcohol disorder affected
				Indians and their families or caretakers.</text>
											</clause><clause id="H90E59F80D6C148D98E3F004B61CB4731"><enum>(iv)</enum><text>To develop and implement
				counseling and support programs in schools for fetal alcohol disorder affected
				Indian children.</text>
											</clause><clause id="H92396C71765447A3A89E4E42103046EB"><enum>(v)</enum><text>To develop prevention and
				intervention models which incorporate practitioners of traditional health care
				practices, cultural values, and community involvement.</text>
											</clause><clause id="H1D56733B5345432E8D69A4E56EF2059E"><enum>(vi)</enum><text>To develop, print, and
				disseminate education and prevention materials on fetal alcohol
				disorder.</text>
											</clause><clause id="H1ACA598B07BB4B32002300482F076010"><enum>(vii)</enum><text>To develop and
				implement, in consultation with Indian Tribes, Tribal Organizations, and Urban
				Indian Organizations, culturally sensitive assessment and diagnostic tools
				including dysmorphology clinics and multidisciplinary fetal alcohol disorder
				clinics for use in Indian communities and Urban Centers.</text>
											</clause></subparagraph><subparagraph id="H28C3A3DE4C864907922497AEDD65651B"><enum>(B)</enum><header>Additional
				uses</header><text>In addition to any purpose under subparagraph (A), funding
				provided pursuant to this section may be used for 1 or more of the
				following:</text>
											<clause id="H57965EB88F424F38A0E219BD8F1ED4E"><enum>(i)</enum><text>Early childhood
				intervention projects from birth on to mitigate the effects of fetal alcohol
				disorder among Indians.</text>
											</clause><clause id="H8308FA2814794259805B38BE2FDDBE90"><enum>(ii)</enum><text>Community-based support
				services for Indians and women pregnant with Indian children.</text>
											</clause><clause id="HE157136FE04046EC00D21CB3AC27B2B"><enum>(iii)</enum><text>Community-based housing
				for adult Indians with fetal alcohol disorder.</text>
											</clause></subparagraph></paragraph><paragraph id="H354DD5A983D14B3BB21D60FAD28196C8"><enum>(3)</enum><header>Criteria for
				applications</header><text>The Secretary shall establish criteria for the
				review and approval of applications for funding under this section.</text>
									</paragraph></subsection><subsection id="H47682D79E5A6436CB35C3980AF001DA5"><enum>(b)</enum><header>Services</header><text>The
				Secretary, acting through the Service and Indian Tribes, Tribal Organizations,
				and Urban Indian Organizations, shall—</text>
									<paragraph id="HCD6134DC8143449B86C1EF474EAE15F4"><enum>(1)</enum><text>develop and provide
				services for the prevention, intervention, treatment, and aftercare for those
				affected by fetal alcohol disorder in Indian communities; and</text>
									</paragraph><paragraph id="H322DAD6BF7AA4992AFCFD11F77178B26"><enum>(2)</enum><text>provide supportive
				services, including services to meet the special educational, vocational,
				school-to-work transition, and independent living needs of adolescent and adult
				Indians with fetal alcohol disorder.</text>
									</paragraph></subsection><subsection id="H7102BCAACE8A4450B5DBFCB69A9D5A"><enum>(c)</enum><header>Task
				force</header><text>The Secretary shall establish a task force to be known as
				the Fetal Alcohol Disorder Task Force to advise the Secretary in carrying out
				subsection (b). Such task force shall be composed of representatives from the
				following:</text>
									<paragraph id="H37F7EDDFA2A9470CB122EAA3F33FDB5D"><enum>(1)</enum><text>The National Institute on
				Drug Abuse.</text>
									</paragraph><paragraph id="HA2103BE62FFC4D94B2F2DA56310770E1"><enum>(2)</enum><text>The National Institute on
				Alcohol and Alcoholism.</text>
									</paragraph><paragraph id="HC2B17B8C97D94A53BBA2CA8883D3D594"><enum>(3)</enum><text>The Office of Substance
				Abuse Prevention.</text>
									</paragraph><paragraph id="H03FDD28EFC2745E48C91E6A3DA22E684"><enum>(4)</enum><text>The National Institute of
				Mental Health.</text>
									</paragraph><paragraph id="HB10E2F22A09045BE81A9C24E3EEEB499"><enum>(5)</enum><text>The Service.</text>
									</paragraph><paragraph id="H80AEC1AE63264930A9285EE52E547FF9"><enum>(6)</enum><text>The Office of Minority
				Health of the Department of Health and Human Services.</text>
									</paragraph><paragraph id="H433D6236EF8E4FDE956F02ED939E9B50"><enum>(7)</enum><text>The Administration for
				Native Americans.</text>
									</paragraph><paragraph id="H8EBE0C038C5D46A9831F127E995E316C"><enum>(8)</enum><text>The National Institute of
				Child Health and Human Development (NICHD).</text>
									</paragraph><paragraph id="H0E3985CE98DA48058BA5C6D8399CC29"><enum>(9)</enum><text>The Centers for Disease
				Control and Prevention.</text>
									</paragraph><paragraph id="HF509B4351DEE460983F68B1ECD6BD6A8"><enum>(10)</enum><text>The Bureau of Indian
				Affairs.</text>
									</paragraph><paragraph id="HA7DD4E37822646D4A529629DD5684875"><enum>(11)</enum><text>Indian Tribes.</text>
									</paragraph><paragraph id="H4F56A278A1D14A108E00C0DA45B6219E"><enum>(12)</enum><text>Tribal
				Organizations.</text>
									</paragraph><paragraph id="H3E0D05F2A68F485EA560341FC92F487B"><enum>(13)</enum><text>Urban Indian
				Organizations.</text>
									</paragraph><paragraph id="H39F6EE6860AB4881950745B4F3522679"><enum>(14)</enum><text>Indian fetal alcohol
				disorder experts.</text>
									</paragraph></subsection><subsection id="H55AD3DA278ED4B83B929535DB5F5ECB2"><enum>(d)</enum><header>Applied research
				projects</header><text>The Secretary, acting through the Substance Abuse and
				Mental Health Services Administration, shall make grants to Indian Tribes,
				Tribal Organizations, and Urban Indian Organizations for applied research
				projects which propose to elevate the understanding of methods to prevent,
				intervene, treat, or provide rehabilitation and behavioral health aftercare for
				Indians and Urban Indians affected by fetal alcohol disorder.</text>
								</subsection><subsection id="HC1C1C3E297C44EACB86BDC41A784521D"><enum>(e)</enum><header>Funding for Urban
				Indian Organizations</header><text>Ten percent of the funds appropriated
				pursuant to this section shall be used to make grants to Urban Indian
				Organizations funded under title V.</text>
								</subsection></section><section id="H00DC5AE3AD5C417997E19B84DF1F4FC6"><enum>713.</enum><header>Child sexual abuse and
				prevention treatment programs</header>
								<subsection id="HE0BC59685C9E43DC93E6DD9FDE79B58E"><enum>(a)</enum><header>Establishment</header><text>The
				Secretary, acting through the Service, and the Secretary of the Interior,
				Indian Tribes, and Tribal Organizations, shall establish, consistent with
				section 701, in every Service Area, programs involving treatment for—</text>
									<paragraph id="H06C5580368FB46F3A82900955718C3BE"><enum>(1)</enum><text>victims of sexual abuse
				who are Indian children or children in an Indian household; and</text>
									</paragraph><paragraph id="H9D647D7C9955442A9D675B4E352F5939"><enum>(2)</enum><text>perpetrators of child
				sexual abuse who are Indian or members of an Indian household.</text>
									</paragraph></subsection><subsection id="HEEA21CD66BE742908E92DCC253CE6893"><enum>(b)</enum><header>Use of
				funds</header><text>Funding provided pursuant to this section shall be used for
				the following:</text>
									<paragraph id="H210F6DB87710410DA2E472928C937EBE"><enum>(1)</enum><text>To develop and provide
				community education and prevention programs related to sexual abuse of Indian
				children or children in an Indian household.</text>
									</paragraph><paragraph id="HD7E71E788A9843AAA11FD812BDB86574"><enum>(2)</enum><text>To identify and provide
				behavioral health treatment to victims of sexual abuse who are Indian children
				or children in an Indian household, and to their family members who are
				affected by sexual abuse.</text>
									</paragraph><paragraph id="H4BC79F52E1D445F900D697643576F609"><enum>(3)</enum><text>To develop prevention and
				intervention models which incorporate traditional health care practices,
				cultural values, and community involvement.</text>
									</paragraph><paragraph id="H5B0B5410AE7F436DAD9C1097668F9C66"><enum>(4)</enum><text>To develop and implement
				culturally sensitive assessment and diagnostic tools for use in Indian
				communities and Urban Centers.</text>
									</paragraph><paragraph id="H49823EB4076E4C6095CDF5DD4F41224"><enum>(5)</enum><text>To identify and provide
				behavioral health treatment to Indian perpetrators and perpetrators who are
				members of an Indian household—</text>
										<subparagraph id="HEE8C63016D69482DA4704BFB56F2E554"><enum>(A)</enum><text>making efforts to begin
				offender and behavioral health treatment while the perpetrator is incarcerated
				or at the earliest possible date if the perpetrator is not incarcerated;
				and</text>
										</subparagraph><subparagraph id="HD7C0EE482F004FB795B1A8B96DC8B9D3"><enum>(B)</enum><text>providing treatment after
				the perpetrator is released, until it is determined that the perpetrator is not
				a threat to children.</text>
										</subparagraph></paragraph></subsection><subsection id="H8A7623CEE59948C0B192D000F2869D00"><enum>(c)</enum><header>Coordination</header><text>The
				programs established under subsection (a) shall be carried out in coordination
				with programs and services authorized under the Indian Child Protection and
				Family Violence Prevention Act (<external-xref legal-doc="usc" parsable-cite="usc/25/3201">25 U.S.C. 3201 et seq.</external-xref>).</text>
								</subsection></section><section id="H3B54670F7F3E4031AFD05C2D8C9C60C2"><enum>714.</enum><header>Behavioral health
				research</header><text display-inline="no-display-inline">The Secretary, in
				consultation with appropriate Federal agencies, shall make grants to, or enter
				into contracts with, Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations or enter into contracts with, or make grants to appropriate
				institutions for, the conduct of research on the incidence and prevalence of
				behavioral health problems among Indians served by the Service, Indian Tribes,
				or Tribal Organizations and among Indians in urban areas. Research priorities
				under this section shall include—</text>
								<paragraph id="H399D926BD56E453BB5CC1E9142D76CC0"><enum>(1)</enum><text>the multifactorial causes
				of Indian youth suicide, including—</text>
									<subparagraph id="HD1B9C094EFFD445491E679406D1C7F39"><enum>(A)</enum><text>protective and risk
				factors and scientific data that identifies those factors; and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H25DF80D024754EC3818F4790E70080F9"><enum>(B)</enum><text display-inline="yes-display-inline">the effects of loss of cultural identity
				and the development of scientific data on those effects;</text>
									</subparagraph></paragraph><paragraph id="HCEA92324F5C4460ABF1F7CEBE6A75B00"><enum>(2)</enum><text>the interrelationship and
				interdependence of behavioral health problems with alcoholism and other
				substance abuse, suicide, homicides, other injuries, and the incidence of
				family violence; and</text>
								</paragraph><paragraph id="HCBAABE6122F74B0D9800BF6039B893DE"><enum>(3)</enum><text>the development of models
				of prevention techniques.</text>
								</paragraph><continuation-text continuation-text-level="section">The
				effect of the interrelationships and interdependencies referred to in paragraph
				(2) on children, and the development of prevention techniques under paragraph
				(3) applicable to children, shall be emphasized.</continuation-text></section><section id="H9961AAD653CD4148BAC77C3BCDCECFC"><enum>715.</enum><header>Definitions</header><text display-inline="no-display-inline">For the purpose of this title, the following
				definitions shall apply:</text>
								<paragraph id="H6566D786E84443B0A4CA15903C347E23"><enum>(1)</enum><header>Assessment</header><text>The
				term <term>assessment</term> means the systematic collection, analysis, and
				dissemination of information on health status, health needs, and health
				problems.</text>
								</paragraph><paragraph id="HCF605163A0954C968D43BE09004E8457"><enum>(2)</enum><header>Alcohol-related
				neurodevelopmental disorders or ARND</header><text>The term
				<term>alcohol-related neurodevelopmental disorders</term> or <term>ARND</term>
				means, with a history of maternal alcohol consumption during pregnancy, central
				nervous system involvement such as developmental delay, intellectual deficit,
				or neurologic abnormalities. Behaviorally, there can be problems with
				irritability, and failure to thrive as infants. As children become older there
				will likely be hyperactivity, attention deficit, language dysfunction, and
				perceptual and judgment problems.</text>
								</paragraph><paragraph id="HFD27897097FB489481C1D1AA7BA467C6"><enum>(3)</enum><header>Behavioral health
				aftercare</header><text>The term <term>behavioral health aftercare</term>
				includes those activities and resources used to support recovery following
				inpatient, residential, intensive substance abuse, or mental health outpatient
				or outpatient treatment. The purpose is to help prevent or deal with relapse by
				ensuring that by the time a client or patient is discharged from a level of
				care, such as outpatient treatment, an aftercare plan has been developed with
				the client. An aftercare plan may use such resources as a community-based
				therapeutic group, transitional living facilities, a 12-step sponsor, a local
				12-step or other related support group, and other community-based
				providers.</text>
								</paragraph><paragraph id="HDC3F052FBF2E46268E043245378EF8B8"><enum>(4)</enum><header>Dual
				diagnosis</header><text>The term <term>dual diagnosis</term> means coexisting
				substance abuse and mental illness conditions or diagnosis. Such clients are
				sometimes referred to as mentally ill chemical abusers (MICAs).</text>
								</paragraph><paragraph id="HC793036791044475B67618AAB8744F2B"><enum>(5)</enum><header>Fetal alcohol
				disorders</header><text>The term <term>fetal alcohol disorders</term> means
				fetal alcohol syndrome, partial fetal alcohol syndrome and alcohol related
				neurodevelopmental disorder (ARND).</text>
								</paragraph><paragraph id="HC7584B66E24A4253A66ECA765D02797C"><enum>(6)</enum><header>Fetal alcohol syndrome
				or FAS</header><text>The term <term>fetal alcohol syndrome</term> or
				<term>FAS</term> means a syndrome in which, with a history of maternal alcohol
				consumption during pregnancy, the following criteria are met:</text>
									<subparagraph id="HB3089A9BC68B43FABB2206738F8096D9"><enum>(A)</enum><text>Central nervous system
				involvement such as developmental delay, intellectual deficit, microencephaly,
				or neurologic abnormalities.</text>
									</subparagraph><subparagraph id="H972ED989EF26419A9902AB983E08E014"><enum>(B)</enum><text>Craniofacial
				abnormalities with at least 2 of the following: microophthalmia, short
				palpebral fissures, poorly developed philtrum, thin upper lip, flat nasal
				bridge, and short upturned nose.</text>
									</subparagraph><subparagraph id="HA2C77A4F435D4678A40072D3BF3C658E"><enum>(C)</enum><text>Prenatal or postnatal
				growth delay.</text>
									</subparagraph></paragraph><paragraph id="H7B6EB42510644860A487333EF200894C"><enum>(7)</enum><header>Partial
				FAS</header><text>The term <term>partial FAS</term> means, with a history of
				maternal alcohol consumption during pregnancy, having most of the criteria of
				FAS, though not meeting a minimum of at least 2 of the following:
				microophthalmia, short palpebral fissures, poorly developed philtrum, thin
				upper lip, flat nasal bridge, and short upturned nose.</text>
								</paragraph><paragraph id="HEF47502C21044934AE6854F1B4B12277"><enum>(8)</enum><header>Rehabilitation</header><text>The
				term <term>rehabilitation</term> means to restore the ability or capacity to
				engage in usual and customary life activities through education and
				therapy.</text>
								</paragraph><paragraph id="H152134992CD641D8B9008DCDEB72AAC"><enum>(9)</enum><header>Substance
				abuse</header><text>The term <term>substance abuse</term> includes inhalant
				abuse.</text>
								</paragraph></section><section id="H902EB842A0F54895A11890373D35355B"><enum>716.</enum><header>Authorization of
				appropriations</header><text display-inline="no-display-inline">There is
				authorized to be appropriated such sums as may be necessary for each fiscal
				year through fiscal year 2017 to carry out the provisions of this title.</text>
							</section></title><title id="HA9588BAA38D24EAFAA647F97EB1B76C3"><enum>VIII</enum><header>Miscellaneous</header>
							<section id="HD452209416F04A50AFDD24BD7B13E709"><enum>801.</enum><header>Reports</header><text display-inline="no-display-inline">For each fiscal year following the date of
				enactment of the <short-title>Indian Health Care
				Improvement Act Amendments of 2007</short-title>, the Secretary shall transmit
				to Congress a report containing the following:</text>
								<paragraph id="HBE0A768F8DC84682B438E100144C2CC"><enum>(1)</enum><text>A report on the progress
				made in meeting the objectives of this Act, including a review of programs
				established or assisted pursuant to this Act and assessments and
				recommendations of additional programs or additional assistance necessary to,
				at a minimum, provide health services to Indians and ensure a health status for
				Indians, which are at a parity with the health services available to and the
				health status of the general population.</text>
								</paragraph><paragraph id="H1371F40031674DE7A37746981B6DA9F5"><enum>(2)</enum><text>A report on whether, and
				to what extent, new national health care programs, benefits, initiatives, or
				financing systems have had an impact on the purposes of this Act and any steps
				that the Secretary may have taken to consult with Indian Tribes, Tribal
				Organizations, and Urban Indian Organizations to address such impact, including
				a report on proposed changes in allocation of funding pursuant to section
				808.</text>
								</paragraph><paragraph id="HD124B455E3FE425B93BB1CEA133FB52"><enum>(3)</enum><text>A report on the use of
				health services by Indians—</text>
									<subparagraph id="H8E41F95A39334D96B27FFD0146797100"><enum>(A)</enum><text>on a national and area or
				other relevant geographical basis;</text>
									</subparagraph><subparagraph id="H475C0E59C6D74B43B1D8875242492C22"><enum>(B)</enum><text>by gender and age;</text>
									</subparagraph><subparagraph id="HA1FAC98AADF24F468016075D1DCA00C"><enum>(C)</enum><text>by source of payment and
				type of service;</text>
									</subparagraph><subparagraph id="HBCA027A81B844D508CA7D7E3F5C37F5"><enum>(D)</enum><text>comparing such rates of
				use with rates of use among comparable non-Indian populations; and</text>
									</subparagraph><subparagraph id="HBBF142E15FAC4762B124A46FD3F117A9"><enum>(E)</enum><text>provided under
				contracts.</text>
									</subparagraph></paragraph><paragraph id="HD6BE400C289145B29FEDA8C6EBD9796"><enum>(4)</enum><text>A report of contractors
				to the Secretary on Health Care Educational Loan Repayments every 6 months
				required by section 110.</text>
								</paragraph><paragraph id="HE225A93ACDC545D7AC6F5D8EAEF1277"><enum>(5)</enum><text>A general audit report of
				the Secretary on the Health Care Educational Loan Repayment Program as required
				by section 110(n).</text>
								</paragraph><paragraph id="H317630CC2E224C6CB8F2385B800C097"><enum>(6)</enum><text>A report of the findings
				and conclusions of demonstration programs on development of educational
				curricula for substance abuse counseling as required in section 125(f).</text>
								</paragraph><paragraph id="HADE93CB7C4B64DDB9344F8D379CD3989"><enum>(7)</enum><text>A separate statement
				which specifies the amount of funds requested to carry out the provisions of
				section 201.</text>
								</paragraph><paragraph id="H01AC5C8E052B4A3F87C611A536B752BC"><enum>(8)</enum><text>A report of the
				evaluations of health promotion and disease prevention as required in section
				203(c).</text>
								</paragraph><paragraph id="HDB6F52D2DE7747E78CDEBCA0FAD88BCC"><enum>(9)</enum><text>A biennial report to
				Congress on infectious diseases as required by section 212.</text>
								</paragraph><paragraph id="HF411B18D7F734F16AC515FCC61FCFF8"><enum>(10)</enum><text>A report on
				environmental and nuclear health hazards as required by section 215.</text>
								</paragraph><paragraph id="HFE6BAB4A0001471FAD5EDAF40020F0E9"><enum>(11)</enum><text>An annual report on the
				status of all health care facilities needs as required by section 301(c)(2)(B)
				and 301(d).</text>
								</paragraph><paragraph id="HEE65DCD0BA944B26824262917C3E6752"><enum>(12)</enum><text>Reports on safe water
				and sanitary waste disposal facilities as required by section 302(h).</text>
								</paragraph><paragraph id="H7CAFA6C83C1C4DF1997CBC1FA9A870AB"><enum>(13)</enum><text>An annual report on the
				expenditure of non-Service funds for renovation as required by sections
				304(b)(2).</text>
								</paragraph><paragraph id="H0B68F0F9867B4C5EB0C2311E85DA1EA"><enum>(14)</enum><text>A report identifying the
				backlog of maintenance and repair required at Service and tribal facilities
				required by section 313(a).</text>
								</paragraph><paragraph id="H736E55F8281B4909BD34ED5BD3F4B500"><enum>(15)</enum><text>A report providing an
				accounting of reimbursement funds made available to the Secretary under titles
				XVIII, XIX, and XXI of the <act-name parsable-cite="SSA">Social Security
				Act</act-name>.</text>
								</paragraph><paragraph id="HCFB75F52FBE74FD4B1B3AFC9CCFA39E2"><enum>(16)</enum><text>A report on any
				arrangements for the sharing of medical facilities or services, as authorized
				by section 406.</text>
								</paragraph><paragraph id="H74E0A0FAB2284C38821E722948EDA413"><enum>(17)</enum><text>A report on evaluation
				and renewal of Urban Indian programs under section 505.</text>
								</paragraph><paragraph id="HB84D775306BA4DAE812FA16DEB2AEE1"><enum>(18)</enum><text>A report on the
				evaluation of programs as required by section 513(d).</text>
								</paragraph><paragraph id="HAE0B8261848F48D5B8B06EC686E074BF"><enum>(19)</enum><text>A report on alcohol and
				substance abuse as required by section 701(f).</text>
								</paragraph><paragraph id="H7BC6FC564C58441887F099141E82E76C"><enum>(20)</enum><text>A report on Indian youth
				mental health services as required by section 707(h).</text>
								</paragraph><paragraph id="HB9AE74EA50B3497E8468B6F5F903645"><enum>(21)</enum><text>A report on the
				reallocation of base resources if required by section 808.</text>
								</paragraph><paragraph commented="no" id="H71E55B9BED3840F3B4A2D9F6DA78D7D9"><enum>(22)</enum><header>Report regarding
				patient movement</header><text>A report on the movement of patients between
				Service Units, including—</text>
									<subparagraph commented="no" id="HB86C236C641E44E985CE83239E8E4964"><enum>(A)</enum><text>a list of those Service
				Units that have a net increase and those that have a net decrease of patients
				due to patients assigned to one Service Unit voluntarily choosing to receive
				service at another Service Unit;</text>
									</subparagraph><subparagraph commented="no" id="H3558D694C2FF43BC83E905E0452C2F3"><enum>(B)</enum><text>an analysis of the effect
				of patient movement on the quality of services for those Service Units
				experiencing an increase in the number of patients served; and</text>
									</subparagraph><subparagraph commented="no" id="H63F9D7FFB8E14134AA8D5BD366EE21FC"><enum>(C)</enum><text>what funding changes are
				necessary to maintain a consistent quality of service at Service Units that
				have an increase in the number of patients served.</text>
									</subparagraph></paragraph></section><section id="H39F73D3B0C304F0B917EC7614E77F2DE"><enum>802.</enum><header>Regulations</header>
								<subsection id="H3EB531B454D24FAAAA390034F61FE034"><enum>(a)</enum><header>Deadlines</header>
									<paragraph id="H3720F88FFFDE44159B67D3CEBEE2E57"><enum>(1)</enum><header>Procedures</header><text>Not
				later than 90 days after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, the Secretary shall initiate procedures under subchapter
				III of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/5">chapter 5</external-xref> of title 5, United States Code, to negotiate and promulgate
				such regulations or amendments thereto that are necessary to carry out titles
				II (except section 202) and VII, the sections of title III for which negotiated
				rulemaking is specifically required, and section 807. Unless otherwise
				required, the Secretary may promulgate regulations to carry out titles I, III,
				IV, and V, and section 202, using the procedures required by chapter V of title
				5, United States Code (commonly known as the <quote>Administrative Procedure
				Act</quote>).</text>
									</paragraph><paragraph id="H8001738601A5465AA044F7E3D3C04409"><enum>(2)</enum><header>Proposed
				regulations</header><text>Proposed regulations to implement this Act shall be
				published in the Federal Register by the Secretary no later than 2 years after
				the date of enactment of the <short-title>Indian Health
				Care Improvement Act Amendments of 2007</short-title> and shall have no less
				than a 120-day comment period.</text>
									</paragraph><paragraph id="H5805CC0E3D9D4326A655B5D3633EB2C6"><enum>(3)</enum><header>Final
				regulations</header><text>The Secretary shall publish in the Federal Register
				final regulations to implement this Act by not later than 3 years after the
				date of enactment of the <short-title>Indian Health Care
				Improvement Act Amendments of 2007</short-title>.</text>
									</paragraph></subsection><subsection id="HC3884D88B03D4368B9293D58A3104936"><enum>(b)</enum><header>Committee</header><text>A
				negotiated rulemaking committee established pursuant to <external-xref legal-doc="usc" parsable-cite="usc/5/565">section 565</external-xref> of title 5,
				United States Code, to carry out this section shall have as its members only
				representatives of the Federal Government and representatives of Indian Tribes,
				and Tribal Organizations, a majority of whom shall be nominated by and be
				representatives of Indian Tribes and Tribal Organizations from each Service
				Area.</text>
								</subsection><subsection id="H46C163ABA14E4A459E907748C7612C6F"><enum>(c)</enum><header>Adaptation of
				procedures</header><text>The Secretary shall adapt the negotiated rulemaking
				procedures to the unique context of self-governance and the
				government-to-government relationship between the United States and Indian
				Tribes.</text>
								</subsection><subsection id="H30CD608381234F71008DA0A81F1C1029"><enum>(d)</enum><header>Lack of
				regulations</header><text>The lack of promulgated regulations shall not limit
				the effect of this Act.</text>
								</subsection><subsection id="HF45F0970A2A14A6C88F71B1191BAE3F5"><enum>(e)</enum><header>Inconsistent
				regulations</header><text>The provisions of this Act shall supersede any
				conflicting provisions of law in effect on the day before the date of enactment
				of the <short-title>Indian Health Care Improvement Act
				Amendments of 2007</short-title>, and the Secretary is authorized to repeal any
				regulation inconsistent with the provisions of this Act.</text>
								</subsection></section><section id="HCF3224E6DEF94CAB99E0E9A9D606E521"><enum>803.</enum><header>Plan of
				implementation</header><text display-inline="no-display-inline">Not later than
				9 months after the date of enactment of the <short-title>Indian Health Care Improvement Act Amendments of
				2007</short-title>, the Secretary, in consultation with Indian Tribes, Tribal
				Organizations, and Urban Indian Organizations, shall submit to Congress a plan
				explaining the manner and schedule, by title and section, by which the
				Secretary will implement the provisions of this Act. This consultation may be
				conducted jointly with the annual budget consultation pursuant to the Indian
				Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq).</text>
							</section><section id="H932E0A4983F3448B852B1BD6BAE004E"><enum>804.</enum><header>Availability of
				funds</header><text display-inline="no-display-inline">The funds appropriated
				pursuant to this Act shall remain available until expended.</text>
							</section><section id="H40AC43D19556438F93FBCF9E528E0043"><enum>805.</enum><header>Limitation on use of
				funds appropriated to Indian Health Service</header><text display-inline="no-display-inline">Any limitation on the use of funds contained
				in an Act providing appropriations for the Department for a period with respect
				to the performance of abortions shall apply for that period with respect to the
				performance of abortions using funds contained in an Act providing
				appropriations for the Service.</text>
							</section><section id="H0E74163F15F0405100B07D2C9F9FC22B"><enum>806.</enum><header>Eligibility of
				California Indians</header>
								<subsection id="H66D680CDF0454614A188B16735E40069"><enum>(a)</enum><header>In
				general</header><text>The following California Indians shall be eligible for
				health services provided by the Service:</text>
									<paragraph id="H89CC484E45894C06B5B66905CF4EF200"><enum>(1)</enum><text>Any member of a federally
				recognized Indian Tribe.</text>
									</paragraph><paragraph id="H4B298455B8DE4F47918C56682FCD8433"><enum>(2)</enum><text>Any descendant of an
				Indian who was residing in California on June 1, 1852, if such
				descendant—</text>
										<subparagraph id="HB93D0D3F62AC48A88B31EAA44592D90"><enum>(A)</enum><text>is a member of the Indian
				community served by a local program of the Service; and</text>
										</subparagraph><subparagraph id="H9346CB122D324469BB23181CBB4006B"><enum>(B)</enum><text>is regarded as an Indian
				by the community in which such descendant lives.</text>
										</subparagraph></paragraph><paragraph id="H44156D02E4F44AD7AD7183BBAEE2D004"><enum>(3)</enum><text>Any Indian who holds
				trust interests in public domain, national forest, or reservation allotments in
				California.</text>
									</paragraph><paragraph id="HEDB028375DB94D7CA1C4613C1174DFBF"><enum>(4)</enum><text>Any Indian in California
				who is listed on the plans for distribution of the assets of rancherias and
				reservations located within the State of California under the Act of August 18,
				1958 (72 Stat. 619), and any descendant of such an Indian.</text>
									</paragraph></subsection><subsection id="HE248F7BCC76D406B90EFB0004021B49"><enum>(b)</enum><header>Clarification</header><text>Nothing
				in this section may be construed as expanding the eligibility of California
				Indians for health services provided by the Service beyond the scope of
				eligibility for such health services that applied on May 1, 1986.</text>
								</subsection></section><section id="HCAD439E817CB43F09EBB45C6A38D86DE"><enum>807.</enum><header>Health services for
				ineligible persons</header>
								<subsection id="H28F980F87042431086C11D084D6F7663"><enum>(a)</enum><header>Children</header><text>Any
				individual who—</text>
									<paragraph id="H7057580145434CB2A098003C5FE0FED"><enum>(1)</enum><text>has not attained 19 years
				of age;</text>
									</paragraph><paragraph id="H3B16574D1091471CA069D335600B1F0"><enum>(2)</enum><text>is the natural or adopted
				child, stepchild, foster child, legal ward, or orphan of an eligible Indian;
				and</text>
									</paragraph><paragraph id="H0B12E708DDB844478CFE35C9D5555912"><enum>(3)</enum><text>is not otherwise eligible
				for health services provided by the Service,</text>
									</paragraph><continuation-text continuation-text-level="subsection">shall be eligible for all health services
				provided by the Service on the same basis and subject to the same rules that
				apply to eligible Indians until such individual attains 19 years of age. The
				existing and potential health needs of all such individuals shall be taken into
				consideration by the Service in determining the need for, or the allocation of,
				the health resources of the Service. If such an individual has been determined
				to be legally incompetent prior to attaining 19 years of age, such individual
				shall remain eligible for such services until 1 year after the date of a
				determination of competency.</continuation-text></subsection><subsection id="HB724299BAA30475C0062EAFC9300EDEA"><enum>(b)</enum><header>Spouses</header><text>Any
				spouse of an eligible Indian who is not an Indian, or who is of Indian descent
				but is not otherwise eligible for the health services provided by the Service,
				shall be eligible for such health services if all such spouses or spouses who
				are married to members of each Indian Tribe being served are made eligible, as
				a class, by an appropriate resolution of the governing body of the Indian Tribe
				or Tribal Organization providing such services. The health needs of persons
				made eligible under this paragraph shall not be taken into consideration by the
				Service in determining the need for, or allocation of, its health
				resources.</text>
								</subsection><subsection id="HAC98EB23A7384B5FB5D7A5CD82D7FFCF"><enum>(c)</enum><header>Provision of services
				to other individuals</header>
									<paragraph id="HFB00C9EAA55F4668BAA8E25070951E49"><enum>(1)</enum><header>In
				general</header><text>The Secretary is authorized to provide health services
				under this subsection through health programs operated directly by the Service
				to individuals who reside within the Service Unit and who are not otherwise
				eligible for such health services if—</text>
										<subparagraph id="H6A8845DCD2774D9180397EC1E7A35C14"><enum>(A)</enum><text>the Indian Tribes served
				by such Service Unit request such provision of health services to such
				individuals; and</text>
										</subparagraph><subparagraph id="H2E28623759DF41BC9CCBA6CCD54141"><enum>(B)</enum><text>the Secretary and the
				served Indian Tribes have jointly determined that—</text>
											<clause id="HFF0CC79651D249D5885FCA5700B103D"><enum>(i)</enum><text>the provision of such
				health services will not result in a denial or diminution of health services to
				eligible Indians; and</text>
											</clause><clause id="HCAFE188C2D0B4B69812DBEA3F8F427C1"><enum>(ii)</enum><text>there is no reasonable
				alternative health facilities or services, within or without the Service Unit,
				available to meet the health needs of such individuals.</text>
											</clause></subparagraph></paragraph><paragraph id="HBA81ECA02E1C4EE4AB64DF0911322B7D"><enum>(2)</enum><header>ISDEAA
				programs</header><text>In the case of health programs and facilities operated
				under a contract or compact entered into under the
				<act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>), the governing body of the
				Indian Tribe or Tribal Organization providing health services under such
				contract or compact is authorized to determine whether health services should
				be provided under such contract to individuals who are not eligible for such
				health services under any other subsection of this section or under any other
				provision of law. In making such determinations, the governing body of the
				Indian Tribe or Tribal Organization shall take into account the considerations
				described in paragraph (1)(B).</text>
									</paragraph><paragraph id="H8047FC04D44C4943A6029B570027A7CA"><enum>(3)</enum><header>Payment for
				services</header>
										<subparagraph id="HFA98037380414C97BDD3AC131453E8AB"><enum>(A)</enum><header>In
				general</header><text>Persons receiving health services provided by the Service
				under this subsection shall be liable for payment of such health services under
				a schedule of charges prescribed by the Secretary which, in the judgment of the
				Secretary, results in reimbursement in an amount not less than the actual cost
				of providing the health services. Notwithstanding section 404 of this Act or
				any other provision of law, amounts collected under this subsection, including
				Medicare, Medicaid, or SCHIP reimbursements under titles XVIII, XIX, and XXI of
				the <act-name parsable-cite="SSA">Social Security Act</act-name>, shall be
				credited to the account of the program providing the service and shall be used
				for the purposes listed in section 401(d)(2) and amounts collected under this
				subsection shall be available for expenditure within such program.</text>
										</subparagraph><subparagraph id="H4107957E08C0433DB891F910E358459D"><enum>(B)</enum><header>Indigent
				people</header><text>Health services may be provided by the Secretary through
				the Service under this subsection to an indigent individual who would not be
				otherwise eligible for such health services but for the provisions of paragraph
				(1) only if an agreement has been entered into with a State or local government
				under which the State or local government agrees to reimburse the Service for
				the expenses incurred by the Service in providing such health services to such
				indigent individual.</text>
										</subparagraph></paragraph><paragraph id="HF2811D3BA2F341C9A513DEDD49F49779"><enum>(4)</enum><header>Revocation of consent
				for services</header>
										<subparagraph id="H278AA468EE624CD9A412667543DF4432"><enum>(A)</enum><header>Single tribe service
				area</header><text>In the case of a Service Area which serves only 1 Indian
				Tribe, the authority of the Secretary to provide health services under
				paragraph (1) shall terminate at the end of the fiscal year succeeding the
				fiscal year in which the governing body of the Indian Tribe revokes its
				concurrence to the provision of such health services.</text>
										</subparagraph><subparagraph id="H6C90CA875F3B4BB48C419B5C242D24C6"><enum>(B)</enum><header>Multitribal service
				area</header><text>In the case of a multitribal Service Area, the authority of
				the Secretary to provide health services under paragraph (1) shall terminate at
				the end of the fiscal year succeeding the fiscal year in which at least 51
				percent of the number of Indian Tribes in the Service Area revoke their
				concurrence to the provisions of such health services.</text>
										</subparagraph></paragraph></subsection><subsection id="H656351D875384850A79251F233C72D00"><enum>(d)</enum><header>Other
				services</header><text>The Service may provide health services under this
				subsection to individuals who are not eligible for health services provided by
				the Service under any other provision of law in order to—</text>
									<paragraph id="H286B0113BA72489C8E4840B39F67A900"><enum>(1)</enum><text>achieve stability in a
				medical emergency;</text>
									</paragraph><paragraph id="HBEDCD5A2685B4D7EAE7180B00B69207"><enum>(2)</enum><text>prevent the spread of a
				communicable disease or otherwise deal with a public health hazard;</text>
									</paragraph><paragraph id="HDCF47103120740F8BB829190B29334C1"><enum>(3)</enum><text>provide care to
				non-Indian women pregnant with an eligible Indian’s child for the duration of
				the pregnancy through postpartum; or</text>
									</paragraph><paragraph id="HFFA946268FC34D72A4C2D2F0917B00E6"><enum>(4)</enum><text>provide care to immediate
				family members of an eligible individual if such care is directly related to
				the treatment of the eligible individual.</text>
									</paragraph></subsection><subsection id="HFF046117B7384D4E861B377771F5A605"><enum>(e)</enum><header>Hospital privileges for
				practitioners</header><text>Hospital privileges in health facilities operated
				and maintained by the Service or operated under a contract or compact pursuant
				to the <act-name parsable-cite="ISDA">Indian Self-Determination and Education
				Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>) may be extended to
				non-Service health care practitioners who provide services to individuals
				described in subsection (a), (b), (c), or (d). Such non-Service health care
				practitioners may, as part of the privileging process, be designated as
				employees of the Federal Government for purposes of section 1346(b) and chapter
				171 of title 28, United States Code (relating to Federal tort claims) only with
				respect to acts or omissions which occur in the course of providing services to
				eligible individuals as a part of the conditions under which such hospital
				privileges are extended.</text>
								</subsection><subsection id="H05C5FBDC9E944FA6A5E09BDEF482900"><enum>(f)</enum><header>Eligible
				Indian</header><text>For purposes of this section, the term <term>eligible
				Indian</term> means any Indian who is eligible for health services provided by
				the Service without regard to the provisions of this section.</text>
								</subsection></section><section id="HEB648E93A039419AAAA90587A2AACC9"><enum>808.</enum><header>Reallocation of base
				resources</header>
								<subsection id="H414DA220D9274553B32D248FF4A63FD2"><enum>(a)</enum><header>Report
				required</header><text>Notwithstanding any other provision of law, any
				allocation of Service funds for a fiscal year that reduces by 5 percent or more
				from the previous fiscal year the funding for any recurring program, project,
				or activity of a Service Unit may be implemented only after the Secretary has
				submitted to Congress, under section 801, a report on the proposed change in
				allocation of funding, including the reasons for the change and its likely
				effects.</text>
								</subsection><subsection id="H480A7A6B0F694E7286387E8B50309679"><enum>(b)</enum><header>Exception</header><text>Subsection
				(a) shall not apply if the total amount appropriated to the Service for a
				fiscal year is at least 5 percent less than the amount appropriated to the
				Service for the previous fiscal year.</text>
								</subsection></section><section id="HC7C71675C1A84F6EAF6B92E5AC7038BA"><enum>809.</enum><header>Results of
				demonstration projects</header><text display-inline="no-display-inline">The
				Secretary shall provide for the dissemination to Indian Tribes, Tribal
				Organizations, and Urban Indian Organizations of the findings and results of
				demonstration projects conducted under this Act.</text>
							</section><section id="HAEF451F470E1456CA52C29163EB1D4F"><enum>810.</enum><header>Provision of services
				in Montana</header>
								<subsection id="H67B89D2A540E49889DCCA498976B13A8"><enum>(a)</enum><header>Consistent with court
				decision</header><text>The Secretary, acting through the Service, shall provide
				services and benefits for Indians in Montana in a manner consistent with the
				decision of the United States Court of Appeals for the Ninth Circuit in McNabb
				for McNabb v. Bowen, 829 F.2d 787 (9th Cir. 1987).</text>
								</subsection><subsection id="H9EFC6A4D1E524A90911CD68DE38FB0F4"><enum>(b)</enum><header>Clarification</header><text>The
				provisions of subsection (a) shall not be construed to be an expression of the
				sense of Congress on the application of the decision described in subsection
				(a) with respect to the provision of services or benefits for Indians living in
				any State other than Montana.</text>
								</subsection></section><section id="HFBAC499C2D52484BB2C6416D94003150"><enum>811.</enum><header>Moratorium</header><text display-inline="no-display-inline">During the period of the moratorium imposed
				on implementation of the final rule published in the Federal Register on
				September 16, 1987, by the Department of Health and Human Services, relating to
				eligibility for the health care services of the Indian Health Service, the
				Indian Health Service shall provide services pursuant to the criteria for
				eligibility for such services that were in effect on September 15, 1987,
				subject to the provisions of sections 806 and 807, until the Service has
				submitted to the Committees on Appropriations of the Senate and the House of
				Representatives a budget request reflecting the increased costs associated with
				the proposed final rule, and the request has been included in an appropriations
				Act and enacted into law.</text>
							</section><section id="H0222E861D5F044189E60748C1C9F9239"><enum>812.</enum><header>Severability
				provisions</header><text display-inline="no-display-inline">If any provision of
				this Act, any amendment made by the Act, or the application of such provision
				or amendment to any person or circumstances is held to be invalid, the
				remainder of this Act, the remaining amendments made by this Act, and the
				application of such provisions to persons or circumstances other than those to
				which it is held invalid, shall not be affected thereby.</text>
							</section><section id="H9980F771F6594CD1BCB5CD0064602462"><enum>813.</enum><header>Establishment of
				National Bipartisan Commission on Indian Health Care</header>
								<subsection id="H813EF44D1B0C45B600628D9899BD5666"><enum>(a)</enum><header>Establishment</header><text>There
				is established the National Bipartisan Indian Health Care Commission (the
				<quote>Commission</quote>).</text>
								</subsection><subsection id="HDACFE62B87184C1F9CCB9BC0D8DFBEF8"><enum>(b)</enum><header>Duties of
				Commission</header><text>The duties of the Commission are the following:</text>
									<paragraph id="H20286A3393534CAB913BD3518D27F611"><enum>(1)</enum><text>To establish a study
				committee composed of those members of the Commission appointed by the Director
				of the Service and at least 4 members of Congress from among the members of the
				Commission, the duties of which shall be the following:</text>
										<subparagraph id="H515CC3C3D4C24B59A0C7A526464060DC"><enum>(A)</enum><text>To the extent necessary
				to carry out its duties, collect and compile data necessary to understand the
				extent of Indian needs with regard to the provision of health services,
				regardless of the location of Indians, including holding hearings and
				soliciting the views of Indians, Indian Tribes, Tribal Organizations, and Urban
				Indian Organizations, which may include authorizing and making funds available
				for feasibility studies of various models for providing and funding health
				services for all Indian beneficiaries, including those who live outside of a
				reservation, temporarily or permanently.</text>
										</subparagraph><subparagraph id="HCB3C670C8EEE4669A24CA9BB15307E4"><enum>(B)</enum><text>To make legislative
				recommendations to the Commission regarding the delivery of Federal health care
				services to Indians. Such recommendations shall include those related to issues
				of eligibility, benefits, the range of service providers, the cost of such
				services, financing such services, and the optimal manner in which to provide
				such services.</text>
										</subparagraph><subparagraph id="HD669DA70F33645B5BE6C35F363DE8B4"><enum>(C)</enum><text>To determine the effect
				of the enactment of such recommendations on (i) the existing system of delivery
				of health services for Indians, and (ii) the sovereign status of Indian
				Tribes.</text>
										</subparagraph><subparagraph id="H39E9AD06F3F4498CB86146004516E85E"><enum>(D)</enum><text>Not later than 12 months
				after the appointment of all members of the Commission, to submit a written
				report of its findings and recommendations to the full Commission. The report
				shall include a statement of the minority and majority position of the
				Committee and shall be disseminated, at a minimum, to every Indian Tribe,
				Tribal Organization, and Urban Indian Organization for comment to the
				Commission.</text>
										</subparagraph><subparagraph id="HDF8C7714C6804440BFB914CB2254889"><enum>(E)</enum><text>To report regularly to
				the full Commission regarding the findings and recommendations developed by the
				study committee in the course of carrying out its duties under this
				section.</text>
										</subparagraph></paragraph><paragraph id="HACF503EAB9B04D32A26BA8D212C7A892"><enum>(2)</enum><text>To review and analyze the
				recommendations of the report of the study committee.</text>
									</paragraph><paragraph id="H2EF6711543654550AB4955B754175872"><enum>(3)</enum><text>To make legislative
				recommendations to Congress regarding the delivery of Federal health care
				services to Indians. Such recommendations shall include those related to issues
				of eligibility, benefits, the range of service providers, the cost of such
				services, financing such services, and the optimal manner in which to provide
				such services.</text>
									</paragraph><paragraph id="H311E57F7736F42C1823274858C43EE83"><enum>(4)</enum><text>Not later than 18 months
				following the date of appointment of all members of the Commission, submit a
				written report to Congress regarding the delivery of Federal health care
				services to Indians. Such recommendations shall include those related to issues
				of eligibility, benefits, the range of service providers, the cost of such
				services, financing such services, and the optimal manner in which to provide
				such services.</text>
									</paragraph></subsection><subsection id="H3B02D558E3684CBF8E3012CA70F611F2"><enum>(c)</enum><header>Members</header>
									<paragraph id="HFB950C7D57734D4B8800BF008D82CEA4"><enum>(1)</enum><header>Appointment</header><text>The
				Commission shall be composed of 25 members, appointed as follows:</text>
										<subparagraph id="H84C360C077EB4292A0BA9FD4F60044B4"><enum>(A)</enum><text>Ten members of Congress,
				including 3 from the House of Representatives and 2 from the Senate, appointed
				by their respective majority leaders, and 3 from the House of Representatives
				and 2 from the Senate, appointed by their respective minority leaders, and who
				shall be members of the standing committees of Congress that consider
				legislation affecting health care to Indians.</text>
										</subparagraph><subparagraph id="H3A2787DC398240038C966B088E958F1C"><enum>(B)</enum><text>Twelve persons chosen by
				the congressional members of the Commission, 1 from each Service Area as
				currently designated by the Director of the Service to be chosen from among 3
				nominees from each Service Area put forward by the Indian Tribes within the
				area, with due regard being given to the experience and expertise of the
				nominees in the provision of health care to Indians and to a reasonable
				representation on the commission of members who are familiar with various
				health care delivery modes and who represent Indian Tribes of various size
				populations.</text>
										</subparagraph><subparagraph id="H0593F31AE7344DBA9C06C4AF524FF92E"><enum>(C)</enum><text>Three persons appointed
				by the Director who are knowledgeable about the provision of health care to
				Indians, at least 1 of whom shall be appointed from among 3 nominees put
				forward by those programs whose funds are provided in whole or in part by the
				Service primarily or exclusively for the benefit of Urban Indians.</text>
										</subparagraph><subparagraph id="HA7AA1CFAE70849B4809848E18EC8624"><enum>(D)</enum><text>All those persons chosen
				by the congressional members of the Commission and by the Director shall be
				members of federally recognized Indian Tribes.</text>
										</subparagraph></paragraph><paragraph id="H18F9CCBCC4BB4CC39768CAFBB0D56000"><enum>(2)</enum><header>Chair; vice
				chair</header><text>The Chair and Vice Chair of the Commission shall be
				selected by the congressional members of the Commission.</text>
									</paragraph><paragraph id="HEE12F4264EE549B4A2B90000E3451D12"><enum>(3)</enum><header>Terms</header><text>The
				terms of members of the Commission shall be for the life of the
				Commission.</text>
									</paragraph><paragraph id="H2019C64C79CF45BAAE8488ADB26C78D3"><enum>(4)</enum><header>Deadline for
				appointments</header><text>Congressional members of the Commission shall be
				appointed not later than 180 days after the date of enactment of the
				<short-title>Indian Health Care Improvement Act Amendments
				of 2007</short-title>, and the remaining members of the Commission shall be
				appointed not later than 60 days following the appointment of the congressional
				members.</text>
									</paragraph><paragraph id="H4FD91155B8DA45ECA328833373298898"><enum>(5)</enum><header>Vacancy</header><text>A
				vacancy in the Commission shall be filled in the manner in which the original
				appointment was made.</text>
									</paragraph></subsection><subsection id="HEEB9592CA4914EEE889F5396FBB13F89"><enum>(d)</enum><header>Compensation</header>
									<paragraph id="HCE176A8D83814675A52DBA9E1CFE72B6"><enum>(1)</enum><header>Congressional
				members</header><text>Each congressional member of the Commission shall receive
				no additional pay, allowances, or benefits by reason of their service on the
				Commission and shall receive travel expenses and per diem in lieu of
				subsistence in accordance with sections <external-xref legal-doc="usc" parsable-cite="usc/5/5702">5702</external-xref> and <external-xref legal-doc="usc" parsable-cite="usc/5/5703">5703</external-xref> of title 5, United States
				Code.</text>
									</paragraph><paragraph id="HEE971A951DB547E8A47D7625D48D92E5"><enum>(2)</enum><header>Other
				members</header><text>Remaining members of the Commission, while serving on the
				business of the Commission (including travel time), shall be entitled to
				receive compensation at the per diem equivalent of the rate provided for level
				IV of the Executive Schedule under <external-xref legal-doc="usc" parsable-cite="usc/5/5315">section 5315</external-xref> of title 5, United States Code,
				and while so serving away from home and the member’s regular place of business,
				a member may be allowed travel expenses, as authorized by the Chairman of the
				Commission. For purpose of pay (other than pay of members of the Commission)
				and employment benefits, rights, and privileges, all personnel of the
				Commission shall be treated as if they were employees of the United States
				Senate.</text>
									</paragraph></subsection><subsection id="H810207039DC14F33A422B80332CF4B29"><enum>(e)</enum><header>Meetings</header><text>The
				Commission shall meet at the call of the Chair.</text>
								</subsection><subsection id="H013C5C518B1941ECB4337B1DC7C6D1B0"><enum>(f)</enum><header>Quorum</header><text>A
				quorum of the Commission shall consist of not less than 15 members, provided
				that no less than 6 of the members of Congress who are Commission members are
				present and no less than 9 of the members who are Indians are present.</text>
								</subsection><subsection id="HBC3DF8F7C04948AEB5C93BD946D46083"><enum>(g)</enum><header>Executive Director;
				staff; facilities</header>
									<paragraph id="HF44DDA21D93C4D57A573D420F7323504"><enum>(1)</enum><header>Appointment;
				pay</header><text>The Commission shall appoint an executive director of the
				Commission. The executive director shall be paid the rate of basic pay for
				level V of the Executive Schedule.</text>
									</paragraph><paragraph id="H8D9834A3307D48C2AD393F45F9AB216E"><enum>(2)</enum><header>Staff
				appointment</header><text>With the approval of the Commission, the executive
				director may appoint such personnel as the executive director deems
				appropriate.</text>
									</paragraph><paragraph id="H07E138809CE9461B92CF1405A95F6E78"><enum>(3)</enum><header>Staff
				pay</header><text>The staff of the Commission shall be appointed without regard
				to the provisions of title 5, United States Code, governing appointments in the
				competitive service, and shall be paid without regard to the provisions of
				chapter 51 and subchapter III of chapter 53 of such title (relating to
				classification and General Schedule pay rates).</text>
									</paragraph><paragraph id="HBDC8042453224697922EDAEAB7EF6D47"><enum>(4)</enum><header>Temporary
				services</header><text>With the approval of the Commission, the executive
				director may procure temporary and intermittent services under section 3109(b)
				of title 5, United States Code.</text>
									</paragraph><paragraph id="H92AF36F676984984AEC9D2454CFACEF6"><enum>(5)</enum><header>Facilities</header><text>The
				Administrator of General Services shall locate suitable office space for the
				operation of the Commission. The facilities shall serve as the headquarters of
				the Commission and shall include all necessary equipment and incidentals
				required for the proper functioning of the Commission.</text>
									</paragraph></subsection><subsection id="HA5142DDEC6C749A40094F5D7490064A0"><enum>(h)</enum><header>Hearings</header><paragraph commented="no" display-inline="yes-display-inline" id="H2632DDDE430F472CB3ED29826FD3F813"><enum>(1)</enum><text>For the purpose of
				carrying out its duties, the Commission may hold such hearings and undertake
				such other activities as the Commission determines to be necessary to carry out
				its duties, provided that at least 6 regional hearings are held in different
				areas of the United States in which large numbers of Indians are present. Such
				hearings are to be held to solicit the views of Indians regarding the delivery
				of health care services to them. To constitute a hearing under this subsection,
				at least 5 members of the Commission, including at least 1 member of Congress,
				must be present. Hearings held by the study committee established in this
				section may count toward the number of regional hearings required by this
				subsection.</text>
									</paragraph><paragraph changed="added" committee-id="HII00" id="H9ADC59467E2F4709B274AD0075F2EB79" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>Upon request of the
				Commission, the Comptroller General shall conduct such studies or
				investigations as the Commission determines to be necessary to carry out its
				duties.</text>
									</paragraph><paragraph changed="added" committee-id="HII00" id="HA1F00DA9EAE4486085887564D6B5DF15" indent="up1" reported-display-style="italic"><enum>(3)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="HB53A52B0F3994A8EBEEDDCF37572E1A2"><enum>(A)</enum><text>The Director of the
				Congressional Budget Office or the Chief Actuary of the Centers for Medicare
				&amp; Medicaid Services, or both, shall provide to the Commission, upon the
				request of the Commission, such cost estimates as the Commission determines to
				be necessary to carry out its duties.</text>
										</subparagraph><subparagraph changed="added" committee-id="HII00" id="HB3AFD936491D4BAC966D7EB590ED74D2" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>The Commission shall
				reimburse the Director of the Congressional Budget Office for expenses relating
				to the employment in the office of that Director of such additional staff as
				may be necessary for the Director to comply with requests by the Commission
				under subparagraph (A).</text>
										</subparagraph></paragraph><paragraph changed="added" committee-id="HII00" id="HB3B8C829FF864E009FCCB52FC945D991" indent="up1" reported-display-style="italic"><enum>(4)</enum><text>Upon the request of the
				Commission, the head of any Federal agency is authorized to detail, without
				reimbursement, any of the personnel of such agency to the Commission to assist
				the Commission in carrying out its duties. Any such detail shall not interrupt
				or otherwise affect the civil service status or privileges of the Federal
				employee.</text>
									</paragraph><paragraph changed="added" committee-id="HII00" id="H8974F820C599417CAC45BD00ADEA5C08" indent="up1" reported-display-style="italic"><enum>(5)</enum><text>Upon the request of the
				Commission, the head of a Federal agency shall provide such technical
				assistance to the Commission as the Commission determines to be necessary to
				carry out its duties.</text>
									</paragraph><paragraph changed="added" committee-id="HII00" id="H97A4E146B0914567954BD42E8E76E0AB" indent="up1" reported-display-style="italic"><enum>(6)</enum><text>The Commission may use
				the United States mails in the same manner and under the same conditions as
				Federal agencies and shall, for purposes of the frank, be considered a
				commission of Congress as described in <external-xref legal-doc="usc" parsable-cite="usc/39/3215">section 3215</external-xref> of title 39, United States
				Code.</text>
									</paragraph><paragraph changed="added" committee-id="HII00" id="H9EE0E78E72AA4B359E88E160093D7DC9" indent="up1" reported-display-style="italic"><enum>(7)</enum><text>The Commission may secure
				directly from any Federal agency information necessary to enable it to carry
				out its duties, if the information may be disclosed under section 552 of title
				4, United States Code. Upon request of the Chairman of the Commission, the head
				of such agency shall furnish such information to the Commission.</text>
									</paragraph><paragraph changed="added" committee-id="HII00" id="H7B5C20427B3D4FB49930CC1FE349759D" indent="up1" reported-display-style="italic"><enum>(8)</enum><text>Upon the request of the
				Commission, the Administrator of General Services shall provide to the
				Commission on a reimbursable basis such administrative support services as the
				Commission may request.</text>
									</paragraph><paragraph changed="added" committee-id="HII00" id="H83F5D8B80EE54775A9F7A9DA7DC695D8" indent="up1" reported-display-style="italic"><enum>(9)</enum><text>For purposes of costs
				relating to printing and binding, including the cost of personnel detailed from
				the Government Printing Office, the Commission shall be deemed to be a
				committee of Congress.</text>
									</paragraph></subsection><subsection id="H9EE7257AC69E47A68189B248A50227E2"><enum>(i)</enum><header>Authorization of
				appropriations</header><text>There is authorized to be appropriated $4,000,000
				to carry out the provisions of this section, which sum shall not be deducted
				from or affect any other appropriation for health care for Indian
				persons.</text>
								</subsection><subsection id="HE8B1BE9DB0A24534A2C6945E0600BDBD"><enum>(j)</enum><header>Nonapplicability of
				FACA</header><text>The <act-name parsable-cite="FACA">Federal Advisory
				Committee Act</act-name> (5 U.S.C. App.) shall not apply to the
				Commission.</text>
								</subsection></section><section id="H153D2272AFD549EAB68ED2A2B9E5EA66"><enum>814.</enum><header>Confidentiality of
				medical quality assurance records; qualified immunity for participants</header>
								<subsection id="HCECD9187EFD24B05A2F8ABE7C57BB758"><enum>(a)</enum><header>Confidentiality of
				records</header><text>Medical quality assurance records created by or for any
				Indian Health Program or a health program of an Urban Indian Organization as
				part of a medical quality assurance program are confidential and privileged.
				Such records may not be disclosed to any person or entity, except as provided
				in subsection (c).</text>
								</subsection><subsection id="H83730A48BDA042DE9CCF1C426D10FCB5"><enum>(b)</enum><header>Prohibition on
				disclosure and testimony</header>
									<paragraph id="H80D48E98E5A04E7E99E5C563EFCF7CB7"><enum>(1)</enum><header>In
				general</header><text>No part of any medical quality assurance record described
				in subsection (a) may be subject to discovery or admitted into evidence in any
				judicial or administrative proceeding, except as provided in subsection
				(c).</text>
									</paragraph><paragraph id="H2A3A8D5C58D042B48BC447FD86E8F80"><enum>(2)</enum><header>Testimony</header><text>A
				person who reviews or creates medical quality assurance records for any Indian
				Health Program or Urban Indian Organization who participates in any proceeding
				that reviews or creates such records may not be permitted or required to
				testify in any judicial or administrative proceeding with respect to such
				records or with respect to any finding, recommendation, evaluation, opinion, or
				action taken by such person or body in connection with such records except as
				provided in this section.</text>
									</paragraph></subsection><subsection id="H43C61013C5814840AA49F3886437072D"><enum>(c)</enum><header>Authorized disclosure
				and testimony</header>
									<paragraph id="HA14D1F3277684B1B844800436F91B2E3"><enum>(1)</enum><header>In
				general</header><text>Subject to paragraph (2), a medical quality assurance
				record described in subsection (a) may be disclosed, and a person referred to
				in subsection (b) may give testimony in connection with such a record, only as
				follows:</text>
										<subparagraph id="H00EB7856CEC345F384CA866651B7C5CA"><enum>(A)</enum><text>To a Federal executive
				agency or private organization, if such medical quality assurance record or
				testimony is needed by such agency or organization to perform licensing or
				accreditation functions related to any Indian Health Program or to a health
				program of an Urban Indian Organization to perform monitoring, required by law,
				of such program or organization.</text>
										</subparagraph><subparagraph id="H67A06DCBE432454BAF2050A902758E7F"><enum>(B)</enum><text>To an administrative or
				judicial proceeding commenced by a present or former Indian Health Program or
				Urban Indian Organization provider concerning the termination, suspension, or
				limitation of clinical privileges of such health care provider.</text>
										</subparagraph><subparagraph id="H8E6D28306DB4473C81BF1EB41138ABD9"><enum>(C)</enum><text>To a governmental board
				or agency or to a professional health care society or organization, if such
				medical quality assurance record or testimony is needed by such board, agency,
				society, or organization to perform licensing, credentialing, or the monitoring
				of professional standards with respect to any health care provider who is or
				was an employee of any Indian Health Program or Urban Indian
				Organization.</text>
										</subparagraph><subparagraph id="HFA7F8C99CA47466BAE78AD8BB1755264"><enum>(D)</enum><text>To a hospital, medical
				center, or other institution that provides health care services, if such
				medical quality assurance record or testimony is needed by such institution to
				assess the professional qualifications of any health care provider who is or
				was an employee of any Indian Health Program or Urban Indian Organization and
				who has applied for or been granted authority or employment to provide health
				care services in or on behalf of such program or organization.</text>
										</subparagraph><subparagraph id="HDBE85AD69A3D4B85AF4DDEC01B109F85"><enum>(E)</enum><text>To an officer, employee,
				or contractor of the Indian Health Program or Urban Indian Organization that
				created the records or for which the records were created. If that officer,
				employee, or contractor has a need for such record or testimony to perform
				official duties.</text>
										</subparagraph><subparagraph id="H286A0DE9A71441CE9533E96844901A0"><enum>(F)</enum><text>To a criminal or civil
				law enforcement agency or instrumentality charged under applicable law with the
				protection of the public health or safety, if a qualified representative of
				such agency or instrumentality makes a written request that such record or
				testimony be provided for a purpose authorized by law.</text>
										</subparagraph><subparagraph id="H9CAB555D772E4CEEA92EDC49002D141C"><enum>(G)</enum><text>In an administrative or
				judicial proceeding commenced by a criminal or civil law enforcement agency or
				instrumentality referred to in subparagraph (F), but only with respect to the
				subject of such proceeding.</text>
										</subparagraph></paragraph><paragraph id="HEDE57A47CFAD4A1D99C6E01B708B69C7"><enum>(2)</enum><header>Identity of
				participants</header><text>With the exception of the subject of a quality
				assurance action, the identity of any person receiving health care services
				from any Indian Health Program or Urban Indian Organization or the identity of
				any other person associated with such program or organization for purposes of a
				medical quality assurance program that is disclosed in a medical quality
				assurance record described in subsection (a) shall be deleted from that record
				or document before any disclosure of such record is made outside such program
				or organization. Such requirement does not apply to the release of information
				pursuant to <external-xref legal-doc="usc" parsable-cite="usc/5/552a">section 552a</external-xref> of title 5.</text>
									</paragraph></subsection><subsection id="HC8E0153C1CE142509E217CE3B8599375"><enum>(d)</enum><header>Disclosure for certain
				purposes</header>
									<paragraph id="H1C1D231EDD464D80A66FD368E283CA7D"><enum>(1)</enum><header>In
				general</header><text>Nothing in this section shall be construed as authorizing
				or requiring the withholding from any person or entity aggregate statistical
				information regarding the results of any Indian Health Program or Urban Indian
				Organizations’s medical quality assurance programs.</text>
									</paragraph><paragraph id="HAA3F22743CCF4837871BB467C9AE4F42"><enum>(2)</enum><header>Withholding from
				Congress</header><text>Nothing in this section shall be construed as authority
				to withhold any medical quality assurance record from a committee of either
				House of Congress, any joint committee of Congress, or the Government
				Accountability Office if such record pertains to any matter within their
				respective jurisdictions.</text>
									</paragraph></subsection><subsection id="HD8D170416F434A3EBAAFC0DB625F1314"><enum>(e)</enum><header>Prohibition on
				disclosure of record or testimony</header><text>A person or entity having
				possession of or access to a record or testimony described by this section may
				not disclose the contents of such record or testimony in any manner or for any
				purpose except as provided in this section.</text>
								</subsection><subsection id="H4EA94720251246E29C5F901C45B38281"><enum>(f)</enum><header>Exemption from Freedom
				of Information Act</header><text>Medical quality assurance records described in
				subsection (a) may not be made available to any person under section 552 of
				title 5.</text>
								</subsection><subsection id="H461FF96BE4184BC98F9C38F6F7759934"><enum>(g)</enum><header>Limitation on civil
				liability</header><text>A person who participates in or provides information to
				a person or body that reviews or creates medical quality assurance records
				described in subsection (a) shall not be civilly liable for such participation
				or for providing such information if the participation or provision of
				information was in good faith based on prevailing professional standards at the
				time the medical quality assurance program activity took place.</text>
								</subsection><subsection id="H266BBE6082CB49E4AEA4FD1EF47516C8"><enum>(h)</enum><header>Application to
				information in certain other records</header><text>Nothing in this section
				shall be construed as limiting access to the information in a record created
				and maintained outside a medical quality assurance program, including a
				patient’s medical records, on the grounds that the information was presented
				during meetings of a review body that are part of a medical quality assurance
				program.</text>
								</subsection><subsection id="H65070706648141DE89091DBA0058EB70"><enum>(i)</enum><header>Regulations</header><text>The
				Secretary, acting through the Service, shall promulgate regulations pursuant to
				section 802.</text>
								</subsection><subsection id="H1ACB903CBB4A45549884E8E7CD4A24"><enum>(j)</enum><header>Definitions</header><text>In
				this section:</text>
									<paragraph id="H7B779E315A924B0CB7CF62C16E118EC"><enum>(1)</enum><text>The term <term>health
				care provider</term> means any health care professional, including community
				health aides and practitioners certified under section 121, who are granted
				clinical practice privileges or employed to provide health care services in an
				Indian Health Program or health program of an Urban Indian Organization, who is
				licensed or certified to perform health care services by a governmental board
				or agency or professional health care society or organization.</text>
									</paragraph><paragraph id="HC82E66E84C9C46059D9C7E38285CD5E1"><enum>(2)</enum><text>The term <term>medical
				quality assurance program</term> means any activity carried out before, on, or
				after the date of enactment of this Act by or for any Indian Health Program or
				Urban Indian Organization to assess the quality of medical care, including
				activities conducted by or on behalf of individuals, Indian Health Program or
				Urban Indian Organization medical or dental treatment review committees, or
				other review bodies responsible for quality assurance, credentials, infection
				control, patient safety, patient care assessment (including treatment
				procedures, blood, drugs, and therapeutics), medical records, health resources
				management review and identification and prevention of medical or dental
				incidents and risks.</text>
									</paragraph><paragraph id="H1B7D316B809A41B5A32E007FCF62616D"><enum>(3)</enum><text>The term <term>medical
				quality assurance record</term> means the proceedings, records, minutes, and
				reports that emanate from quality assurance program activities described in
				paragraph (2) and are produced or compiled by or for an Indian Health Program
				or Urban Indian Organization as part of a medical quality assurance
				program.</text>
									</paragraph></subsection></section><section id="H8C024D92F64D47779748C52BF09E03F"><enum>815.</enum><header>Appropriations;
				availability</header><text display-inline="no-display-inline">Any new spending
				authority (described in subparagraph (A) or (B) of section 401(c)(2) of the
				Congressional Budget Act of 1974 (<external-xref legal-doc="public-law" parsable-cite="pl/93/344">Public Law 93–344</external-xref>; 88 Stat. 317)) which is
				provided under this Act shall be effective for any fiscal year only to such
				extent or in such amounts as are provided in appropriation Acts.</text>
							</section><section id="H0511340702C44363A49673F5356B6409"><enum>816.</enum><header>Authorization of
				appropriations</header><text display-inline="no-display-inline">There are
				authorized to be appropriated such sums as may be necessary for each fiscal
				year through fiscal year 2017 to carry out this
				title.</text>
							</section></title><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection id="H0807547CE8524542A1E76BCC449132A9"><enum>(b)</enum><header>Rate of pay</header>
					<paragraph id="H720E97D1129548D10051C5D8D54F339"><enum>(1)</enum><header>Positions at level
			 IV</header><text><external-xref legal-doc="usc" parsable-cite="usc/5/5315">Section 5315</external-xref> of title 5, United States Code, is amended by
			 striking <quote>Assistant Secretaries of Health and Human Services (6)</quote>
			 and inserting <quote>Assistant Secretaries of Health and Human Services
			 (7)</quote>.</text>
					</paragraph><paragraph id="HDD8D834DB1AD42E5835F5969719B4FB"><enum>(2)</enum><header>Positions at level
			 V</header><text><external-xref legal-doc="usc" parsable-cite="usc/5/5316">Section 5316</external-xref> of title 5, United States Code, is amended by
			 striking <quote>Director, Indian Health Service, Department of Health and Human
			 Services</quote>.</text>
					</paragraph></subsection><subsection id="H10314E060F2E412FA11464849F69E6A7"><enum>(c)</enum><header>Amendments to other
			 provisions of law</header>
					<paragraph id="HF2D048E28FB74500B791A431F3489DA1"><enum>(1)</enum><text>Section 3307(b)(1)(C) of
			 the Children’s Health Act of 2000 (<external-xref legal-doc="usc" parsable-cite="usc/25/1671">25 U.S.C. 1671</external-xref> note; <external-xref legal-doc="public-law" parsable-cite="pl/106/310">Public Law 106–310</external-xref>) is
			 amended by striking <quote>Director of the Indian Health Service</quote> and
			 inserting <quote>Assistant Secretary for Indian Health</quote>.</text>
					</paragraph><paragraph id="H5C2CA59F28594856951253056300D32D"><enum>(2)</enum><text>The Indian Lands Open
			 Dump Cleanup Act of 1994 is amended—</text>
						<subparagraph id="HD197A55DEE5E425B928640968CAA93F0"><enum>(A)</enum><text>in section 3 (25 U.S.C.
			 3902)—</text>
							<clause id="H51597EE2E8DD4CCEA89566F8A69F4813"><enum>(i)</enum><text>by striking paragraph
			 (2);</text>
							</clause><clause id="H291F6DAF924347C18900006CFB433293"><enum>(ii)</enum><text>by redesignating
			 paragraphs (1), (3), (4), (5), and (6) as paragraphs (4), (5), (2), (6), and
			 (1), respectively, and moving those paragraphs so as to appear in numerical
			 order; and</text>
							</clause><clause id="H8F05093B640043C20066B70000C0AA51"><enum>(iii)</enum><text>by inserting before
			 paragraph (4) (as redesignated by clause (ii)) the following:</text>
								<quoted-block changed="added" committee-id="HII00" id="H2BD07CA966B143B6A2384C7919B96D9D" reported-display-style="italic" style="OLC">
									<paragraph id="H397BDBF70F3F4B7C902300F8B99BE0FA"><enum>(3)</enum><header>Assistant
				Secretary</header><text>The term <term>Assistant Secretary</term> means the
				Assistant Secretary for Indian
				Health.</text>
									</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
							</clause></subparagraph><subparagraph id="H47FF5977A41E423498A5B200903F58C7"><enum>(B)</enum><text>in section 5 (25 U.S.C.
			 3904), by striking the section designation and heading and inserting the
			 following:</text>
							<quoted-block changed="added" committee-id="HII00" id="H33AA51D3EBA74315B728E2CD3F7D2E07" reported-display-style="italic" style="OLC">
								<section id="HB0CE7C2791164950BE4937DB24272FCB"><enum>5.</enum><header>Authority of Assistant
				Secretary for Indian
				Health</header>
								</section><after-quoted-block>;</after-quoted-block></quoted-block>
						</subparagraph><subparagraph id="HD161D78F3D764A8BA2BD922F40D823"><enum>(C)</enum><text>in section 6(a) (25
			 U.S.C. 3905(a)), in the subsection heading, by striking <quote><header-in-text level="subsection">Director</header-in-text></quote> and inserting
			 <quote><header-in-text level="subsection">Assistant
			 Secretary</header-in-text></quote>;</text>
						</subparagraph><subparagraph id="HD8505F8996A0427380C9D26FC12DF5E6"><enum>(D)</enum><text>in section 9(a) (25
			 U.S.C. 3908(a)), in the subsection heading, by striking <quote><header-in-text level="subsection">Director</header-in-text></quote> and inserting
			 <quote><header-in-text level="subsection">Assistant
			 Secretary</header-in-text></quote>; and</text>
						</subparagraph><subparagraph id="HC2DDC1E35A0C4D34B8CEF8BD9F00C1F3"><enum>(E)</enum><text>by striking
			 <quote>Director</quote> each place it appears and inserting <quote>Assistant
			 Secretary</quote>.</text>
						</subparagraph></paragraph><paragraph id="HBFC82327ADE84547A7F008988312B9B2"><enum>(3)</enum><text>Section 5504(d)(2) of the
			 Augustus F. Hawkins-Robert T. Stafford Elementary and Secondary School
			 Improvement Amendments of 1988 (<external-xref legal-doc="usc" parsable-cite="usc/25/2001">25 U.S.C. 2001</external-xref> note; <external-xref legal-doc="public-law" parsable-cite="pl/100/297">Public Law 100–297</external-xref>) is
			 amended by striking <quote>Director of the Indian Health Service</quote> and
			 inserting <quote>Assistant Secretary for Indian Health</quote>.</text>
					</paragraph><paragraph id="H55DB8ED035FF442098FAFEE68AD5515"><enum>(4)</enum><text>Section 203(a)(1) of the
			 <act-name parsable-cite="REH">Rehabilitation Act of 1973</act-name> (29 U.S.C.
			 763(a)(1)) is amended by striking <quote>Director of the Indian Health
			 Service</quote> and inserting <quote>Assistant Secretary for Indian
			 Health</quote>.</text>
					</paragraph><paragraph id="HD32FB832FC9649F880C9E000AB565913"><enum>(5)</enum><text>Subsections (b) and (e)
			 of section 518 of the <act-name parsable-cite="FWPCA">Federal Water Pollution
			 Control Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/33/1377">33 U.S.C. 1377</external-xref>) are amended by striking <quote>Director
			 of the Indian Health Service</quote> each place it appears and inserting
			 <quote>Assistant Secretary for Indian Health</quote>.</text>
					</paragraph><paragraph id="HF424783501894CE897D984C102715D92"><enum>(6)</enum><text>Section 317M(b) of the
			 <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
			 247b–14(b)) is amended—</text>
						<subparagraph id="H65E27EE404134D3A968067A822E8B49B"><enum>(A)</enum><text>by striking
			 <quote>Director of the Indian Health Service</quote> each place it appears and
			 inserting <quote>Assistant Secretary for Indian Health</quote>; and</text>
						</subparagraph><subparagraph id="HE51D7A723D02417D9DE176056C73D597"><enum>(B)</enum><text>in paragraph (2)(A), by
			 striking <quote>the Directors referred to in such paragraph</quote> and
			 inserting <quote>the Director of the Centers for Disease Control and Prevention
			 and the Assistant Secretary for Indian Health</quote>.</text>
						</subparagraph></paragraph><paragraph id="HA9B5FA9A48E8493BB3595134DD229560"><enum>(7)</enum><text>Section 417C(b) of the
			 <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
			 285–9(b)) is amended by striking <quote>Director of the Indian Health
			 Service</quote> and inserting <quote>Assistant Secretary for Indian
			 Health</quote>.</text>
					</paragraph><paragraph id="H8013D7E06F454247B5C15750635D8DF4"><enum>(8)</enum><text>Section 1452(i) of the
			 Safe Drinking Water Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300j-12">42 U.S.C. 300j–12(i)</external-xref>) is amended by striking
			 <quote>Director of the Indian Health Service</quote> each place it appears and
			 inserting <quote>Assistant Secretary for Indian Health</quote>.</text>
					</paragraph><paragraph id="HCB0B8AFC6B3940818B311FDB1BD4573"><enum>(9)</enum><text>Section 803B(d)(1) of the
			 Native American Programs Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/42/2991b-2">42 U.S.C. 2991b–2(d)(1)</external-xref>) is amended in
			 the last sentence by striking <quote>Director of the Indian Health
			 Service</quote> and inserting <quote>Assistant Secretary for Indian
			 Health</quote>.</text>
					</paragraph><paragraph id="H41A1BB484FD14CA082BBDAABF19F8E00"><enum>(10)</enum><text>Section 203(b) of the
			 Michigan Indian Land Claims Settlement Act (<external-xref legal-doc="public-law" parsable-cite="pl/105/143">Public Law 105–143</external-xref>; 111 Stat. 2666)
			 is amended by striking <quote>Director of the Indian Health Service</quote> and
			 inserting <quote>Assistant Secretary for Indian Health</quote>.</text>
					</paragraph></subsection></section><section id="H338773E6E9A54EE6BC8DEB8C78F07271"><enum>102.</enum><header>Soboba sanitation
			 facilities</header><text display-inline="no-display-inline">The Act of December
			 17, 1970 (84 Stat. 1465), is amended by adding at the end the following:</text>
				<quoted-block changed="added" committee-id="HII00" id="HC4FF37CDB81643ECB6BF58141F1BA1F7" reported-display-style="italic" style="traditional">
					<section id="H999D7171DEA6487CB5656941FDD36D5E"><enum>9.</enum><text display-inline="yes-display-inline">Nothing in this Act shall preclude the
				Soboba Band of Mission Indians and the Soboba Indian Reservation from being
				provided with sanitation facilities and services under the authority of section
				7 of the Act of August 5, 1954 (68 Stat. 674), as amended by the Act of July
				31, 1959 (73 Stat.
				267).</text>
					</section><after-quoted-block>.</after-quoted-block></quoted-block>
			</section><section id="H8E2971DAC79043BEA449BAD799CE2B03"><enum>103.</enum><header>Native American Health
			 and Wellness Foundation</header>
				<subsection id="H1429CA8FE92B4A079B086D0036DCDDF"><enum>(a)</enum><header>In
			 general</header><text>The <act-name parsable-cite="ISDA">Indian
			 Self-Determination and Education Assistance Act</act-name> (25 U.S.C. 450 et
			 seq.) is amended by adding at the end the following:</text>
					<quoted-block act-name="Indian Self-Determination and Education Assistance Act" changed="added" committee-id="HII00" id="H67C3CFB70D5143B397E71FD7D413031" reported-display-style="italic" style="OLC">
						<title id="H1D92C0578FFE4719B7DED8CD2FF0BCF4"><enum>VIII</enum><header>Native American Health
				and Wellness Foundation</header>
							<section id="H558D1331793340F0A3ACDAE7A3BB133D"><enum>801.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text>
								<paragraph id="HD06A792AB8A84BAB99C3F5AC7BE1E550"><enum>(1)</enum><header>Board</header><text>The
				term <term>Board</term> means the Board of Directors of the Foundation.</text>
								</paragraph><paragraph id="H7E28165615D14562B12DE7E37D05F57E"><enum>(2)</enum><header>Committee</header><text>The
				term <term>Committee</term> means the Committee for the Establishment of Native
				American Health and Wellness Foundation established under section
				802(f).</text>
								</paragraph><paragraph id="H69528F990E5B4801A0B83D5DAE9876F7"><enum>(3)</enum><header>Foundation</header><text>The
				term <term>Foundation</term> means the Native American Health and Wellness
				Foundation established under section 802.</text>
								</paragraph><paragraph id="H7C2B23D97340463AA200B92CC2FF77C5"><enum>(4)</enum><header>Secretary</header><text>The
				term <term>Secretary</term> means the Secretary of Health and Human
				Services.</text>
								</paragraph><paragraph id="H59A39EECAEB2407CA9AC601D00BDDFE7"><enum>(5)</enum><header>Service</header><text>The
				term <term>Service</term> means the Indian Health Service of the Department of
				Health and Human Services.</text>
								</paragraph></section><section id="H374E614046834BC9A8E8B909C3D0517E"><enum>802.</enum><header>Native American Health
				and Wellness Foundation</header>
								<subsection id="HB3DF7219D7E14E968B004F835081E4AE"><enum>(a)</enum><header>Establishment</header>
									<paragraph id="HD77D1E65A9674AA9BCADB7F439758400"><enum>(1)</enum><header>In
				general</header><text>As soon as practicable after the date of enactment of
				this title, the Secretary shall establish, under the laws of the District of
				Columbia and in accordance with this title, the Native American Health and
				Wellness Foundation.</text>
									</paragraph><paragraph id="H9B8BBDEABFDB4343A7AE636B0019D032"><enum>(2)</enum><header>Funding
				determinations</header><text>No funds, gift, property, or other item of value
				(including any interest accrued on such an item) acquired by the Foundation
				shall—</text>
										<subparagraph id="HCCB6467AE5974E29835550E353C5FBDC"><enum>(A)</enum><text>be taken into
				consideration for purposes of determining Federal appropriations relating to
				the provision of health care and services to Indians; or</text>
										</subparagraph><subparagraph id="H875BC60B1A7E47DE84FABEA3751DAF"><enum>(B)</enum><text>otherwise limit,
				diminish, or affect the Federal responsibility for the provision of health care
				and services to Indians.</text>
										</subparagraph></paragraph></subsection><subsection id="H592F2878CEE84FAB90546F9CB2DE0622"><enum>(b)</enum><header>Perpetual
				existence</header><text>The Foundation shall have perpetual existence.</text>
								</subsection><subsection id="H30F7C02AA8184C80A900164800F9992E"><enum>(c)</enum><header>Nature of
				corporation</header><text>The Foundation—</text>
									<paragraph id="H62ED5A27FB7A4A9FBDA800C63DF21D7F"><enum>(1)</enum><text>shall be a charitable and
				nonprofit federally chartered corporation; and</text>
									</paragraph><paragraph id="H531E8F3DFB3A45909233957DFB4C198"><enum>(2)</enum><text>shall not be an agency or
				instrumentality of the United States.</text>
									</paragraph></subsection><subsection id="H6F89459E99A54C77AF8873E2095EE183"><enum>(d)</enum><header>Place of incorporation
				and domicile</header><text>The Foundation shall be incorporated and domiciled
				in the District of Columbia.</text>
								</subsection><subsection id="H1CAF6C17F5154F2C9200A13F00926F96"><enum>(e)</enum><header>Duties</header><text>The
				Foundation shall—</text>
									<paragraph id="H2710FB0E8E7C49048F4235629400E1A0"><enum>(1)</enum><text>encourage, accept, and
				administer private gifts of real and personal property, and any income from or
				interest in such gifts, for the benefit of, or in support of, the mission of
				the Service;</text>
									</paragraph><paragraph id="H771C05ECFA764B38B0A76503C44953A2"><enum>(2)</enum><text>undertake and conduct
				such other activities as will further the health and wellness activities and
				opportunities of Native Americans; and</text>
									</paragraph><paragraph id="HD9923261B6844B5FBC9F7E4B13245B8B"><enum>(3)</enum><text>participate with and
				assist Federal, State, and tribal governments, agencies, entities, and
				individuals in undertaking and conducting activities that will further the
				health and wellness activities and opportunities of Native Americans.</text>
									</paragraph></subsection><subsection id="H432FB06F5A2E4FF0B642D797913500BB"><enum>(f)</enum><header>Committee for the
				Establishment of Native American Health and Wellness Foundation</header>
									<paragraph id="H6EBC679C0F0B402D98F45B4C111934A7"><enum>(1)</enum><header>In
				general</header><text>The Secretary shall establish the Committee for the
				Establishment of Native American Health and Wellness Foundation to assist the
				Secretary in establishing the Foundation.</text>
									</paragraph><paragraph id="HE1CFC414581B4E978B33007FB158B5BE"><enum>(2)</enum><header>Duties</header><text>Not
				later than 180 days after the date of enactment of this section, the Committee
				shall—</text>
										<subparagraph id="H1A7BD1D3674D4E2085CF805F4EAD97D6"><enum>(A)</enum><text>carry out such activities
				as are necessary to incorporate the Foundation under the laws of the District
				of Columbia, including acting as incorporators of the Foundation;</text>
										</subparagraph><subparagraph id="H3BF52494B9014701B230874C538268ED"><enum>(B)</enum><text>ensure that the
				Foundation qualifies for and maintains the status required to carry out this
				section, until the Board is established;</text>
										</subparagraph><subparagraph id="HF5BCF7998ADD4878A73003D3E77313F9"><enum>(C)</enum><text>establish the
				constitution and initial bylaws of the Foundation;</text>
										</subparagraph><subparagraph id="H490756DE54FF48B388D1FF5C6320097"><enum>(D)</enum><text>provide for the initial
				operation of the Foundation, including providing for temporary or interim
				quarters, equipment, and staff; and</text>
										</subparagraph><subparagraph id="HBBB6AF7CF8324E64B70238E0A1B5A044"><enum>(E)</enum><text>appoint the initial
				members of the Board in accordance with the constitution and initial bylaws of
				the Foundation.</text>
										</subparagraph></paragraph></subsection><subsection id="H4F2C02D095D84D9D867FE84CD7EAA31"><enum>(g)</enum><header>Board of
				Directors</header>
									<paragraph id="HA9601260C1C64BDD96DCF3D953041A5"><enum>(1)</enum><header>In
				general</header><text>The Board of Directors shall be the governing body of the
				Foundation.</text>
									</paragraph><paragraph id="HF47C464C99DE40CEA3965C93DCF61F7"><enum>(2)</enum><header>Powers</header><text>The
				Board may exercise, or provide for the exercise of, the powers of the
				Foundation.</text>
									</paragraph><paragraph id="H3BD2E8BAB69A4D648C7594A603DF21A0"><enum>(3)</enum><header>Selection</header>
										<subparagraph id="HD72D2761543B4E658270A77FC314FF00"><enum>(A)</enum><header>In
				general</header><text>Subject to subparagraph (B), the number of members of the
				Board, the manner of selection of the members (including the filling of
				vacancies), and the terms of office of the members shall be as provided in the
				constitution and bylaws of the Foundation.</text>
										</subparagraph><subparagraph id="HD8AE403653ED4725B446C4E370FF288C"><enum>(B)</enum><header>Requirements</header>
											<clause id="HA3B7317BE3EC4E6D8E65005500480449"><enum>(i)</enum><header>Number of
				members</header><text>The Board shall have at least 11 members, who shall have
				staggered terms.</text>
											</clause><clause id="H3756004D7E084C0BA6EBDABB19F9EDED"><enum>(ii)</enum><header>Initial voting
				members</header><text>The initial voting members of the Board—</text>
												<subclause id="H743273BAEC824F7CA5DAD4A835F04DF4"><enum>(I)</enum><text>shall be appointed by the
				Committee not later than 180 days after the date on which the Foundation is
				established; and</text>
												</subclause><subclause id="H7B9B672C9DEE40248C005E9559426F66"><enum>(II)</enum><text>shall have staggered
				terms.</text>
												</subclause></clause><clause id="H67F3CF07207F4073886DEB6BF957D845"><enum>(iii)</enum><header>Qualification</header><text>The
				members of the Board shall be United States citizens who are knowledgeable or
				experienced in Native American health care and related matters.</text>
											</clause></subparagraph><subparagraph id="HFD09B110C9334453AC98498639DEB0FD"><enum>(C)</enum><header>Compensation</header><text>A
				member of the Board shall not receive compensation for service as a member, but
				shall be reimbursed for actual and necessary travel and subsistence expenses
				incurred in the performance of the duties of the Foundation.</text>
										</subparagraph></paragraph></subsection><subsection id="H596D9C292EA44BA58FC3006862AA20A1"><enum>(h)</enum><header>Officers</header>
									<paragraph id="H395E805BDD2E454397CEF78D28C902B"><enum>(1)</enum><header>In
				general</header><text>The officers of the Foundation shall be—</text>
										<subparagraph id="HC1F87F53B158460F8F20274389F86070"><enum>(A)</enum><text>a secretary, elected from
				among the members of the Board; and</text>
										</subparagraph><subparagraph id="H895F551CDC8544DF8C8C003F7B687D5D"><enum>(B)</enum><text>any other officers
				provided for in the constitution and bylaws of the Foundation.</text>
										</subparagraph></paragraph><paragraph id="HC4402CEDA26B44DB8DE34FC38FBC2F7C"><enum>(2)</enum><header>Chief Operating
				Officer</header><text>The secretary of the Foundation may serve, at the
				direction of the Board, as the chief operating officer of the Foundation, or
				the Board may appoint a chief operating officer, who shall serve at the
				direction of the Board.</text>
									</paragraph><paragraph id="HF5BD09FAABB748C7A04540466B7CF7A1"><enum>(3)</enum><header>Election</header><text>The
				manner of election, term of office, and duties of the officers of the
				Foundation shall be as provided in the constitution and bylaws of the
				Foundation.</text>
									</paragraph></subsection><subsection id="HB43472D31F664109A82FC02B489FE480"><enum>(i)</enum><header>Powers</header><text>The
				Foundation—</text>
									<paragraph id="H01E6A4B13BED479EA3D9B5EDC71682"><enum>(1)</enum><text>shall adopt a
				constitution and bylaws for the management of the property of the Foundation
				and the regulation of the affairs of the Foundation;</text>
									</paragraph><paragraph id="H955F598AD4D04084B7CB6F35E3A71875"><enum>(2)</enum><text>may adopt and alter a
				corporate seal;</text>
									</paragraph><paragraph id="HD11EB26C2EF649329C6F1EEC72D3801E"><enum>(3)</enum><text>may enter into
				contracts;</text>
									</paragraph><paragraph id="HF2242F4CA5BD4F52AB5152AA5F7931ED"><enum>(4)</enum><text>may acquire (through a
				gift or otherwise), own, lease, encumber, and transfer real or personal
				property as necessary or convenient to carry out the purposes of the
				Foundation;</text>
									</paragraph><paragraph id="H6DC732CF254541E0AF23CD51B1DC37A3"><enum>(5)</enum><text>may sue and be sued;
				and</text>
									</paragraph><paragraph id="H360A89D3D8DA4A3AA4BB3628733B1DE1"><enum>(6)</enum><text>may perform any other act
				necessary and proper to carry out the purposes of the Foundation.</text>
									</paragraph></subsection><subsection id="H6C7C2762944B4D17860276BAC3F430DA"><enum>(j)</enum><header>Principal
				office</header>
									<paragraph id="H5F5A8D5EB5DB458AAEA2F0AD00DA00E1"><enum>(1)</enum><header>In
				general</header><text>The principal office of the Foundation shall be in the
				District of Columbia.</text>
									</paragraph><paragraph id="H3B5F59BDD6FC4E899536E0642F81E75E"><enum>(2)</enum><header>Activities;
				offices</header><text>The activities of the Foundation may be conducted, and
				offices may be maintained, throughout the United States in accordance with the
				constitution and bylaws of the Foundation.</text>
									</paragraph></subsection><subsection id="H64ADB9FC5B964D199E827F1FC3C0DD20"><enum>(k)</enum><header>Service of
				process</header><text>The Foundation shall comply with the law on service of
				process of each State in which the Foundation is incorporated and of each State
				in which the Foundation carries on activities.</text>
								</subsection><subsection id="HEF888BBC670E4D18B7BEC1A75C947DE7"><enum>(l)</enum><header>Liability of officers,
				employees, and agents</header>
									<paragraph id="HE0AB102C566842A3BA38003457B0D917"><enum>(1)</enum><header>In
				general</header><text>The Foundation shall be liable for the acts of the
				officers, employees, and agents of the Foundation acting within the scope of
				their authority.</text>
									</paragraph><paragraph id="H07891602A80A4A3EB2E570A9704C1969"><enum>(2)</enum><header>Personal
				liability</header><text>A member of the Board shall be personally liable only
				for gross negligence in the performance of the duties of the member.</text>
									</paragraph></subsection><subsection id="H243DADB6A6AA4807BE22DF61A589949D"><enum>(m)</enum><header>Restrictions</header>
									<paragraph id="HBE9864712F8A4039B47610FA5825F7A4"><enum>(1)</enum><header>Limitation on
				spending</header><text>Beginning with the fiscal year following the first full
				fiscal year during which the Foundation is in operation, the administrative
				costs of the Foundation shall not exceed the percentage described in paragraph
				(2) of the sum of—</text>
										<subparagraph id="H0509E37025874912BFE91686E7BBFC54"><enum>(A)</enum><text>the amounts transferred
				to the Foundation under subsection (o) during the preceding fiscal year;
				and</text>
										</subparagraph><subparagraph id="H283CE0286D0B4B18BA5C737CED13D1C9"><enum>(B)</enum><text>donations received from
				private sources during the preceding fiscal year.</text>
										</subparagraph></paragraph><paragraph id="H6F4526DCB36447A2A204008623E9314E"><enum>(2)</enum><header>Percentages</header><text>The
				percentages referred to in paragraph (1) are—</text>
										<subparagraph id="H7CB63D4842F84003BF39008B38539EDB"><enum>(A)</enum><text>for the first fiscal year
				described in that paragraph, 20 percent;</text>
										</subparagraph><subparagraph id="H4C3EEB83374A4BC38FD600117D2BE98"><enum>(B)</enum><text>for the following fiscal
				year, 15 percent; and</text>
										</subparagraph><subparagraph id="HFCE90E127702449BBDE4ADB8FCABDACA"><enum>(C)</enum><text>for each fiscal year
				thereafter, 10 percent.</text>
										</subparagraph></paragraph><paragraph id="H45B0DB53326947F0A239845B0276DBA8"><enum>(3)</enum><header>Appointment and
				hiring</header><text>The appointment of officers and employees of the
				Foundation shall be subject to the availability of funds.</text>
									</paragraph><paragraph id="HBF6EFBB83F094FD2961666BE215232A1"><enum>(4)</enum><header>Status</header><text>A
				member of the Board or officer, employee, or agent of the Foundation shall not
				by reason of association with the Foundation be considered to be an officer,
				employee, or agent of the United States.</text>
									</paragraph></subsection><subsection id="H555E5626094F4877A553F48FBD30E625"><enum>(n)</enum><header>Audits</header><text>The
				Foundation shall comply with <external-xref legal-doc="usc" parsable-cite="usc/36/10101">section 10101</external-xref> of title 36, United States Code, as
				if the Foundation were a corporation under part B of subtitle II of that
				title.</text>
								</subsection><subsection id="H0D20B1CF735B4262982D40EC2138E5C"><enum>(o)</enum><header>Funding</header>
									<paragraph id="H8FEC996B7C4D415D81ACBFDE4B6053FC"><enum>(1)</enum><header>Authorization of
				appropriations</header><text>There is authorized to be appropriated to carry
				out subsection (e)(1) $500,000 for each fiscal year, as adjusted to reflect
				changes in the Consumer Price Index for all-urban consumers published by the
				Department of Labor.</text>
									</paragraph><paragraph id="H8C75EBCC19E243AC85C75784F2091CD4"><enum>(2)</enum><header>Transfer of donated
				funds</header><text>The Secretary shall transfer to the Foundation funds held
				by the Department of Health and Human Services under the Act of August 5, 1954
				(<external-xref legal-doc="usc" parsable-cite="usc/42/2001">42 U.S.C. 2001 et seq.</external-xref>), if the transfer or use of the funds is not prohibited
				by any term under which the funds were donated.</text>
									</paragraph></subsection></section><section id="H082C94A1EEF74103863E051CAEA1C37F"><enum>803.</enum><header>Administrative
				services and support</header>
								<subsection id="HC63E617FDDCE4176958EAB3EDD4974D6"><enum>(a)</enum><header>Provision of support by
				Secretary</header><text>Subject to subsection (b), during the 5-year period
				beginning on the date on which the Foundation is established, the
				Secretary—</text>
									<paragraph id="H9C330DC5C3AE41EFB001F7108FF0EE2"><enum>(1)</enum><text>may provide personnel,
				facilities, and other administrative support services to the Foundation;</text>
									</paragraph><paragraph id="H0B5D7A5761484DBF9E6D3D9F9081DE77"><enum>(2)</enum><text>may provide funds for
				initial operating costs and to reimburse the travel expenses of the members of
				the Board; and</text>
									</paragraph><paragraph id="HDEE4AF810FD940DFACF06C80C34527DA"><enum>(3)</enum><text>shall require and accept
				reimbursements from the Foundation for—</text>
										<subparagraph id="H03A3F9A7C4714FC3842FF580CE130018"><enum>(A)</enum><text>services provided under
				paragraph (1); and</text>
										</subparagraph><subparagraph id="H300F0EB4737E4BDB8095C097006F30D9"><enum>(B)</enum><text>funds provided under
				paragraph (2).</text>
										</subparagraph></paragraph></subsection><subsection id="HD1C19A4EEA44415D9939F66FF5B290FA"><enum>(b)</enum><header>Reimbursement</header><text>Reimbursements
				accepted under subsection (a)(3)—</text>
									<paragraph id="H90D8248764484994B45E596B3F4502D7"><enum>(1)</enum><text>shall be deposited in the
				Treasury of the United States to the credit of the applicable appropriations
				account; and</text>
									</paragraph><paragraph id="HBA1427329A374922A7152F3117F2C2C"><enum>(2)</enum><text>shall be chargeable for
				the cost of providing services described in subsection (a)(1) and travel
				expenses described in subsection (a)(2).</text>
									</paragraph></subsection><subsection id="H3C001934E246494A962B47C04379AC3B"><enum>(c)</enum><header>Continuation of certain
				services</header><text>The Secretary may continue to provide facilities and
				necessary support services to the Foundation after the termination of the
				5-year period specified in subsection (a) if the facilities and
				services—</text>
									<paragraph id="H4EE50A4CD60B4504AF4DBC5BFC77D7"><enum>(1)</enum><text>are available; and</text>
									</paragraph><paragraph id="H9A1B7D239B134C019EDF476073BD9132"><enum>(2)</enum><text>are provided on
				reimbursable cost
				basis.</text>
									</paragraph></subsection></section></title><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection id="HE2062C0C75C34596B2F300900775B63F"><enum>(b)</enum><header>Technical
			 amendments</header><text>The <act-name parsable-cite="ISDA">Indian
			 Self-Determination and Education Assistance Act</act-name> is amended—</text>
					<paragraph id="HA4F03C60C55C4678B53BFC4B80BDEFB"><enum>(1)</enum><text>by redesignating the
			 second title V (<external-xref legal-doc="usc" parsable-cite="usc/25/458bbb">25 U.S.C. 458bbb et seq.</external-xref>) as title VII;</text>
					</paragraph><paragraph id="H68069A82651D4ECB88658FAA7ED44382"><enum>(2)</enum><text>by redesignating sections
			 501, 502, and 503 (<external-xref legal-doc="usc" parsable-cite="usc/25/458bbb">25 U.S.C. 458bbb</external-xref>, 458bbb–1, 458bbb–2) as sections 701, 702,
			 and 703, respectively; and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H74DC717C76A942BFA96C8D9028404FAF"><enum>(3)</enum><text>in subsection (a)(2) of
			 section 702 and paragraph (2) of section 703 (as redesignated by paragraph
			 (2)), by striking <quote>section 501</quote> and inserting <quote>section
			 701</quote>.</text>
					</paragraph></subsection></section></title><title id="H1E0C0CAF19D941A8829BC53829D295CC"><enum>II</enum><header>Improvement of Indian
			 health care provided under the Social Security Act </header>
			<section id="H73EEBF30936C4B148BBBAC742BC2452"><enum>201.</enum><header>Expansion of payments
			 under Medicare, Medicaid, and SCHIP for all covered services furnished by
			 Indian Health Programs</header>
				<subsection id="H9D8754227D9A49B2B8A7B8C4F1CF0061"><enum>(a)</enum><header>Medicaid</header>
					<paragraph id="H581CA5FEC1E54536B5C0B8CABE6800ED"><enum>(1)</enum><header>Expansion to all
			 covered services</header><text display-inline="yes-display-inline">Section 1911
			 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396j">42 U.S.C. 1396j</external-xref>) is amended—</text>
						<subparagraph id="H6BB6577BE0F2497DA700A170E6EC1A5"><enum>(A)</enum><text>by amending the section
			 designation and heading to read as follows:</text>
							<quoted-block display-inline="no-display-inline" id="H35A3B4A96ADC4B34824FA88D7896DE80" style="OLC">
								<section id="HA684134A67BD4FA2B27B15C720E5E332"><enum>1911.</enum><header>Indian Health
				Programs</header>
								</section><after-quoted-block>;</after-quoted-block></quoted-block>
							<continuation-text continuation-text-level="subparagraph">and</continuation-text></subparagraph><subparagraph id="HD64BCD24500C4E9FA3E77FB4110973AD"><enum>(B)</enum><text>by amending subsection
			 (a) to read as follows:</text>
							<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H979DE1012E57478F00E627B608A13E95" reported-display-style="italic" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="H8713969CA2074E98B040F4A524B242E9"><enum>(a)</enum><header>Eligibility for payment
				for medical assistance</header><text display-inline="yes-display-inline">The
				Indian Health Service and an Indian Tribe, Tribal Organization, or an Urban
				Indian Organization shall be eligible for payment for medical assistance
				provided under a State plan or under waiver authority with respect to items and
				services furnished by the Indian Health Service, Indian Tribe, Tribal
				Organization, or Urban Indian Organization if the furnishing of such services
				meets all the conditions and requirements which are applicable generally to the
				furnishing of items and services under this title and under such plan or waiver
				authority.</text>
								</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph id="H8DFB3F14D0BA4716A3BE00C3B04810B6"><enum>(2)</enum><header>Compliance with
			 conditions and requirements</header><text>Subsection (b) of such section is
			 amended to read as follows:</text>
						<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H8E9CC968F32B44BAA7C4006E028FE5C5" reported-display-style="italic" style="OLC">
							<subsection id="H60EC2ED8B793466AB85B2167A252BD5F"><enum>(b)</enum><header>Compliance with
				conditions and requirements</header><text>A facility of the Indian Health
				Service or an Indian Tribe, Tribal Organization, or an Urban Indian
				Organization which is eligible for payment under subsection (a) with respect to
				the furnishing of items and services, but which does not meet all of the
				conditions and requirements of this title and under a State plan or waiver
				authority which are applicable generally to such facility, shall make such
				improvements as are necessary to achieve or maintain compliance with such
				conditions and requirements in accordance with a plan submitted to and accepted
				by the Secretary for achieving or maintaining compliance with such conditions
				and requirements, and shall be deemed to meet such conditions and requirements
				(and to be eligible for payment under this title), without regard to the extent
				of its actual compliance with such conditions and requirements, during the
				first 12 months after the month in which such plan is
				submitted.</text>
							</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph><paragraph id="HCC1026D658284CB0B83B00008429B5F7"><enum>(3)</enum><header>Revision of authority
			 to enter into agreements</header><text>Subsection (c) of such section is
			 amended to read as follows:</text>
						<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H64ECBD676974499C93B506B94DE20035" reported-display-style="italic" style="OLC">
							<subsection id="H3216A273BB66469AA1A1CDEEAF419290"><enum>(c)</enum><header>Authority To enter into
				agreements</header><text>The Secretary may enter into an agreement with a State
				for the purpose of reimbursing the State for medical assistance provided by the
				Indian Health Service, an Indian Tribe, Tribal Organization, or an Urban Indian
				Organization (as so defined), directly, through referral, or under contracts or
				other arrangements between the Indian Health Service, an Indian Tribe, Tribal
				Organization, or an Urban Indian Organization and another health care provider
				to Indians who are eligible for medical assistance under the State plan or
				under waiver
				authority.</text>
							</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph><paragraph id="H8F47D6ABD4D2430281D75E668543839B"><enum>(4)</enum><header>Cross-references to
			 special fund for improvement of IHS facilities; direct billing option;
			 definitions</header><text>Such section is further amended by striking
			 subsection (d) and adding at the end the following new subsections:</text>
						<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HA373595B642746459EB7838D0029159C" reported-display-style="italic" style="OLC">
							<subsection id="H5DF6A4CBBD764796971C14654F6BCF05"><enum>(d)</enum><header>Special fund for
				improvement of IHS facilities</header><text>For provisions relating to the
				authority of the Secretary to place payments to which a facility of the Indian
				Health Service is eligible for payment under this title into a special fund
				established under section 401(c)(1) of the Indian Health Care Improvement Act,
				and the requirement to use amounts paid from such fund for making improvements
				in accordance with subsection (b), see subparagraphs (A) and (B) of section
				401(c)(1) of such Act.</text>
							</subsection><subsection id="H0463B96A630C488094D7378EDE57FB11"><enum>(e)</enum><header>Direct
				billing</header><text>For provisions relating to the authority of a Tribal
				Health Program or an Urban Indian Organization to elect to directly bill for,
				and receive payment for, health care items and services provided by such
				Program or Organization for which payment is made under this title, see section
				401(d) of the Indian Health Care Improvement Act.</text>
							</subsection><subsection commented="no" display-inline="no-display-inline" id="H5FE81C54698E4F0CB6F5C124E179E282"><enum>(f)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section, the terms <term>Indian
				Health Program</term>, <term>Indian Tribe</term>, <term>Tribal Health
				Program</term>, <term>Tribal Organization</term>, and <term>Urban Indian
				Organization</term> have the meanings given those terms in section 4 of the
				Indian Health Care Improvement
				Act.</text>
							</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></subsection><subsection id="HF0017AAE5306481A86FCFF22A4F4DB6"><enum>(b)</enum><header>Medicare</header>
					<paragraph id="H402C1DBAFE8B44A5B85D538985003657"><enum>(1)</enum><header>Expansion to all
			 covered services</header><text>Section 1880 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395qq">42 U.S.C. 1395qq</external-xref>) is
			 amended—</text>
						<subparagraph id="HA45D91DF46234D0EA900F4059EA5B6DB"><enum>(A)</enum><text>by amending the section
			 designation and heading to read as follows:</text>
							<quoted-block display-inline="no-display-inline" id="H2A9A174D77FE4F129290F2A260DE0250" style="OLC">
								<section id="H5E2F247DDFAC43B8A5713CEDFB73154B"><enum>1880.</enum><header>Indian Health
				Programs</header>
								</section><after-quoted-block>;
				</after-quoted-block></quoted-block>
							<continuation-text continuation-text-level="subparagraph">and</continuation-text></subparagraph><subparagraph id="H60F49610F3374265A59DD4110000A942"><enum>(B)</enum><text>by amending subsection
			 (a) to read as follows:</text>
							<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H1092C538EF174964A9A129A9928D95FC" reported-display-style="italic" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="H65767E7EF63E444D83ECE5562F165DBD"><enum>(a)</enum><header>Eligibility for
				payments</header><text display-inline="yes-display-inline">Subject to
				subsection (e), the Indian Health Service and an Indian Tribe, Tribal
				Organization, or an Urban Indian Organization shall be eligible for payments
				under this title with respect to items and services furnished by the Indian
				Health Service, Indian Tribe, Tribal Organization, or Urban Indian Organization
				if the furnishing of such services meets all the conditions and requirements
				which are applicable generally to the furnishing of items and services under
				this
				title.</text>
								</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph id="HFAA1845711AD4ADAB7883F98009BDAA0"><enum>(2)</enum><header>Compliance with
			 conditions and requirements</header><text>Subsection (b) of such section is
			 amended to read as follows:</text>
						<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HF8FC7CC6BBE64B32A4E097259F07AD83" reported-display-style="italic" style="OLC">
							<subsection id="HFCC9501495954C5B983828181F28BACF"><enum>(b)</enum><header>Compliance with
				conditions and requirements</header><text>Subject to subsection (e), a facility
				of the Indian Health Service or an Indian Tribe, Tribal Organization, or an
				Urban Indian Organization which is eligible for payment under subsection (a)
				with respect to the furnishing of items and services, but which does not meet
				all of the conditions and requirements of this title which are applicable
				generally to such facility, shall make such improvements as are necessary to
				achieve or maintain compliance with such conditions and requirements in
				accordance with a plan submitted to and accepted by the Secretary for achieving
				or maintaining compliance with such conditions and requirements, and shall be
				deemed to meet such conditions and requirements (and to be eligible for payment
				under this title), without regard to the extent of its actual compliance with
				such conditions and requirements, during the first 12 months after the month in
				which such plan is
				submitted.</text>
							</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph><paragraph id="H13A8F461C9F24F11B9290637A4B2989E"><enum>(3)</enum><header>Cross-references to
			 special fund for improvement of IHS facilities; direct billing option;
			 definitions</header>
						<subparagraph id="H34566B72A5944C35ADECC8B1C05B91B9"><enum>(A)</enum><header>In
			 general</header><text>Such section is further amended by striking subsections
			 (c) and (d) and inserting the following new subsections:</text>
							<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H94768727F114478F906704BBDFF91548" reported-display-style="italic" style="OLC">
								<subsection id="H712097B2B04F4F2D9018E5D0ED6FC31F"><enum>(c)</enum><header>Special fund for
				improvement of IHS facilities</header><text>For provisions relating to the
				authority of the Secretary to place payments to which a facility of the Indian
				Health Service is eligible for payment under this title into a special fund
				established under section 401(c)(1) of the Indian Health Care Improvement Act,
				and the requirement to use amounts paid from such fund for making improvements
				in accordance with subsection (b), see subparagraphs (A) and (B) of section
				401(c)(1) of such Act.</text>
								</subsection><subsection id="H0211DF8FBC064668BCEA82FD5CCF5E0"><enum>(d)</enum><header>Direct
				billing</header><text>For provisions relating to the authority of a Tribal
				Health Program or an Urban Indian Organization to elect to directly bill for,
				and receive payment for, health care items and services provided by such
				Program or Organization for which payment is made under this title, see section
				401(d) of the Indian Health Care Improvement
				Act.</text>
								</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph><subparagraph id="H62BB3DA81BB7416B9E5664D9B11B2302"><enum>(B)</enum><header>Conforming
			 amendment</header><text>Paragraph (3) of section 1880(e) of such Act (42 U.S.C.
			 1395qq(e)) is amended by inserting <quote>and section 401(c)(1) of the Indian
			 Health Care Improvement Act</quote> after <quote>Subsection (c)</quote>.</text>
						</subparagraph></paragraph><paragraph id="H37B986742C514C95A9001159BF06E000"><enum>(4)</enum><header>Definitions</header><text>Such
			 section is further amended by amending subsection (f) to read as
			 follows:</text>
						<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HB4E6ED471C0542E1B889EA05584B7242" reported-display-style="italic" style="OLC">
							<subsection commented="no" display-inline="no-display-inline" id="H871E99A5863E4F2EAF2F9347400647D2"><enum>(f)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section, the terms <term>Indian
				Health Program</term>, <term>Indian Tribe</term>, <term>Service Unit</term>,
				<term>Tribal Health Program</term>, <term>Tribal Organization</term>, and
				<term>Urban Indian Organization</term> have the meanings given those terms in
				section 4 of the Indian Health Care Improvement
				Act.</text>
							</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></subsection><subsection id="H4353D9D6203B4603873200E62BB8932C"><enum>(c)</enum><header>Application to
			 SCHIP</header><text>Section 2107(e)(1) of the Social Security Act (42 U.S.C.
			 1397gg(e)(1)) is amended—</text>
					<paragraph id="HB2B67FC37F5B4EF8A41CEDA590500FA"><enum>(1)</enum><text>by redesignating
			 subparagraph (D) as subparagraph (E); and</text>
					</paragraph><paragraph id="H6096647BDFCD47B39EF10740D06549E"><enum>(2)</enum><text>by inserting after
			 subparagraph (C), the following new subparagraph:</text>
						<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HE5237EEFB4B94B15ABF77B804821EB99" reported-display-style="italic" style="OLC">
							<subparagraph id="HED17AD9A986B48C1A3876D009974F12F"><enum>(D)</enum><text>Section 1911 (relating to
				Indian Health Programs, other than subsection (d) of such
				section).</text>
							</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></subsection></section><section id="H4050E4F7C27F405F8CF9339738802230"><enum>202.</enum><header> Increased outreach to
			 Indians under Medicaid and SCHIP and improved cooperation in the provision of
			 items and services to Indians under Social Security Act health benefit
			 programs</header><text display-inline="no-display-inline">Section 1139 of the
			 Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-9">42 U.S.C. 1320b–9</external-xref>) is amended to read as follows:</text>
				<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HA404D1DC445F4371A5F376720518DB43" reported-display-style="italic" style="OLC">
					<section id="H1492C03837F7404100DB314CE9F081E0"><enum>1139.</enum><header>Improved access to,
				and delivery of, health care for Indians under titles XVIII, XIX, and
				XXI</header>
						<subsection id="HC9BB037B5158433EB4F59CFF30C9E744"><enum>(a)</enum><header>Agreements with States
				for Medicaid and SCHIP outreach on or near reservations To increase the
				enrollment of Indians in those programs</header>
							<paragraph id="HEEA496BAF181483691718EE335810AE"><enum>(1)</enum><header>In
				general</header><text>In order to improve the access of Indians residing on or
				near a reservation to obtain benefits under the Medicaid and State children's
				health insurance programs established under titles XIX and XXI, the Secretary
				shall encourage the State to take steps to provide for enrollment on or near
				the reservation. Such steps may include outreach efforts such as the
				outstationing of eligibility workers, entering into agreements with the Indian
				Health Service, Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations to provide outreach, education regarding eligibility and
				benefits, enrollment, and translation services when such services are
				appropriate.</text>
							</paragraph><paragraph id="H179AD9E3BA4C48CFB830686E67A3F7A6"><enum>(2)</enum><header>Construction</header><text>Nothing
				in subparagraph (A) shall be construed as affecting arrangements entered into
				between States and the Indian Health Service, Indian Tribes, Tribal
				Organizations, or Urban Indian Organizations for such Service, Tribes, or
				Organizations to conduct administrative activities under such titles.</text>
							</paragraph></subsection><subsection id="HC387FB486953419884EC6F5CEE9D1F7C"><enum>(b)</enum><header>Requirement To
				facilitate cooperation</header><text>The Secretary, acting through the Centers
				for Medicare &amp; Medicaid Services, shall take such steps as are necessary to
				facilitate cooperation with, and agreements between, States and the Indian
				Health Service, Indian Tribes, Tribal Organizations, or Urban Indian
				Organizations with respect to the provision of health care items and services
				to Indians under the programs established under title XVIII, XIX, or
				XXI.</text>
						</subsection><subsection id="HDFF4A702CE4A48148FC300DE61E8E0B8"><enum>(c)</enum><header>Definition of Indian;
				Indian Tribe; Indian Health Program; Tribal Organization; Urban Indian
				Organization</header><text>In this section, the terms <term>Indian</term>,
				<term>Indian Tribe</term>, <term>Indian Health Program</term>, <term>Tribal
				Organization</term>, and <term>Urban Indian Organization</term> have the
				meanings given those terms in section 4 of the Indian Health Care Improvement
				Act.</text>
						</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
			</section><section id="HCB18F5AF31214F4BA44CF2F86755B4C2"><enum>203.</enum><header>Additional provisions
			 to increase outreach to, and enrollment of, Indians in SCHIP and
			 Medicaid</header>
				<subsection id="H459B076DF6AE4BA9BFE1A94CEB73CB8C"><enum>(a)</enum><header>Nonapplication of 10
			 percent limit on outreach and certain other expenditures</header><text>Section
			 2105(c)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ee">42 U.S.C. 1397ee(c)(2)</external-xref>) is amended by
			 adding at the end the following new subparagraph:</text>
					<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HC9F2AB4B082041E38CF8A7BDC7CACB2" reported-display-style="italic" style="OLC">
						<subparagraph id="H9907E62C57BB4C1C95DDA1C675435200"><enum>(C)</enum><header>Nonapplication to
				expenditures for outreach to increase the enrollment of Indian children under
				this title and title XIX</header><text>The limitation under subparagraph (A) on
				expenditures for items described in subsection (a)(1)(D) shall not apply in the
				case of expenditures for outreach activities to families of Indian children
				likely to be eligible for child health assistance under the plan or medical
				assistance under the State plan under title XIX (or under a waiver of such
				plan), to inform such families of the availability of, and to assist them in
				enrolling their children in, such plans, including such activities conducted
				under grants, contracts, or agreements entered into under section
				1139(a).</text>
						</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection id="H9C8375FB27BF461989F25E8F1FD88C32"><enum>(b)</enum><header>Assurance of payments
			 to Indian health care providers for child health
			 assistance</header><text>Section 2102(b)(3)(D) of such Act (42 U.S.C.
			 1397bb(b)(3)(D)) is amended by striking <quote>(as defined in section 4(c) of
			 the Indian Health Care Improvement Act, <external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603(c)</external-xref>)</quote> and
			 inserting <quote>, including how the State will ensure that payments are made
			 to Indian Health Programs and Urban Indian Organizations operating in the State
			 for the provision of such assistance</quote>.</text>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="H16533741CF85490F8290D86F50599EB0"><enum>(c)</enum><header>Inclusion of other
			 Indian financed health care programs in exemption from prohibition on certain
			 payments</header><text>Section 2105(c)(6)(B) of such Act (42 U.S.C.
			 1397ee(c)(6)(B)) is amended by striking <quote>insurance program, other than an
			 insurance program operated or financed by the Indian Health Service</quote> and
			 inserting <quote>program, other than a health care program operated or financed
			 by the Indian Health Service or by an Indian Tribe, Tribal Organization, or
			 Urban Indian Organization</quote>.</text>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="HA94D21E9CF8C47E885CC1E29BD809C99"><enum>(d)</enum><header>Satisfaction of
			 Medicaid documentation requirements</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H5EB8C873332E45C9816368784FEFA98C"><enum>(1)</enum><header>In
			 general</header><text>Section 1903(x)(3)(B) of the Social Security Act (42
			 U.S.C. 1396b(x)(3)(B)) is amended—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HC2162563150B4248B17D99ACCB7893A6"><enum>(A)</enum><text>by redesignating clause
			 (v) as clause (vi); and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H62345184573A42D888C6C159253348B4"><enum>(B)</enum><text>by inserting after clause
			 (iv), the following new clause:</text>
							<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H407D8991596047CBB8D4F0BDCA3FE3B8" reported-display-style="italic" style="OLC">
								<clause commented="no" display-inline="no-display-inline" id="H2AD0285266404C3BB0B5B9CC8C652EB2" indent="up2"><enum>(v)</enum><subclause commented="no" display-inline="yes-display-inline" id="HF9CD11CE26454ED8A0758906E25FCCCD"><enum>(I)</enum><text>Except as provided in
				subclause (II), a document issued by a federally-recognized Indian tribe
				evidencing membership or enrollment in, or affiliation with, such tribe.</text>
									</subclause><subclause changed="added" commented="no" committee-id="HII00" display-inline="no-display-inline" id="H2FC1B63F8C634E968648F2E28411ABCF" indent="up1" reported-display-style="italic"><enum>(II)</enum><text>With
				respect to those federally-recognized Indian tribes located within States
				having an international border whose membership includes individuals who are
				not citizens of the United States, the Secretary shall, after consulting with
				such tribes, issue regulations authorizing the presentation of such other forms
				of documentation (including tribal documentation, if appropriate) that the
				Secretary determines to be satisfactory documentary evidence of citizenship or
				nationality for purposes of satisfying the requirement of this
				subsection.</text>
									</subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph id="H28D87710D4554393A70982AA1B3CF450"><enum>(2)</enum><header>Transition
			 rule</header><text>During the period that begins on July 1, 2006, and ends on
			 the effective date of final regulations issued under subclause (II) of section
			 1903(x)(3)(B)(v) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(x)(3)(B)(v)</external-xref>) (as
			 added by paragraph (1)), an individual who is a member of a
			 federally-recognized Indian tribe described in subclause (II) of that section
			 who presents a document described in subclause (I) of such section that is
			 issued by such Indian tribe, shall be deemed to have presented satisfactory
			 evidence of citizenship or nationality for purposes of satisfying the
			 requirement of subsection (x) of section 1903 of such Act.</text>
					</paragraph></subsection><subsection id="H000419B3DB4B48D0B75F21D58D5EF1DB"><enum>(e)</enum><header>Definitions</header><text>Section
			 2110(c) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397jj">42 U.S.C. 1397jj(c)</external-xref>) is amended by adding at the end the
			 following new paragraph:</text>
					<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H6B94023BC0DF425690121256CA51FD9F" reported-display-style="italic" style="OLC">
						<paragraph commented="no" display-inline="no-display-inline" id="HF1DE12717960447EA8DFC12189B9097C"><enum>(9)</enum><header>Indian; Indian Health
				Program; Indian Tribe; etc</header><text display-inline="yes-display-inline">The terms <term>Indian</term>, <term>Indian
				Health Program</term>, <term>Indian Tribe</term>, <term>Tribal
				Organization</term>, and <term>Urban Indian Organization</term> have the
				meanings given those terms in section 4 of the Indian Health Care Improvement
				Act.</text>
						</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection></section><section commented="no" display-inline="no-display-inline" id="H4AE82B5E8FFE4A89A6E4CC3417F05BB0"><enum>204.</enum><header>Premiums and cost
			 sharing protections under Medicaid, eligibility determinations under Medicaid
			 and SCHIP, and protection of certain Indian property from Medicaid estate
			 recovery</header>
				<subsection id="HAE2A1A3041FE40D380A3D2733961FEB7"><enum>(a)</enum><header>Premiums and cost
			 sharing protection under Medicaid</header>
					<paragraph id="H0822CADB74124546855FA74FC48C857"><enum>(1)</enum><header>In
			 general</header><text>Section 1916 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396o">42 U.S.C. 1396o</external-xref>)
			 is amended—</text>
						<subparagraph id="H0D744AD1482A48B69DFEFB99EC4A297"><enum>(A)</enum><text>in subsection (a), in the
			 matter preceding paragraph (1), by striking <quote>and (i)</quote> and
			 inserting <quote>, (i), and (j)</quote>; and</text>
						</subparagraph><subparagraph id="H0CCE04BBB88548A498FD5D049C2C00F2"><enum>(B)</enum><text>by adding at the end the
			 following new subsection:</text>
							<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H8057E8C8C889487DB8ACD15DEAC4568C" reported-display-style="italic" style="OLC">
								<subsection id="H1162266DF78145FCBF91BA66FD2DE730"><enum>(j)</enum><header>No premiums or cost
				sharing for Indians furnished items or services directly by Indian Health
				Programs or through referral under the contract health service</header>
									<paragraph id="H4FEE76CC2EAD4BF2AD055C2461399F00"><enum>(1)</enum><header>No cost sharing for
				items or services furnished to Indians through Indian Health Programs</header>
										<subparagraph id="H22B33C4859804A5E853B3B0019D1BBC8"><enum>(A)</enum><header>In
				general</header><text>No enrollment fee, premium, or similar charge, and no
				deduction, copayment, cost sharing, or similar charge shall be imposed against
				an Indian who is furnished an item or service directly by the Indian Health
				Service, an Indian Tribe, Tribal Organization, or Urban Indian Organization or
				through referral under the contract health service for which payment may be
				made under this title.</text>
										</subparagraph><subparagraph id="H1062698B94EE4E96AE377C00B3F3145F"><enum>(B)</enum><header>No reduction in amount
				of payment to Indian health providers</header><text>Payment due under this
				title to the Indian Health Service, an Indian Tribe, Tribal Organization, or
				Urban Indian Organization, or a health care provider through referral under the
				contract health service for the furnishing of an item or service to an Indian
				who is eligible for assistance under such title, may not be reduced by the
				amount of any enrollment fee, premium, or similar charge, or any deduction,
				copayment, cost sharing, or similar charge that would be due from the Indian
				but for the operation of subparagraph (A).</text>
										</subparagraph></paragraph><paragraph id="HD8FA2A15493648C7B298024D5733DB32"><enum>(2)</enum><header>Rule of
				construction</header><text>Nothing in this subsection shall be construed as
				restricting the application of any other limitations on the imposition of
				premiums or cost sharing that may apply to an individual receiving medical
				assistance under this title who is an Indian.</text>
									</paragraph><paragraph id="H13B0D6277B5A4CE6B38CD16DC5C418A5"><enum>(3)</enum><header>Definitions</header><text>In
				this subsection, the terms <term>contract health service</term>,
				<term>Indian</term>, <term>Indian Tribe</term>, <term>Tribal
				Organization</term>, and <term>Urban Indian Organization</term> have the
				meanings given those terms in section 4 of the Indian Health Care Improvement
				Act.</text>
									</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph id="H582B4370D441445C82863831D61E2166"><enum>(2)</enum><header>Conforming
			 amendment</header><text>Section 1916A (a)(1) of such Act (42 U.S.C.
			 1396o–1(a)(1)) is amended by striking <quote>section 1916(g)</quote> and
			 inserting <quote>subsections (g), (i), or (j) of section 1916</quote>.</text>
					</paragraph></subsection><subsection id="H167B6EEF90F04B119696A082021289A1"><enum>(b)</enum><header>Treatment of certain
			 property for Medicaid and SCHIP eligibility</header>
					<paragraph id="H26A93B4C491F4E038750F6F90089C6E"><enum>(1)</enum><header>Medicaid</header><text>Section
			 1902(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref>) is amended by adding at
			 the end the following new paragraph:</text>
						<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HB68975F73DFD41D39400D066603FF490" reported-display-style="italic" style="OLC">
							<paragraph id="HB6F502D892E148B2AC00BD9796D3D6CF" indent="up1"><enum>(13)</enum><text>Notwithstanding any
				other requirement of this title or any other provision of Federal or State law,
				a State shall disregard the following property for purposes of determining the
				eligibility of an individual who is an Indian (as defined in section 4 of the
				Indian Health Care Improvement Act) for medical assistance under this
				title:</text>
								<subparagraph id="H10A38177AE2E462A92BC99641D68C4F2"><enum>(A)</enum><text>Property, including real
				property and improvements, that is held in trust, subject to Federal
				restrictions, or otherwise under the supervision of the Secretary of the
				Interior, located on a reservation, including any federally recognized Indian
				Tribe’s reservation, pueblo, or colony, including former reservations in
				Oklahoma, Alaska Native regions established by the Alaska Native Claims
				Settlement Act, and Indian allotments on or near a reservation as designated
				and approved by the Bureau of Indian Affairs of the Department of the
				Interior.</text>
								</subparagraph><subparagraph id="H156B6D7A599446C2A2DAB76D5753DC61"><enum>(B)</enum><text>For any federally
				recognized Tribe not described in subparagraph (A), property located within the
				most recent boundaries of a prior Federal reservation.</text>
								</subparagraph><subparagraph id="H465C537C2E464777A0B7A179819C8FD4"><enum>(C)</enum><text>Ownership interests in
				rents, leases, royalties, or usage rights related to natural resources
				(including extraction of natural resources or harvesting of timber, other
				plants and plant products, animals, fish, and shellfish) resulting from the
				exercise of federally protected rights.</text>
								</subparagraph><subparagraph id="H56A21D5EBE6E476C9C5553B2D5DABC6"><enum>(D)</enum><text>Ownership interests in or
				usage rights to items not covered by subparagraphs (A) through (C) that have
				unique religious, spiritual, traditional, or cultural significance or rights
				that support subsistence or a traditional lifestyle according to applicable
				tribal law or
				custom.</text>
								</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph><paragraph id="H25313FFB2AD44BE984FA7FC3F34B04EE"><enum>(2)</enum><header>Application to
			 SCHIP</header><text>Section 2107(e)(1) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397gg">42 U.S.C. 1397gg(e)(1)</external-xref>), as
			 amended by section 201(c), is amended—</text>
						<subparagraph id="HABF5CE3728B14A5E844C4679F81BF792"><enum>(A)</enum><text>by redesignating
			 subparagraphs (B) through (E), as subparagraphs (C) through (F), respectively;
			 and</text>
						</subparagraph><subparagraph id="H5AA9DEE1601C44E5B7BDCF3557107D99"><enum>(B)</enum><text>by inserting after
			 subparagraph (A), the following new subparagraph:</text>
							<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HD00FC436FF6D4B4E8589174E91C97375" reported-display-style="italic" style="OLC">
								<subparagraph id="H63B3FE85DEAA41CCB6CC80A4B31B00FD"><enum>(B)</enum><text>Section 1902(e)(13)
				(relating to disregard of certain property for purposes of making eligibility
				determinations).</text>
								</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph></subsection><subsection id="H7811C818C8594360B3175336E13C5BC3"><enum>(c)</enum><header>Continuation of current
			 law protections of certain Indian property from Medicaid estate
			 recovery</header><text>Section 1917(b)(3) of the Social Security Act (42 U.S.C.
			 1396p(b)(3)) is amended—</text>
					<paragraph id="H51BD80631EE34EEBA5C8FAE80592677D"><enum>(1)</enum><text>by inserting
			 <quote>(A)</quote> after <quote>(3)</quote>; and</text>
					</paragraph><paragraph id="H35EAB862244745C49F92D6647F35621C"><enum>(2)</enum><text>by adding at the end the
			 following new subparagraph:</text>
						<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H84B02F7FE52D4211B1C07C373CF8385D" reported-display-style="italic" style="OLC">
							<subparagraph id="H38EAA5AAC6A34907AC80F2D18FD3D19C" indent="up2"><enum>(B)</enum><text>The standards specified
				by the Secretary under subparagraph (A) shall require that the procedures
				established by the State agency under subparagraph (A) exempt income,
				resources, and property that are exempt from the application of this subsection
				as of April 1, 2003, under manual instructions issued to carry out this
				subsection (as in effect on such date) because of the Federal responsibility
				for Indian Tribes and Alaska Native Villages. Nothing in this subparagraph
				shall be construed as preventing the Secretary from providing additional estate
				recovery exemptions under this title for
				Indians.</text>
							</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></subsection></section><section id="H1CB1083C7A3D47FD8DFB93D07EAD8FC4"><enum>205.</enum><header>Nondiscrimination in
			 qualifications for payment for services under Federal health care
			 programs</header><text display-inline="no-display-inline">Section 1139 of the
			 Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-9">42 U.S.C. 1320b–9</external-xref>), as amended by section 202, is amended
			 by redesignating subsection (c) as subsection (d), and inserting after
			 subsection (b) the following new subsection:</text>
				<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H4FC964DBE86A40B18C89000055E11597" reported-display-style="italic" style="OLC">
					<subsection id="HBD56AE9D25394EFD82EA3D09FE84B9AC"><enum>(c)</enum><header>Nondiscrimination in
				qualifications for payment for services under Federal health care
				programs</header>
						<paragraph id="H4ABFE104149446C7A20939B420F08621"><enum>(1)</enum><header>Requirement to satisfy
				generally applicable participation requirements</header>
							<subparagraph id="HDAD5D02297F3419798A5C8C764B6496C"><enum>(A)</enum><header>In
				general</header><text display-inline="yes-display-inline">A Federal health care
				program must accept an entity that is operated by the Indian Health Service, an
				Indian Tribe, Tribal Organization, or Urban Indian Organization as a provider
				eligible to receive payment under the program for health care services
				furnished to an Indian on the same basis as any other provider qualified to
				participate as a provider of health care services under the program if the
				entity meets generally applicable State or other requirements for participation
				as a provider of health care services under the program.</text>
							</subparagraph><subparagraph id="HE656BE6813AC46F6A4B14B8DA13417E4"><enum>(B)</enum><header>Satisfaction of State
				or local licensure or recognition requirements</header><text display-inline="yes-display-inline">Any requirement for participation as a
				provider of health care services under a Federal health care program that an
				entity be licensed or recognized under the State or local law where the entity
				is located to furnish health care services shall be deemed to have been met in
				the case of an entity operated by the Indian Health Service, an Indian Tribe,
				Tribal Organization, or Urban Indian Organization if the entity meets all the
				applicable standards for such licensure or recognition, regardless of whether
				the entity obtains a license or other documentation under such State or local
				law. In accordance with section 221 of the Indian Health Care Improvement Act,
				the absence of the licensure of a health care professional employed by such an
				entity under the State or local law where the entity is located shall not be
				taken into account for purposes of determining whether the entity meets such
				standards, if the professional is licensed in another State.</text>
							</subparagraph></paragraph><paragraph id="HC028ACAF27C54DABA66D3362B391A481"><enum>(2)</enum><header>Prohibition on Federal
				payments to entities or individuals excluded from participation in Federal
				health care programs or whose State licenses are under suspension or have been
				revoked</header>
							<subparagraph id="H51E051D6FF15485FBFA5381BFB95B0CC"><enum>(A)</enum><header>Excluded
				entities</header><text display-inline="yes-display-inline">No entity operated
				by the Indian Health Service, an Indian Tribe, Tribal Organization, or Urban
				Indian Organization that has been excluded from participation in any Federal
				health care program or for which a license is under suspension or has been
				revoked by the State where the entity is located shall be eligible to receive
				payment under any such program for health care services furnished to an
				Indian.</text>
							</subparagraph><subparagraph id="H4BFCDB0BF8D84A04948F3C7C4700A100"><enum>(B)</enum><header>Excluded
				individuals</header><text display-inline="yes-display-inline">No individual who
				has been excluded from participation in any Federal health care program or
				whose State license is under suspension or has been revoked shall be eligible
				to receive payment under any such program for health care services furnished by
				that individual, directly or through an entity that is otherwise eligible to
				receive payment for health care services, to an Indian.</text>
							</subparagraph><subparagraph id="H6E99C279B86F44AEB0B4D3CD63CFB5F6"><enum>(C)</enum><header>Federal health care
				program defined</header><text>In this subsection, the term, <term>Federal
				health care program</term> has the meaning given that term in section 1128B(f),
				except that, for purposes of this subsection, such term shall include the
				health insurance program under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/89">chapter 89</external-xref> of title 5, United States
				Code.</text>
							</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
			</section><section id="HDB8B6FB0F1D947A892B66EE5AED88981"><enum>206.</enum><header>Consultation on
			 Medicaid, SCHIP, and other health care programs funded under the Social
			 Security Act involving Indian Health Programs and Urban Indian
			 Organizations</header>
				<subsection id="H3664152984934CDEB9FF53910061C56B"><enum>(a)</enum><header>In
			 general</header><text display-inline="yes-display-inline">Section 1139 of the
			 Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-9">42 U.S.C. 1320b–9</external-xref>), as amended by sections 202 and 205, is
			 amended by redesignating subsection (d) as subsection (e), and inserting after
			 subsection (c) the following new subsection:</text>
					<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H12E6A98CEC4443DBBA3714458597D500" reported-display-style="italic" style="OLC">
						<subsection id="H833D60DA60DE4A719DFE00AA9BAD7200"><enum>(d)</enum><header>Consultation with
				Tribal Technical Advisory Group (TTAG)</header><text>The Secretary shall
				maintain within the Centers for Medicaid &amp; Medicare Services (CMS) a Tribal
				Technical Advisory Group, established in accordance with requirements of the
				charter dated September 30, 2003, and in such group shall include a
				representative of the Urban Indian Organizations and the Service. The
				representative of the Urban Indian Organization shall be deemed to be an
				elected officer of a tribal government for purposes of applying section 204(b)
				of the Unfunded Mandates Reform Act of 1995 (2 U.S.C.
				1534(b)).</text>
						</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection id="H69DE63A792714861B0973F3D346770BF"><enum>(b)</enum><header>Solicitation of Advice
			 Under Medicaid and SCHIP</header>
					<paragraph id="H30F1FF051C1C47958CE386C25E40302"><enum>(1)</enum><header>Medicaid State plan
			 amendment</header><text>Section 1902(a) of the Social Security Act (42 U.S.C.
			 1396a(a)) is amended—</text>
						<subparagraph id="HFE57DA8B9A6E4768B8FA4BA7D66ECBE3"><enum>(A)</enum><text>in paragraph (69), by
			 striking <quote>and</quote> at the end;</text>
						</subparagraph><subparagraph id="H1A091040371C4C19A7F312639C52DB6F"><enum>(B)</enum><text>in paragraph (70)(B)(iv),
			 by striking the period at the end and inserting <quote>; and</quote>;
			 and</text>
						</subparagraph><subparagraph id="HDC7434C4CD1D4962AE1CE403EA14EF16"><enum>(C)</enum><text>by inserting after
			 paragraph (70)(B)(iv), the following new paragraph:</text>
							<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H684518721EA64FB7AD6D02B2E00333BF" reported-display-style="italic" style="OLC">
								<paragraph id="HA14377E7A910463894B1EAD43CB0C0EA"><enum>(71)</enum><text>in the case of any State
				in which the Indian Health Service operates or funds health care programs, or
				in which 1 or more Indian Health Programs or Urban Indian Organizations (as
				such terms are defined in section 4 of the Indian Health Care Improvement Act)
				provide health care in the State for which medical assistance is available
				under such title, provide for a process under which the State seeks advice on a
				regular, ongoing basis from designees of such Indian Health Programs and Urban
				Indian Organizations on matters relating to the application of this title that
				are likely to have a direct effect on such Indian Health Programs and Urban
				Indian Organizations and that—</text>
									<subparagraph id="H0D02C64B39114915B42B48F9B210383"><enum>(A)</enum><text>shall include
				solicitation of advice prior to submission of any plan amendments, waiver
				requests, and proposals for demonstration projects likely to have a direct
				effect on Indians, Indian Health Programs, or Urban Indian Organizations;
				and</text>
									</subparagraph><subparagraph id="H6C83C1025C9F46809DB84948E4257B41"><enum>(B)</enum><text>may include appointment
				of an advisory committee and of a designee of such Indian Health Programs and
				Urban Indian Organizations to the medical care advisory committee advising the
				State on its State plan under this
				title.</text>
									</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph id="H682696A976414A968BEFC796B9D4005F"><enum>(2)</enum><header>Application to
			 SCHIP</header><text>Section 2107(e)(1) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397gg">42 U.S.C. 1397gg(e)(1)</external-xref>), as
			 amended by section 204(b)(2), is amended—</text>
						<subparagraph id="HDE1AC2C017C74FA6AE13EF7F55B8D8D"><enum>(A)</enum><text>by redesignating
			 subparagraphs (B) through (F) as subparagraphs (C) through (G), respectively;
			 and</text>
						</subparagraph><subparagraph id="HB9821C38A55E467EA46E6EACCA72D8AF"><enum>(B)</enum><text>by inserting after
			 subparagraph (A), the following new subparagraph:</text>
							<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H48481A56EEA1486C83D95E4C779F78D2" reported-display-style="italic" style="OLC">
								<subparagraph id="HAB51880DF6264833AB75F16FA6D0AF23"><enum>(B)</enum><text>Section 1902(a)(71)
				(relating to the option of certain States to seek advice from designees of
				Indian Health Programs and Urban Indian
				Organizations).</text>
								</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph></subsection><subsection id="H15BCA699375D4C1386A4D8B47FFA2603"><enum>(c)</enum><header>Rule of
			 construction</header><text>Nothing in the amendments made by this section shall
			 be construed as superseding existing advisory committees, working groups,
			 guidance, or other advisory procedures established by the Secretary of Health
			 and Human Services or by any State with respect to the provision of health care
			 to Indians.</text>
				</subsection></section><section id="H28127B0333B44CDFA59509D4EC44CC1E"><enum>207.</enum><header>Exclusion waiver
			 authority for affected Indian Health Programs and safe harbor transactions
			 under the Social Security Act</header>
				<subsection id="H8A92A6C65EBF428096E04BE6A23579ED"><enum>(a)</enum><header>Exclusion waiver
			 authority</header><text display-inline="yes-display-inline">Section 1128 of the
			 Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320a-7">42 U.S.C. 1320a–7</external-xref>) is amended by adding at the end the
			 following new subsection:</text>
					<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H3095B07D401B40A891F98367553B73A1" reported-display-style="italic" style="OLC">
						<subsection id="H34F313379BD8467BB810365351BFCC00"><enum>(k)</enum><header>Additional exclusion
				<act-name parsable-cite="SSA">waiver authority for affected Indian Health
				Programs</act-name></header><text>In addition to the authority granted the
				Secretary under subsections (c)(3)(B) and (d)(3)(B) to waive an exclusion under
				subsection (a)(1), (a)(3), (a)(4), or (b), the Secretary may, in the case of an
				Indian Health Program, waive such an exclusion upon the request of the
				administrator of an affected Indian Health Program (as defined in section 4 of
				the Indian Health Care Improvement Act) who determines that the exclusion would
				impose a hardship on individuals entitled to benefits under or enrolled in a
				Federal health care
				program.</text>
						</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection id="HEF613807EDD74BB59D22AA775216E9CB"><enum>(b)</enum><header>Certain transactions
			 involving Indian health care programs deemed To be in safe
			 harbors</header><text>Section 1128B(b) of the Social Security Act (42 U.S.C.
			 1320a–7b(b)) is amended by adding at the end the following new
			 paragraph:</text>
					<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="HAF49A2DCE6EF41BB8017E03DF816CC25" reported-display-style="italic" style="OLC">
						<paragraph id="H201AF28723C34B2397666BD5B5E13B4" indent="up1"><enum>(4)</enum><text>Subject to such
				conditions as the Secretary may promulgate from time to time as necessary to
				prevent fraud and abuse, for purposes of paragraphs (1) and (2) and section
				1128A(a), the following transfers shall not be treated as remuneration:</text>
							<subparagraph id="H7F11E74B1E9C410FAD69A28EBCF00800"><enum>(A)</enum><header>Transfers between
				Indian Health Programs, Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations</header><text>Transfers of anything of value between or among an
				Indian Health Program, Indian Tribe, Tribal Organization, or Urban Indian
				Organization, that are made for the purpose of providing necessary health care
				items and services to any patient served by such Program, Tribe, or
				Organization and that consist of—</text>
								<clause id="H3C7D26070D2540258F1BEF033AB8C76"><enum>(i)</enum><text>services in connection
				with the collection, transport, analysis, or interpretation of diagnostic
				specimens or test data;</text>
								</clause><clause id="H5F6093C25F234A59B1AB3D98A953BAAA"><enum>(ii)</enum><text>inventory or
				supplies;</text>
								</clause><clause id="HB4AC7166612C4EB9A48900DC258675A1"><enum>(iii)</enum><text>staff; or</text>
								</clause><clause id="H071766C8841340149BA6374986855C62"><enum>(iv)</enum><text>a waiver of all or part
				of premiums or cost sharing.</text>
								</clause></subparagraph><subparagraph id="H0656CC401EB241EDBA57699FADF8F8D4"><enum>(B)</enum><header>Transfers between
				Indian Health Programs, Indian Tribes, Tribal Organizations, or Urban Indian
				Organizations and patients</header><text>Transfers of anything of value between
				an Indian Health Program, Indian Tribe, Tribal Organization, or Urban Indian
				Organization and any patient served or eligible for service from an Indian
				Health Program, Indian Tribe, Tribal Organization, or Urban Indian
				Organization, including any patient served or eligible for service pursuant to
				section 807 of the Indian Health Care Improvement Act, but only if such
				transfers—</text>
								<clause id="H8BC3D43A163348AEB5AE6534FDBF8391"><enum>(i)</enum><text>consist of expenditures
				related to providing transportation for the patient for the provision of
				necessary health care items or services, provided that the provision of such
				transportation is not advertised, nor an incentive of which the value is
				disproportionately large in relationship to the value of the health care item
				or service (with respect to the value of the item or service itself or, for
				preventative items or services, the future health care costs reasonably
				expected to be avoided);</text>
								</clause><clause id="H49D22EF016384E14803C3534DE330047"><enum>(ii)</enum><text>consist of expenditures
				related to providing housing to the patient (including a pregnant patient) and
				immediate family members or an escort necessary to assuring the timely
				provision of health care items and services to the patient, provided that the
				provision of such housing is not advertised nor an incentive of which the value
				is disproportionately large in relationship to the value of the health care
				item or service (with respect to the value of the item or service itself or,
				for preventative items or services, the future health care costs reasonably
				expected to be avoided); or</text>
								</clause><clause id="H10E72C747D61499497E0D662BDBB47D0"><enum>(iii)</enum><text>are for the purpose of
				paying premiums or cost sharing on behalf of such a patient, provided that the
				making of such payment is not subject to conditions other than conditions
				agreed to under a contract for the delivery of contract health services.</text>
								</clause></subparagraph><subparagraph id="HF36A242ECA2C41AD94BBEFE3D006E95"><enum>(C)</enum><header>Contract health
				services</header><text>A transfer of anything of value negotiated as part of a
				contract entered into between an Indian Health Program, Indian Tribe, Tribal
				Organization, Urban Indian Organization, or the Indian Health Service and a
				contract care provider for the delivery of contract health services authorized
				by the Indian Health Service, provided that—</text>
								<clause id="HE6F99E2FE42A417CA5E2DE8B04C14000"><enum>(i)</enum><text>such a transfer is not
				tied to volume or value of referrals or other business generated by the
				parties; and</text>
								</clause><clause id="H94C69F7159224D54AB10E755F78663B9"><enum>(ii)</enum><text>any such transfer is
				limited to the fair market value of the health care items or services provided
				or, in the case of a transfer of items or services related to preventative
				care, the value of the future health care costs reasonably expected to be
				avoided.</text>
								</clause></subparagraph><subparagraph id="HF2D69133E8D94FEEA6001FFBDD3BEBED"><enum>(D)</enum><header>Other
				transfers</header><text>Any other transfer of anything of value involving an
				Indian Health Program, Indian Tribe, Tribal Organization, or Urban Indian
				Organization, or a patient served or eligible for service from an Indian Health
				Program, Indian Tribe, Tribal Organization, or Urban Indian Organization, that
				the Secretary, in consultation with the Attorney General, determines is
				appropriate, taking into account the special circumstances of such Indian
				Health Programs, Indian Tribes, Tribal Organizations, and Urban Indian
				Organizations, and of patients served by such Programs, Tribes, and
				Organizations.</text>
							</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection></section><section id="HFAC89C5EEF66473CA21DC7E8E2DE5147"><enum>208.</enum><header>Rules applicable under
			 Medicaid and SCHIP to managed care entities with respect to Indian enrollees
			 and Indian health care providers and Indian managed care entities</header>
				<subsection id="H9A48A0584849429A84D13B4C386FE500"><enum>(a)</enum><header>In
			 general</header><text>Section 1932 of the Social Security Act (42 U.S.C.
			 1396u–2) is amended by adding at the end the following new subsection:</text>
					<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H5487E3DBFD6C479E9C4E8587E204175B" reported-display-style="italic" style="OLC">
						<subsection id="HE50A2631C04E453B9FD9B919007F8FFB"><enum>(h)</enum><header>Special rules with
				respect to Indian enrollees, Indian health care providers, and Indian managed
				care entities</header>
							<paragraph id="HABFD4A459FEE42628C70272D47A200E9"><enum>(1)</enum><header>Enrollee option to
				select an Indian health care provider as primary care provider</header><text>In
				the case of a non-Indian Medicaid managed care entity that—</text>
								<subparagraph id="H27BF871DEF16487299E1B05E3280A6D"><enum>(A)</enum><text>has an Indian enrolled
				with the entity; and</text>
								</subparagraph><subparagraph id="HD3D72CB588EC4AC0A23EF581C2A6A86E"><enum>(B)</enum><text>has an Indian health care
				provider that is participating as a primary care provider within the network of
				the entity,</text>
								</subparagraph><continuation-text continuation-text-level="paragraph">insofar as the Indian is otherwise
				eligible to receive services from such Indian health care provider and the
				Indian health care provider has the capacity to provide primary care services
				to such Indian, the contract with the entity under section 1903(m) or under
				section 1905(t)(3) shall require, as a condition of receiving payment under
				such contract, that the Indian shall be allowed to choose such Indian health
				care provider as the Indian’s primary care provider under the entity.</continuation-text></paragraph><paragraph id="H5879E299DE8D47FD90B1494050C72F24"><enum>(2)</enum><header>Assurance of payment to
				Indian health care providers for provision of covered
				services</header><text>Each contract with a managed care entity under section
				1903(m) or under section 1905(t)(3) shall require any such entity that has a
				significant percentage of Indian enrollees (as determined by the Secretary), as
				a condition of receiving payment under such contract to satisfy the following
				requirements:</text>
								<subparagraph id="H9507FE99334F481281A7893D33F4FB0"><enum>(A)</enum><header>Demonstration of
				participating indian health care providers or application of alternative
				payment arrangements</header><text>Subject to subparagraph (E), to—</text>
									<clause id="H5CA3E96620E9488998B1411443C6013"><enum>(i)</enum><text>demonstrate that the
				number of Indian health care providers that are participating providers with
				respect to such entity are sufficient to ensure timely access to covered
				Medicaid managed care services for those enrollees who are eligible to receive
				services from such providers; or</text>
									</clause><clause id="H88D18840B9F64D388B92C019766F0016"><enum>(ii)</enum><text>agree to pay Indian
				health care providers who are not participating providers with the entity for
				covered Medicaid managed care services provided to those enrollees who are
				eligible to receive services from such providers at a rate equal to the rate
				negotiated between such entity and the provider involved or, if such a rate has
				not been negotiated, at a rate that is not less than the level and amount of
				payment which the entity would make for the services if the services were
				furnished by a participating provider which is not an Indian health care
				provider.</text>
									</clause></subparagraph><subparagraph id="H5F8F4E48CD4E4075A8CBE83781AF423B"><enum>(B)</enum><header>Prompt
				payment</header><text>To agree to make prompt payment (in accordance with rules
				applicable to managed care entities) to Indian health care providers that are
				participating providers with respect to such entity or, in the case of an
				entity to which subparagraph (A)(ii) or (E) applies, that the entity is
				required to pay in accordance with that subparagraph.</text>
								</subparagraph><subparagraph id="H4A7A599ADCAD47C8B090066D36DE6025"><enum>(C)</enum><header>Satisfaction of claim
				requirement</header><text>To deem any requirement for the submission of a claim
				or other documentation for services covered under subparagraph (A) by the
				enrollee to be satisfied through the submission of a claim or other
				documentation by an Indian health care provider that is consistent with section
				403(h) of the Indian Health Care Improvement Act.</text>
								</subparagraph><subparagraph id="HEFFE9A600D8345B685CAD1EDAB54003D"><enum>(D)</enum><header>Compliance with
				generally applicable requirements</header>
									<clause id="H8FC7B764F9B64470B2E79612002EA2DF"><enum>(i)</enum><header>In
				general</header><text>Subject to clause (ii), as a condition of payment under
				subparagraph (A), an Indian health care provider shall comply with the
				generally applicable requirements of this title, the State plan, and such
				entity with respect to covered Medicaid managed care services provided by the
				Indian health care provider to the same extent that non-Indian providers
				participating with the entity must comply with such requirements.</text>
									</clause><clause id="HDED6B327725A4A9E979D019F9CCF595"><enum>(ii)</enum><header>Limitations on
				compliance with managed care entity generally applicable
				requirements</header><text>An Indian health care provider—</text>
										<subclause id="HEA3BD95D36CA4C91B271836F006039EE"><enum>(I)</enum><text>shall not be required to
				comply with a generally applicable requirement of a managed care entity
				described in clause (i) as a condition of payment under subparagraph (A) if
				such compliance would conflict with any other statutory or regulatory
				requirements applicable to the Indian health care provider; and</text>
										</subclause><subclause id="H8790DCD1D8BF47D08CC8D7162D8E6E1B"><enum>(II)</enum><text>shall only need to
				comply with those generally applicable requirements of a managed care entity
				described in clause (i) as a condition of payment under subparagraph (A) that
				are necessary for the entity's compliance with the State plan, such as those
				related to care management, quality assurance, and utilization
				management.</text>
										</subclause></clause></subparagraph><subparagraph id="H2B9D6B69D07048BD9786E1B12CCE0852"><enum>(E)</enum><header>Application of special
				payment requirements for Federally-qualified health centers and encounter rate
				for services provided by certain Indian health care providers</header>
									<clause id="H15A0B506E5FE402DA40291C6622769B"><enum>(i)</enum><header>Federally-qualified
				health centers</header>
										<subclause id="HDB6857AB74294303BB7B8F8EC42EE800"><enum>(I)</enum><header>Managed care entity
				payment requirement</header><text>To agree to pay any Indian health care
				provider that is a federally-qualified health center but not a participating
				provider with respect to the entity, for the provision of covered Medicaid
				managed care services by such provider to an Indian enrollee of the entity at a
				rate equal to the amount of payment that the entity would pay a
				federally-qualified health center that is a participating provider with respect
				to the entity but is not an Indian health care provider for such
				services.</text>
										</subclause><subclause id="HAAC8EF459BDC4762009D7000FA000463"><enum>(II)</enum><header>Continued application
				of State requirement to make supplemental payment</header><text>Nothing in
				subclause (I) or subparagraph (A) or (B) shall be construed as waiving the
				application of section 1902(bb)(5) regarding the State plan requirement to make
				any supplemental payment due under such section to a federally-qualified health
				center for services furnished by such center to an enrollee of a managed care
				entity (regardless of whether the federally-qualified health center is or is
				not a participating provider with the entity).</text>
										</subclause></clause><clause id="H0FC286A4D9FB4B609B93BA14501F57AF"><enum>(ii)</enum><header>Continued application
				of encounter rate for services provided by certain Indian health care
				providers</header><text>If the amount paid by a managed care entity to an
				Indian health care provider that is not a federally-qualified health center and
				that has elected to receive payment under this title as an Indian Health
				Service provider under the July 11, 1996, Memorandum of Agreement between the
				Health Care Financing Administration (now the Centers for Medicare &amp;
				Medicaid Services) and the Indian Health Service for services provided by such
				provider to an Indian enrollee with the managed care entity is less than the
				encounter rate that applies to the provision of such services under such
				memorandum, the State plan shall provide for payment to the Indian health care
				provider of the difference between the applicable encounter rate under such
				memorandum and the amount paid by the managed care entity to the provider for
				such services.</text>
									</clause></subparagraph><subparagraph id="H37193EDBC8594BF8934086C20007F47E"><enum>(F)</enum><header>Construction</header><text>Nothing
				in this paragraph shall be construed as waiving the application of section
				1902(a)(30)(A) (relating to application of standards to assure that payments
				are consistent with efficiency, economy, and quality of care).</text>
								</subparagraph></paragraph><paragraph id="HAD87BF4D48E94508A14543DAA1C59507"><enum>(3)</enum><header>Offering of managed
				care through Indian Medicaid managed care entities</header><text>If—</text>
								<subparagraph id="H34145CD6F5A54251A46C924ECF67BA7D"><enum>(A)</enum><text>a State elects to provide
				services through Medicaid managed care entities under its Medicaid managed care
				program; and</text>
								</subparagraph><subparagraph id="H3FC6AABD2D8A41DF957DCD7F8F71CDD"><enum>(B)</enum><text>an Indian health care
				provider that is funded in whole or in part by the Indian Health Service, or a
				consortium composed of 1 or more Tribes, Tribal Organizations, or Urban Indian
				Organizations, and which also may include the Indian Health Service, has
				established an Indian Medicaid managed care entity in the State that meets
				generally applicable standards required of such an entity under such Medicaid
				managed care program,</text>
								</subparagraph><continuation-text continuation-text-level="paragraph">the
				State shall offer to enter into an agreement with the entity to serve as a
				Medicaid managed care entity with respect to eligible Indians served by such
				entity under such program.</continuation-text></paragraph><paragraph id="HE88EAA8F5AC9424C98F533904E23F7AB"><enum>(4)</enum><header>Special rules for
				Indian managed care entities</header><text>The following are special rules
				regarding the application of a Medicaid managed care program to Indian Medicaid
				managed care entities:</text>
								<subparagraph id="H8167A25383664ED69EB11211DD853D12"><enum>(A)</enum><header>Enrollment</header>
									<clause id="HB830F0EC8ECA4A48A7D7AEF024AB2CA4"><enum>(i)</enum><header>Limitation to
				Indians</header><text>An Indian Medicaid managed care entity may restrict
				enrollment under such program to Indians and to members of specific Tribes in
				the same manner as Indian Health Programs may restrict the delivery of services
				to such Indians and tribal members.</text>
									</clause><clause id="HCE178213B9534F90A2AD00880DFC193"><enum>(ii)</enum><header>No less choice of
				plans</header><text>Under such program the State may not limit the choice of an
				Indian among Medicaid managed care entities only to Indian Medicaid managed
				care entities or to be more restrictive than the choice of managed care
				entities offered to individuals who are not Indians.</text>
									</clause><clause id="HC8DF423878EE42DA93E3A3F267FEA422"><enum>(iii)</enum><header>Default
				enrollment</header>
										<subclause id="HB69345970FDD4EB194546565EE00E8C5"><enum>(I)</enum><header>In
				general</header><text>If such program of a State requires the enrollment of
				Indians in a Medicaid managed care entity in order to receive benefits, the
				State, taking into consideration the criteria specified in subsection
				(a)(4)(D)(ii)(I), shall provide for the enrollment of Indians described in
				subclause (II) who are not otherwise enrolled with such an entity in an Indian
				Medicaid managed care entity described in such clause.</text>
										</subclause><subclause id="H9B881B09CBD14DC7B20076B998515E1D"><enum>(II)</enum><header>Indian
				described</header><text>An Indian described in this subclause, with respect to
				an Indian Medicaid managed care entity, is an Indian who, based upon the
				service area and capacity of the entity, is eligible to be enrolled with the
				entity consistent with subparagraph (A).</text>
										</subclause></clause><clause id="HCA9C05B45027418EB9AEEFE94721E3B9"><enum>(iv)</enum><header>Exception to State
				lock-in</header><text>A request by an Indian who is enrolled under such program
				with a non-Indian Medicaid managed care entity to change enrollment with that
				entity to enrollment with an Indian Medicaid managed care entity shall be
				considered cause for granting such request under procedures specified by the
				Secretary.</text>
									</clause></subparagraph><subparagraph id="H6ADAB3FF41C246D0BE275C8CE16B7E00"><enum>(B)</enum><header>Flexibility in
				application of solvency</header><text>In applying section 1903(m)(1) to an
				Indian Medicaid managed care entity—</text>
									<clause id="H60F2B194ACF64E18A4CC40275C6653AE"><enum>(i)</enum><text>any reference to a
				<quote>State</quote> in subparagraph (A)(ii) of that section shall be deemed to
				be a reference to the <quote>Secretary</quote>; and</text>
									</clause><clause id="H9030578618C94039B037BB3D36F708BD"><enum>(ii)</enum><text>the entity shall be
				deemed to be a public entity described in subparagraph (C)(ii) of that
				section.</text>
									</clause></subparagraph><subparagraph id="HF1D3C59659E545C1BA15AF8D3EA1121"><enum>(C)</enum><header>Exceptions to advance
				directives</header><text>The Secretary may modify or waive the requirements of
				section 1902(w) (relating to provision of written materials on advance
				directives) insofar as the Secretary finds that the requirements otherwise
				imposed are not an appropriate or effective way of communicating the
				information to Indians.</text>
								</subparagraph><subparagraph id="HFFB8C60E3FB1493BA027EF8062ED5325"><enum>(D)</enum><header>Flexibility in
				information and marketing</header>
									<clause id="H55C26723DAF0434A81A82916F9D27575"><enum>(i)</enum><header>Materials</header><text>The
				Secretary may modify requirements under subsection (a)(5) to ensure that
				information described in that subsection is provided to enrollees and potential
				enrollees of Indian Medicaid managed care entities in a culturally appropriate
				and understandable manner that clearly communicates to such enrollees and
				potential enrollees their rights, protections, and benefits.</text>
									</clause><clause id="H9E5F23EFDD784344B7CD7F3F6C696912"><enum>(ii)</enum><header>Distribution of
				marketing materials</header><text>The provisions of subsection (d)(2)(B)
				requiring the distribution of marketing materials to an entire service area
				shall be deemed satisfied in the case of an Indian Medicaid managed care entity
				that distributes appropriate materials only to those Indians who are
				potentially eligible to enroll with the entity in the service area.</text>
									</clause></subparagraph></paragraph><paragraph id="HFBF18C416CE24EAF81A8851331265B1F"><enum>(5)</enum><header>Malpractice
				insurance</header><text>Insofar as, under a Medicaid managed care program, a
				health care provider is required to have medical malpractice insurance coverage
				as a condition of contracting as a provider with a Medicaid managed care
				entity, an Indian health care provider that is—</text>
								<subparagraph id="H397F015C463445EC8FEFB191A6606D85"><enum>(A)</enum><text>a federally-qualified
				health center that is covered under the Federal Tort Claims Act (28 U.S.C.
				1346(b), 2671 et seq.);</text>
								</subparagraph><subparagraph id="H64E74E7780314B2299B518386B293FBC"><enum>(B)</enum><text>providing health care
				services pursuant to a contract or compact under the Indian Self-Determination
				and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>) that are covered under the
				Federal Tort Claims Act (<external-xref legal-doc="usc" parsable-cite="usc/28/1346">28 U.S.C. 1346(b)</external-xref>, 2671 et seq.); or</text>
								</subparagraph><subparagraph id="H711DF9449EFC447B80B0D5B34FD89216"><enum>(C)</enum><text>the Indian Health Service
				providing health care services that are covered under the Federal Tort Claims
				Act (<external-xref legal-doc="usc" parsable-cite="usc/28/1346">28 U.S.C. 1346(b)</external-xref>, 2671 et seq.);</text>
								</subparagraph><continuation-text continuation-text-level="paragraph">are
				deemed to satisfy such requirement.</continuation-text></paragraph><paragraph id="H333EA65BE99E4C1FA450A2E6F0E404B5"><enum>(6)</enum><header>Definitions</header><text>For
				purposes of this subsection:</text>
								<subparagraph id="H972D0B4572CB401080365200E22768BE"><enum>(A)</enum><header>Indian health care
				provider</header><text>The term <term>Indian health care provider</term> means
				an Indian Health Program or an Urban Indian Organization.</text>
								</subparagraph><subparagraph id="HE68F54E5EA984BD3AB9DFA00F0C7DD00"><enum>(B)</enum><header>Indian; Indian Health
				Program; Service; Tribe; Tribal Organization; Urban Indian
				Organization</header><text>The terms <term>Indian</term>, <term>Indian Health
				Program</term>, <term>Service</term>, <term>Tribe</term>, <term>tribal
				organization</term>, <term>Urban Indian Organization</term> have the meanings
				given such terms in section 4 of the Indian Health Care Improvement Act.</text>
								</subparagraph><subparagraph id="HD9920DDB78764F4A980055F0D2FF6CC1"><enum>(C)</enum><header>Indian Medicaid managed
				care entity</header><text>The term <term>Indian Medicaid managed care
				entity</term> means a managed care entity that is controlled (within the
				meaning of the last sentence of section 1903(m)(1)(C)) by the Indian Health
				Service, a Tribe, Tribal Organization, or Urban Indian Organization, or a
				consortium, which may be composed of 1 or more Tribes, Tribal Organizations, or
				Urban Indian Organizations, and which also may include the Service.</text>
								</subparagraph><subparagraph id="HC7D374C85E95438CA00040E168224752"><enum>(D)</enum><header>Non-Indian Medicaid
				managed care entity</header><text>The term <term>non-Indian Medicaid managed
				care entity</term> means a managed care entity that is not an Indian Medicaid
				managed care entity.</text>
								</subparagraph><subparagraph id="H1F742F497C374F65A6EEDCA1767E5900"><enum>(E)</enum><header>Covered Medicaid
				managed care services</header><text>The term <term>covered Medicaid managed
				care services</term> means, with respect to an individual enrolled with a
				managed care entity, items and services that are within the scope of items and
				services for which benefits are available with respect to the individual under
				the contract between the entity and the State involved.</text>
								</subparagraph><subparagraph id="H48372BD71CD44954B78E134B4900E8AD"><enum>(F)</enum><header>Medicaid managed care
				program</header><text>The term <term>Medicaid managed care program</term> means
				a program under sections 1903(m) and 1932 and includes a managed care program
				operating under a waiver under section 1915(b) or 1115 or
				otherwise.</text>
								</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection id="H08FBE6BB032744369089A0FF00482E41"><enum>(b)</enum><header>Application to
			 SCHIP</header><text>Section 2107(e)(1) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397gg">42 U.S.C. 1397gg(1)</external-xref>), as
			 amended by section 206(b)(2), is amended by adding at the end the following new
			 subparagraph:</text>
					<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H31210AA3CE654EF88293965F11C976E9" reported-display-style="italic" style="OLC">
						<subparagraph id="H75B68666DA3F45A4BCEA9024718C4CF8"><enum>(H)</enum><text>Subsections (a)(2)(C) and
				(h) of section
				1932.</text>
						</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection></section><section id="HBD48078C96E9449BAB5C47A3017498D6"><enum>209.</enum><header>Annual report on
			 Indians served by Social Security Act health benefit programs</header><text display-inline="no-display-inline">Section 1139 of the Social Security Act (42
			 U.S.C. 1320b–9), as amended by the sections 202, 205, and 206, is amended by
			 redesignating subsection (e) as subsection (f), and inserting after subsection
			 (d) the following new subsection:</text>
				<quoted-block changed="added" committee-id="HII00" display-inline="no-display-inline" id="H52B2A8A86F5645A999A2D5F1A3F1F00" reported-display-style="italic" style="OLC">
					<subsection id="H4896EA4C11074C1BA4C4EA38D0A138F2"><enum>(e)</enum><header>Annual report on
				Indians served by health benefit programs funded under this Act</header><text display-inline="yes-display-inline">Beginning January 1, 2007, and annually
				thereafter, the Secretary, acting through the Administrator of the Centers for
				Medicare &amp; Medicaid Services and the Director of the Indian Health Service,
				shall submit a report to Congress regarding the enrollment and health status of
				Indians receiving items or services under health benefit programs funded under
				this Act during the preceding year. Each such report shall include the
				following:</text>
						<paragraph id="HFDD5844FD4D54CD8A01F62506591F2B9"><enum>(1)</enum><text>The total number of
				Indians enrolled in, or receiving items or services under, such programs,
				disaggregated with respect to each such program.</text>
						</paragraph><paragraph id="H47277EFF96E24DD393AD900225E87BF"><enum>(2)</enum><text>The number of Indians
				described in paragraph (1) that also received health benefits under programs
				funded by the Indian Health Service.</text>
						</paragraph><paragraph id="H96A9828C5815475494BD2CDACC6800A6"><enum>(3)</enum><text>General information
				regarding the health status of the Indians described in paragraph (1),
				disaggregated with respect to specific diseases or conditions and presented in
				a manner that is consistent with protections for privacy of individually
				identifiable health information under section 264(c) of the Health Insurance
				Portability and Accountability Act of 1996.</text>
						</paragraph><paragraph id="H7E0949CBA16242388032582D794C78B"><enum>(4)</enum><text>A detailed statement of
				the status of facilities of the Indian Health Service or an Indian Tribe,
				Tribal Organization, or an Urban Indian Organization with respect to such
				facilities' compliance with the applicable conditions and requirements of
				titles XVIII, XIX, and XXI, and, in the case of title XIX or XXI, under a State
				plan under such title or under waiver authority, and of the progress being made
				by such facilities (under plans submitted under section 1880(b), 1911(b) or
				otherwise) toward the achievement and maintenance of such compliance.</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H58968DA8E79B4A04BA9F109012B2E95"><enum>(5)</enum><text>Such other information as
				the Secretary determines is
				appropriate.</text>
						</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
			</section></title></legis-body>
	<endorsement display="yes">
		<action-date date="20080606">June 6, 2008</action-date>
		<action-desc> Committees on <committee-name committee-id="HIF00">Energy
		  and Commerce</committee-name> and <committee-name committee-id="HWM00">Ways and
		  Means</committee-name> discharged; committed to the Committee of the Whole
		  House on the State of the Union and ordered to be printed</action-desc>
	</endorsement>
</bill>


